title: Health state utility values for diabetic retinopathy: protocol for a systematic review and meta-analysis.
abstract: BACKGROUND
  People with diabetic retinopathy tend to have lower levels of health-related quality of life than individuals with no retinopathy. Strategies for screening and treatment have been shown to be cost-effective. In order to reduce the bias in cost-effectiveness estimates, systematic reviews of health state utility values (HSUVs) are crucial for health technology assessment and the development of decision analytic models. A review and synthesis of HSUVs for the different stages of disease progression in diabetic retinopathy has not previously been conducted.
  
  
  METHODS
  We will conduct a systematic review of the available literature that reports HSUVs for people with diabetic retinopathy, in correspondence with current stage of disease progression and/or visual acuity. We will search Medline, EMBASE, Web of Science, Cost-Effectiveness Analysis Registry, Centre for Reviews and Dissemination Database, and EconLit to identify relevant English-language articles. Data will subsequently be synthesized using linear mixed effects modeling meta-regression. Additionally, reported disease severity classifications will be mapped to a four-level grading scale for diabetic retinopathy.
  
  
  CONCLUSIONS
  The systematic review and meta-analysis will provide important evidence for future model-based economic evaluations of technologies for diabetic retinopathy. The meta-regression will enable the estimation of utility values at different disease stages for patients with particular characteristics and will also highlight where the design of the study and HSUV instrument have influenced the reported utility values. We believe this protocol to be the first of its kind to be published.
  
  
  BACKGROUND
  PROSPERO CRD42014012891.
authors: Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. chris.sampson@nottingham.ac.uk.
authors: Christopher J
authors: CJ
authors: Sampson
authors: School of Health and Related Research, University of Sheffield, Regent Court, Sheffield, S1 4DA, UK. j.tosh@sheffield.ac.uk.
authors: Jonathan C
authors: JC
authors: Tosh
authors: Department of Biostatistics, University of Liverpool, Daulby Street, Liverpool, L69 3GA, UK. c.p.cheyne@liverpool.ac.uk.
authors: Christopher P
authors: CP
authors: Cheyne
authors: Department of Eye and Vision Science, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK. deborah.broadbent@rlbuht.nhs.uk.
authors: Deborah
authors: D
authors: Broadbent
authors: Division of Rehabilitation and Ageing, School of Medicine, University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK. marilyn.james@nottingham.ac.uk.
authors: Marilyn
authors: M
authors: James
mesh_terms: D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003930:Diabetic Retinopathy / Q000628:therapy*; D006304:Health Status; D006801:Humans; D011788:Quality of Life; D012107:Research Design; D012720:Severity of Illness Index; D000078202:Systematic Reviews as Topic; D013673:Technology Assessment, Biomedical; D015201:Meta-Analysis as Topic