A Systematic Review and Critical Assessment of Health State Utilities

Abstract

The study aimed to conduct a systematic literature search to identify health state utilities for weight change in type 2 diabetes mellitus (T2DM) and to review those values for appropriateness for inclusion in a submission to the National Institute for Health and Clinical Excellence (NICE). The search was conducted using keywords and Medical Subject Heading (MeSH) terms designed to exhaustively capture health state utility values across a variety of known economic, health technology assessment and peer-reviewed publication databases. The values were then critically reviewed from the perspective of the NICE reference case (2008 methods guide). The search resulted in a large number of repeat references across databases suggesting good sensitivity. Thirty-three articles were selected for inclusion and subjected to a critical review including their methodological quality, symmetry with the NICE reference case, sample size and country source. This critical review led to a shortlist of nine utility studies, all of which had potential for inclusion in cost-utility models or a meta-analysis. A relatively large number of utilities have been collected in weight change and T2DM. Many of these utility values are not suitable for inclusion in a NICE submission. A better way of reviewing the methodological quality of utilities is needed.