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Cardiovascular disease is the leading cause of death and is associated with significant clinical and economic burden. Utilities reflect individuals’ preferences for different health outcomes and are used to understand health state burden and to generate quality-adjusted life years (QALYs) for use in economic evaluations. The aim of this literature review was to identify currently available utilities associated with cardiovascular (CV) events, including myocardial infarction (MI), stroke, revascularization, angina, and transient ischemic attack (TIA), and consider suitability for use in cost-utility analysis.
The search strategy focused on identifying published articles reporting utilities. Searches were conducted using Medline/EMBASE. Articles reporting economic analyses were searched to identify additional utilities or references. Articles cited as a source for utilities within the economic articles were obtained and included if they were a primary source for utilities. Publically available health technology assessment (HTA) appraisals from England, Scotland, Canada, and Australia were also reviewed to identify additional published articles.
Of the CV events examined in the current review, stroke (34 articles) and MI (12) yielded the greatest number of articles providing utility values. There were relatively few articles reporting utilities for angina (10), revascularization (5), TIA (2), and hyperlipidemia (1). The published utilities had several limitations including: not reporting time since CV event; not clearly specifying the medical condition that is represented (e.g., type of angina or stroke); not using methodology that is preferred by reimbursement agencies; utilities derived from large patient surveys with limited information about each patient.
Economic models often use utilities for CV events from published literature. However, published articles reporting these models often provide little or no justification for the appropriateness of these utilities, and examination of study methods revealed limitations of every utility study identified within the current review.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Critical Appraisal of Research Methods
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1287-95
- 2013 American College of Cardiology Foundation