Health State Utility Values in People With Stroke: A Systematic Review and Meta-Analysis.

Area of Science:

• Health economics and outcomes research.
• Neurology and public health.

Background:

• Health state utility values are crucial for measuring quality of life in stroke research.
• Current benchmarks are needed to assess interventions and future studies on post-stroke quality of life.

Purpose of the Study:

• To systematically review and pool health utility values for stroke survivors.
• To establish contemporaneous benchmarks for health-related quality of life in stroke.
• To identify subgroups with lower health utility.

Main Methods:

• Systematic literature search of Medline, EMBASE, and Web of Science (1995-2020).
• Inclusion of 111 studies reporting utility values for EQ-5D-3L, EQ-5D-5L, AQoL, HUI2, HUI3, 15D, and SF-6D.
• Pooled estimates calculated using random effects models, with meta-regression for EQ-5D-3L.

Main Results:

• Pooled estimate for EQ-5D-3L (≥3 months post-stroke) was 0.65 (95% CI, 0.63-0.67), approximately 20% below population norms.
• High heterogeneity (I²>90%) observed, with variations by study size, stroke definition, and country.
• Lower EQ-5D-3L estimates found in women, older individuals, hemorrhagic stroke patients, and those awaiting discharge.

Conclusions:

• Stroke survivors exhibit significantly lower health utility values compared to the general population.
• The study provides essential reference values for health utility in stroke.
• Identified subgroups with diminished health utility can inform targeted interventions.