title: A systematic review of utilities in hand surgery literature.
abstract: OBJECTIVE
  To systematically review the literature to determine if utilities (a quantitative way to express patient preferences for health outcomes) have been measured in hand surgery studies.
  
  
  METHODS
  A literature search was conducted using Cochrane, EMBASE, HealthSTAR, MEDLINE, and CINAHL electronic databases (1966-2013). This search was supplemented by cited and manual reference searches and expert consultation to retrieve all relevant studies. Studies were selected by 2 independent reviewers if they pertained to hand or wrist surgery, were published in English, and measured utilities as an outcome. Descriptive data were extracted, including the hand surgery procedure investigated, study design, value of utilities, and methodology of utilities measurement.
  
  
  RESULTS
  Eleven studies were included after reviewing 989 studies. Most hand conditions were associated with utilities less than 0.8. Utilities in the reviewed studies were measured using different methods and from different subjects. Three studies paradoxically mapped greater utilities for poorer heath states.
  
  
  CONCLUSIONS
  Hand conditions cause impairment, as evidenced by their utilities. Measurement of utilities remains uncommon in hand surgery literature. Future studies should not only measure utilities but also do so with consistent and appropriate methodology to ensure that mapped values are valid and comparable.
  
  
  METHODS
  Economic/decision analysis III.
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Yu Kit
authors.initials: YK
authors.lastname: Li
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Noor
authors.initials: N
authors.lastname: Alolabi
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Manraj Nirmal
authors.initials: MN
authors.lastname: Kaur
authors.affiliation: Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Surgical Outcomes Research Centre, Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: athoma@mcmaster.ca.
authors.forename: Achilleas
authors.initials: A
authors.lastname: Thoma
mesh_terms: D004185:Disability Evaluation; D006225:Hand / Q000601:surgery*; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D057240:Patient Preference
keywords: Hand; preferences; quality of life; quality-adjusted life years; utilities