Every Monday our authors provide a round-up of the latest peer-reviewed journal publications. We cover all issues of major health economics journals as well as some other notable releases. If you’d like to write one of our weekly journal round-ups, get in touch.
Health Economics Review
Volume 10, December 2020
This week’s round-up is a BMC bonanza! HER published four articles in December, demonstrating a variety of topics, methods, and grammatical misdemeanors.
A report from a systematic review identifies some issues in the context of discrete choice experiments with primary health care professionals. The authors assessed the validity of the methods reported across 13 criteria. All but two of the 34 included studies fell short in at least one respect. This may well be more about poor reporting than poor methodology, but it’s useful to see the common shortcomings mapped out. Another study looked at physician behaviour in a laboratory experiment. The researchers asked physicians to make treatment decisions under fee-for-service and capitation payment scenarios. Physicians over- and under-served patients in each scenario, respectively.
Two papers are concerned with cancer care. One compares the cost of illness for liver cancer in Japan and Taiwan. Based on national insurance data, the authors show that the cost of illness has been decreasing in Japan but increasing in Taiwan, though the cost per capita remains higher in Japan. The authors attribute the differences and trends to prevalent hepatitis types and technological advances. Another article reports on the EQ-5D-5L in colorectal cancer. The researchers collected additional data from 433 people present on a German tumour registry, then conducted regression analyses to reveal associations in the data. EQ-5D index values were generally high and few variables, other than symptom-related indicators, explained any differences .
Cost Effectiveness and Resource Allocation
Volume 18, December 2020
Just three papers from CERA last month: one review and two models. The first modelling study evaluated treatments for dry eye syndrome. The model is a simple decision tree built in TreeAge and shows that an amniotic membrane is likely to be more cost-effective than topical treatment. The second modelling study reports on an ‘early economic evaluation’ of real-time analytics in the context of caring for patients on mechanical ventilation. With no mention of COVID! The study suggests that a system to identify ‘ineffective effort events’ has the potential to reduce unnecessary care and improve outcomes.
The systematic review study is for budget impact analyses in anti-tumour drugs for lung cancer. The researchers found 14 studies, extracted their key methods and results, and assessed their quality. In general, as do almost all studies of this nature, the findings demonstrate the need for adherence to methodological and reporting standards. Notably, the authors found that studies of the same drugs in different countries were not consistent.
Health and Quality of Life Outcomes
Volume 18, December 2020
Thirteen articles were published in HQLO last month. Several studies report new outcomes data, in the context of atrial fibrillation, Marfan syndrome, oral diseases, and COVID-19. The article on COVID-19 focusses on the impact of the pandemic on people with cardiovascular disease, measured using the EQ-5D. Based on data from 81 outpatients, the researchers show that the pandemic had a negative impact on the anxiety/depression domain.
Several studies were published that tackle methodological issues relating to the EQ-5D. A mapping study provides a crosswalk algorithm from the PROMIS-29 to the EQ-5D-5L. A model already exists for the US, and this paper presents models for the UK, France, and Germany. Another study examined the role of the age of a hypothetical child in EQ-5D-Y valuation; participants were asked to value states for 4-, 10-, and 16-year old children. The study doesn’t identify much in the way of differences, but the study design doesn’t seem ideal; asking the same respondents to value the same states for different ages may encourage consistency in valuation.
The most interesting EQ-5D study to me is a think aloud study that asked people to value their own health using the EQ-5D-5L and time trade-off. The researchers recruited twenty people with diabetes in Sweden and asked them to describe their thoughts as they completed the tasks. Unsurprisingly, the approach that people took varied, particularly in terms of time perspectives and reference points. EQ-5D responses focussed on the past, while TTO responses focussed on the future, which also incorporated non-health considerations. Even though this is a small study, it provides a wealth of information that is worthy of further investigation, both qualitative and quantitative. Of most interest to me is the finding that people had difficulty in understanding the meaning of ‘full health’, and there are a few insights into how people thought about trade-offs with death.
There are studies on the performance and characteristics of measures other than the EQ-5D, including the SF-6D in hypertension, a Canadian version of the Seattle Angina Questionnaire, and resilience scales in cancer. Another study advises that a 100% response rate is needed to evaluate total hip arthroplasty using patient-reported outcome measures; is that useful?
Finally, a couple of articles report on associations with health-related quality of life. A cross-sectional study conducted in China found that 11% of patients with hypertension had depressive symptoms. Indicators of social capital were protective, while depressive symptoms were correlated with perceived quality of care. A longitudinal study used Behavioral Risk Factor Surveillance System data for people in Hawaii to identify differences according to race and ethnicity. The associations varied across different ethnicities and different measures of health but, in general, white people tended to be better off.