Abstract:
BACKGROUND:Health-related quality of life (HRQoL) is a key outcome in cost-utility analyses, which are commonly used to inform healthcare decisions. Different instruments exist to evaluate HRQoL, however while some jurisdictions have a preferred system, no gold standard exists. Standard meta-analysis struggles with the variety of outcome measures, which may result in the exclusion of potentially relevant evidence. OBJECTIVE:Using a case study in multimorbidity, the objective of this analysis is to illustrate how a Bayesian hierarchical model can be used to combine data across different instruments. The outcome of interest is the slope relating HRQoL to the number of coexisting conditions. METHODS:We propose a three-level Bayesian hierarchical model to systematically include a large number of studies evaluating HRQoL using multiple instruments. Random effects assumptions yield instrument-level estimates benefitting from borrowing strength across the evidence base. This is particularly useful where little evidence is available for the outcome of choice for further evaluation. RESULTS:Our analysis estimated a reduction in quality of life of 3.8-4.1% per additional condition depending on HRQoL instrument. Uncertainty was reduced by approximately 80% for the instrument with the least evidence. CONCLUSION:Bayesian hierarchical models may provide a useful modelling approach to systematically synthesize data from HRQoL studies.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Schmitz S,Makovski TT,Adams R,van den Akker M,Stranges S,Zeegers MPdoi
10.1007/s40273-019-00843-zsubject
Has Abstractpub_date
2020-01-01 00:00:00pages
85-95issue
1eissn
1170-7690issn
1179-2027pii
10.1007/s40273-019-00843-zjournal_volume
38pub_type
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199406020-00007
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journal_title:PharmacoEconomics
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journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:PharmacoEconomics
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更新日期:1999-08-01 00:00:00
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