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A systematic review of utility values in children with cerebral palsy

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Abstract

Purpose

Project aims include the following: (i) to identify reported utility values associated with CP in children aged ≤ 18 years; (ii) to explore utility value elicitation techniques in published studies; and (iii) to examine performance of the measures and/or elicitation approaches.

Methods

Peer-reviewed studies published prior to March 2017 were identified from six electronic databases. Construct validity, convergent validity, responsiveness, and reliability of instruments were assessed.

Results

Five studies met the inclusion criteria. Utility values of hypothetical general CP states obtained from a general population of parents ranged from 0.55 to 0.88 using time trade off (TTO) and 0.60–0.87 using standard gamble (SG) techniques. Utility values reported by clinicians of three hypothetical spastic quadriplegic CP states, using the Health Utility Index Mark 2 (HUI-2), ranged from 0.40 to 0.13. Other sources of utilities identified were based on both proxy and child ratings using Health Utility Index Mark 3 (HUI-3) (values ranged from − 0.013 to 0.84 depending on the valuation source) and the Assessment of Quality of Life 4 Dimension instrument, with values ranging from 0.01 to 0.58. Construct validity of the HUI-3 varied from moderate to strong, whereas mixed results were found for convergent validity. Responsiveness and reliability were not reported.

Conclusion

There was substantial variation in reported utilities. Indirect techniques (i.e. via multi-attribute utility instruments) were more frequently used than direct techniques (e.g. TTO, SG). Further research is required to improve the robustness of utility valuation of health-related quality of life in children with CP for use in economic evaluation.

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Funding

This study was funded by the Centre of Research Excellence in Cerebral Palsy (NHMRC APP 1057997) for supporting the conduct of this systematic review. The author UT has received PhD scholarship from the Centre of Research Excellence in Cerebral Palsy.

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Authors and Affiliations

  1. Deakin Health Economics, Centre for Population Health Research, Deakin University, Locked Bag 20000, Geelong, VIC, 3220, Australia

    Utsana Tonmukayakul, Long Khanh-Dao Le, Shalika Bohingamu Mudiyanselage, Lidia Engel, Jessica Bucholc, Rob Carter & Cathrine Mihalopoulos

  2. Centre for Health Economics Research and Evaluation, University of Technology Sydney, 1-59 Quay Street, Hay Market, Sydney, NSW, 2000, Australia

    Brendan Mulhern

  3. Deakin Health Economics, Centre for Population Health Research, Deakin University, 3rd Floor BC Building 221 Burwood Highway, Burwood, Melbourne, VIC, 3125, Australia

    Utsana Tonmukayakul

Authors
  1. Utsana Tonmukayakul
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  2. Long Khanh-Dao Le
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  3. Shalika Bohingamu Mudiyanselage
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  4. Lidia Engel
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  5. Jessica Bucholc
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  7. Rob Carter
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  8. Cathrine Mihalopoulos
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Correspondence to Utsana Tonmukayakul.

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Tonmukayakul, U., Le, L.KD., Mudiyanselage, S.B. et al. A systematic review of utility values in children with cerebral palsy. Qual Life Res 28, 1–12 (2019). https://doi.org/10.1007/s11136-018-1955-8

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