Estimation of utilities for chronic hepatitis C from SF-36 scores.
OBJECTIVE
Utilities are the recommended health-related quality of life (HRQOL) measure for cost-effectiveness studies. The aim of this study was to estimate utilities for chronic hepatitis C health states from published studies reporting Short Form-36 (SF-36) quality-of-life scores.


METHODS
A systematic review of published studies was undertaken. Articles were eligible for review if direct HRQOL assessment using the SF-36 in a chronic hepatitis C population was reported. SF-36 data were grouped according to hepatitis C virus (HCV) treatment status at baseline, stage of liver disease, association with comorbidity, and HCV treatment response. The SF-36 scores were then transformed into utilities using three different methods.


RESULTS
Using Nichol's method, the estimated SF-36 mean utilities were 0.87 for sustained virological response (SVR) to interferon-based treatment, 0.82 for untreated chronic hepatitis C, 0.81 for precirrhosis, 0.76 for compensated cirrhosis, 0.69 for decompensated cirrhosis, 0.67 for hepatocellular carcinoma (HCC), and 0.77 for liver transplant. Other methods showed differences across comparison groups (e.g., treated vs untreated) but absolute scores differed substantially by translation method. SF-36 utilities for different stages of liver disease varied considerably from expert estimates but comparable to direct patient-elicited utilities.


CONCLUSIONS
Application of SF-36 translation methods facilitate use of large existing datasets to generate community-weighted utilities for cost-effectiveness analyses, an important consideration in the absence of large studies of direct patient-elicited utilities in chronic hepatitis C.
Thein
Hla-Hla
HH
National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia.
Krahn
Murray
M
Kaldor
John M
JM
Dore
Gregory J
GJ
D000328:Adult; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy / Q000191:economics / Q000503:physiopathology*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome
D007372:Interferons