Health Utility Weighting of the Modified Rankin Scale

作者：Alexander D. Rebchuk, Zoe R. O’Neill, Elena Szefer, Michael D. Hill, Thalia S. Field · 发表于：JAMA Network Open · 年份：2020 · DOI：10.1001/jamanetworkopen.2020.3767 · 被引用次数：61 · 研究领域：Acute Ischemic Stroke Management、Health Systems, Economic Evaluations, Quality of Life、Meta-analysis and systematic reviews

Importance: The utility-weighted modified Rankin Scale (UW-mRS) has been proposed as a patient-centered alternative primary outcome for stroke clinical trials. However, to date, there is no clear consensus on an approach to weighting the mRS. Objective: To characterize the between-study variability in utility weighting of the mRS in a population of patients who experienced stroke and its implications when applied to the results of a clinical trial. Data Sources: In this systematic review and meta-analysis, MEDLINE, Embase, and PsycINFO were searched from January 1987 through May 2019 using major search terms for stroke, health utility, and mRS. Study Selection: Original research articles published in English were reviewed. Included were studies with participants 18 years or older with ischemic or hemorrhagic stroke, transient ischemic attack, or subarachnoid hemorrhage, with mRS scores and utility weights evaluated concurrently. A total of 5725 unique articles were identified. Of these, 283 met criteria for full-text review, and 24 were included in the meta-analysis. Data Extraction and Synthesis: PRISMA guidelines for systematic review were followed. Data extraction was performed independently by multiple researchers. Data were pooled using mixed models. Main Outcomes and Measures: The mean utility weights and 95% CIs were calculated for each mRS score and health utility scale. Geographic differences in weighting for the EuroQoL 5-dimension (EQ-5D) and Stroke Impact Scale-ba...