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Utility-Based Instruments for People with Dementia: A Systematic Review and Meta-Regression Analysis
Li Li1, Kim-Huong Nguyen2, Tracy Comans3
1Centre for Applied Health Economics, Menzies Health Institute Queensland, School of Medicine, Griffith University, Nathan, Queensland, Australia.
The EuroQol five-dimension questionnaire (EQ-5D) is the most valid instrument for assessing health states in dementia patients. However, variations in utility values impact cost-utility analyses, influencing healthcare decisions.
Area of Science:
- Health Economics
- Psychometrics
- Gerontology
Background:
- Utility-based instruments are used in cost-utility analyses for dementia.
- Concerns exist regarding the performance of these instruments in dementia populations.
Purpose of the Study:
- Compare psychometric properties of utility instruments for dementia.
- Explore factors causing variations in health state values using meta-regression.
Main Methods:
- Conducted a literature search and synthesized psychometric properties.
- Extracted health state values and covariates (instrument type, cognitive impairment).
- Performed meta-regression analyses with available covariates.
Main Results:
- Included 64 studies with preference-based values.
- EuroQol five-dimension questionnaire (EQ-5D) showed best feasibility, reliability, and validity.
- Meta-regression revealed significant differences between instruments, respondent types, and administration modes, impacting utility values and quality-adjusted life-year calculations.
Conclusions:
- EQ-5D is the most valid utility instrument for dementia, with potential alternatives in specific situations.
- Variations in utility estimates significantly impact cost-utility analysis and decision-making.
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