EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis

Rheumatol Int. 2017 Dec;37(12):1957-1977. doi: 10.1007/s00296-017-3800-8. Epub 2017 Aug 28.

Abstract

EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.

Keywords: Central and Eastern Europe; EQ-5D; Health-related quality of life; Meta-analysis; Musculoskeletal diseases; Patient reported outcomes.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Chronic Pain / psychology
  • Chronic Pain / therapy
  • Connective Tissue Diseases / psychology
  • Connective Tissue Diseases / therapy*
  • Cross-Sectional Studies
  • Europe
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Male
  • Musculoskeletal Diseases / psychology
  • Musculoskeletal Diseases / therapy*
  • Prospective Studies
  • Qualitative Research
  • Quality of Life*
  • Quality-Adjusted Life Years*
  • Randomized Controlled Trials as Topic
  • Retrospective Studies