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. 2015 Jul 7:6:167-77.
doi: 10.2147/PROM.S81428. eCollection 2015.

A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

Anders Holmen Møller  1 , Sandra Erntoft  1 , Gabrielle R Vinding  2 , Gregor Be Jemec  2
Affiliations

A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

Anders Holmen Møller et al. Patient Relat Outcome Meas. .

Abstract

Background: Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden.

Objective: The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D) index scores reported in the published literature, and to compare this to patients with other chronic diseases.

Methods: Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL). The first search (December 2013) used search terms psoria* AND (EQ5D OR EQ OR EUROQoL). Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014) used the terms (systematic review) AND (EQ5D OR EQ 5D OR EuroQoL). Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search.

Results: Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities) ranged from 0.52 (standard deviation: 0.39) to 0.9 (standard deviation: 0.1). Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus) to 0.66 (liver diseases). The highest EQ-5D estimates for other diseases ranged from 0.79 (liver diseases) to 0.93 (cancer patients). Both lower and upper EQ-5D estimates in psoriasis patients were within the range of those reported for other chronic diseases.

Conclusion: Comparative studies of morbidity are relevant in health care studies and patient advocacy. This systematic review demonstrates that the ranges of disutility among psoriasis patients are within the ranges of other chronic diseases (cardiovascular diseases, diabetes, end-stage renal diseases, liver diseases, cancer, and visual disorders).

Keywords: EuroQoL; HRQoL; dermatology; disutility; humanistic burden.

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Figures

Figure 1
Figure 1
PRISMA flow charts of the selection process for including studies in the systematic reviews. Notes: (A) Studies reporting EQ-5D scores for psoriasis patients. (B) Studies reporting EQ-5D scores for other chronic diseases (not including psoriasis). Abbreviations: n, number; EQ-5D, EuroQoL five dimensions; SF-36, Short Form-36; PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses.
Figure 1
Figure 1
PRISMA flow charts of the selection process for including studies in the systematic reviews. Notes: (A) Studies reporting EQ-5D scores for psoriasis patients. (B) Studies reporting EQ-5D scores for other chronic diseases (not including psoriasis). Abbreviations: n, number; EQ-5D, EuroQoL five dimensions; SF-36, Short Form-36; PRISMA, Preferred Reporting Items for Systematic reviews and Meta-Analyses.
Figure 2
Figure 2
Mean baseline EQ-5D utility index and VAS score estimates for psoriasis patients. Notes: Scale for utility index score: 0= dead; 1= full health. Scale for VAS score: 0= worst health imaginable; 100= best health imaginable. Rosen et al reported utility scores to one decimal place (all other studies reported to two decimal places). Abbreviations: EQ-5D, EuroQoL five dimensions; VAS, Visual Analog Scale; mod, moderate; NR, not reported.
Figure 3
Figure 3
Upper and lower EQ-5D utility index score estimates for psoriasis and other chronic diseases. Notes: Scale: 0= dead; 1= full health. *Rosen et al reported the utility score to one decimal place (all other studies reported to two decimal places). Rosen and Wade were included in the chart in order to distinguish them from the other psoriasis articles, highlighting that these only reflect the findings from two of the papers. Abbreviation: EQ-5D, EuroQoL five dimensions.
Figure 4
Figure 4
Upper and lower EQ-5D VAS score estimates for psoriasis and other chronic diseases. Notes: Scale: 0= worst health imaginable; 100= best health imaginable. Rosen and Wade were included in the chart in order to distinguish them from the other psoriasis articles, highlighting that these only reflect the findings from two of the papers. Abbreviations: VAS, Visual Analog Scale; EQ-5D, EuroQoL five dimensions.
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