The impact of loneliness and social isolation on health state utility values: a systematic literature review.
Ontology highlight
ABSTRACT: Background
Loneliness and social isolation are recognised as social problems and denote a significant health burden. The aim of this study was to conduct a systematic literature review to explore the health state utility values (HSUVs) associated with loneliness and/or social isolation.Method
Peer-reviewed journals published in English language that reported both HSUVs along with loneliness and/or social isolation scores were identified through five databases. No restrictions were made relating to the population, study design or utility estimation method used.Results
In total, 19 papers were included; 12 included a measure of loneliness, four studies included a measure of social isolation and three studies considered both loneliness and social isolation. All studies focused on individuals with pre-existing health conditions-where the EQ-5D-3L instrument was most frequently used to assess HSUVs. HSUVs ranged from 0.5 to 0.95 in those who reported not being lonely, 0.42 to 0.97 in those who experienced some level of loneliness, 0.3 to 0.87 in those who were socially isolated and 0.63 to 0.94 in those who were not socially isolated.Conclusion
There was significant variation in HSUVs complicated by the presence of co-morbidities, population heterogeneity, variations in methods used to derive utility scores and differences in the measurement of loneliness and/or social isolation. Nevertheless, the lower HSUVs observed should be considered to significantly impact quality of life, though we also note the need for further research to explore the unique impact of loneliness and social isolation on HSUVs that can be used in the future economic evaluations.
SUBMITTER: Majmudar IK
PROVIDER: S-EPMC8785005 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:ObjectivesCancer diagnoses at later stages are associated with a decrease in health-related quality of life (HRQOL). Health state utility values (HSUVs) reflect preference-based HRQOL and can vary based on cancer type, stage, treatment, and disease progression. Detecting and treating cancer at earlier stages may lead to improved HRQOL, which is important for value assessments. We describe published HSUVs by cancer type and stage.MethodsA systematic review was conducted using Embase, MEDLINE®, EconLit, and gray literature to identify studies published from January 1999 to September 2019 that reported HSUVs by cancer type and stage. Disutility values were calculated from differences in reported HSUVs across cancer stages.ResultsFrom 13,872 publications, 27 were eligible for evidence synthesis. The most frequent cancer types were breast (n = 9), lung (n = 5), colorectal (n = 4), and cervical cancer (n = 3). Mean HSUVs decreased with increased cancer stage, with consistently lower values seen in stage IV or later-stage cancer across studies (e.g., - 0.74, - 0.44, and - 0.51 for breast, colorectal, and cervical cancer, respectively). Disutility values were highest between later-stage (metastatic or stage IV) cancers compared to earlier-stage (localized or stage I-III) cancers.ConclusionsThis study provides a summary of HSUVs across different cancer types and stages that can inform economic evaluations. Despite the large variation in HSUVs overall, a consistent decline in HSUVs can be seen in the later stages, including stage IV. These findings indicate substantial impairment on individuals' quality of life and suggest value in early detection and intervention.
| S-EPMC8526485 | biostudies-literature
Project description:Cost-utility analyses assess health gains acquired by interventions by incorporating weighted health state utility values (HSUVs). HSUVs are important in plastic and reconstructive surgery (PRS) because they include qualitative metrics when comparing operative techniques or interventions. We systematically reviewed the literature to identify the extent and quality of existing original utilities research within PRS.MethodsA systematic review of articles with original PRS utility data was conducted in accordance with the Preferred Reporting Items for a Systematic Review and Meta-Analysis guidelines. Subspecialty, survey sample size, and respondent characteristics were extracted. For each HSUV, the utility measure [direct (standard gamble, time trade off, visual analog scale) and/or indirect], mean utility score, and measure of variance were recorded. Similar HSUVs were pooled into weighted averages based on sample size if they were derived from the same utility measure.ResultsIn total, 348 HSUVs for 194 disease states were derived from 56 studies within seven PRS subspecialties. Utility studies were most common in breast (n = 17, 30.4%) and hand/upper extremity (n = 15, 26.8%), and direct measurements were most frequent [visual analog scale (55.4%), standard gamble (46.4%), time trade off (57.1%)]. Studies surveying the general public had more respondents (n = 165, IQR 103-299) than those that surveyed patients (n = 61, IQR 48-79) or healthcare professionals (n = 42, IQR 10-109). HSUVs for 18 health states were aggregated.ConclusionsThe HSUV literature within PRS is scant and heterogeneous. Researchers should become familiar with these outcomes, as integrating utility and cost data will help illustrate that the impact of certain interventions are cost-effective when we consider patient quality of life.
| S-EPMC8615317 | biostudies-literature
Project description:Background. Treatment options in oncology are rapidly advancing, and public payer systems are increasingly under pressure to adopt new but expensive cancer treatments. Cost-utility analyses (CUAs) are used to estimate the relative costs and effects of competing interventions, where health outcomes are measured using quality-adjusted life years (QALYs). Health state utility values (HSUVs) are used to reflect health-related quality of life or health status in the calculation of QALYs. To support reimbursement agencies in the appraisal of oncology drug submissions, which typically include a CUA component, we have proposed a systematic literature review of published HSUV estimates in the field of oncology. Methods. The following databases will be searched: MEDLINE, EMBASE, EconLit, and CINAHL. A team of reviewers, working independently and in duplicate, will evaluate abstracts and full-text publications for eligibility against broad inclusion criteria. Studies using a direct, indirect, or combination approach to eliciting preferences related to cancer or cancer treatments are eligible. Data extraction will capture details of study methodology, participants, health states, and corresponding HSUVs. We will summarize our findings with descriptive analyses at this stage. A pilot review in thyroid cancer is presented to illustrate the proposed methods. Discussion. This systematic review will generate a comprehensive summary of the oncology HSUV literature. As a component of the Health Utility Book (HUB) project, we anticipate that this work will assist both health economic modelers as well as critical reviewers in the development and appraisal of CUAs in oncology.
| S-EPMC6696850 | biostudies-literature
Project description:BackgroundNon-small cell lung cancer (NSCLC) is the predominant histological subtype of lung cancer and is the leading cause of cancer-related deaths globally. Quality of life is an important consideration for patients and current treatments can adversely affect health-related quality of life (HRQoL).ObjectiveThe objectives of this systematic literature review (SLR) were to identify and provide a comprehensive catalogue of published health state utility values (HSUVs) in patients with early-stage NSCLC and to understand the factors impacting on HSUVs in this indication.MethodsElectronic searches of Embase, MEDLINE and Evidence-Based Medicine Reviews were conducted via the Ovid platform in March 2021 and June 2022 and were supplemented by grey literature searches of conference proceedings, reference lists, health technology assessment bodies, and other relevant sources. Eligibility criteria were based on patients with early-stage (stage I-III) resectable NSCLC receiving treatment in the adjuvant or neoadjuvant setting. No restriction was placed on interventions or comparators, geography, or publication date. English language publications or non-English language publications with an English abstract were of primary interest. A validated checklist was applied to conduct quality assessment of the full publications.ResultsTwenty-nine publications (27 full publications and two conference abstracts) met all eligibility criteria and reported 217 HSUVs and seven disutilities associated with patients with early NSCLC. The data showed that increasing disease stage is associated with decreasing HRQoL. It was also indicated that utility values vary by treatment approach; however, the choice of treatment may be influenced by the patients' disease stage at presentation. Few studies aligned with the requirements of health technology assessment (HTA) bodies, indicating a need for future studies to conform to these preferences, making them suitable for use in economic evaluations.ConclusionsThis SLR found that disease stage and treatment approach were two of several factors that can impact patient-reported HRQoL. Additional studies are warranted to confirm these findings and to investigate emerging therapies for early NSCLC. In collecting a catalogue of HSUV data, this SLR has begun to identify the challenges associated with identifying reliable utility value estimates suitable for use in economic evaluations of early NSCLC.
| S-EPMC10471534 | biostudies-literature
Project description:PurposeHealth state utility values are commonly used to inform economic evaluations and determine the cost-effectiveness of an intervention. The aim of this systematic review is to summarise the utility values available to represent the health-related quality of life (HRQoL) of patients with thyroid cancer.MethodsEight electronic databases were searched from January 1999 to April 2019 for studies which included assessment of HRQoL for patients with thyroid cancer. Utility estimates derived from multiple sources (EuroQol questionnaire 5-dimension (EQ-5D), time trade-off [TTO] and standard gamble [SG] methods) were extracted. In addition, utility estimates were generated by mapping from SF-36 and EORTC QLQ-30 to the EQ-5D-3L UK value set using published mapping algorithms.ResultsSearches identified 33 eligible studies. Twenty-six studies reported HRQoL for patients with differentiated thyroid cancer and seven studies for patients with general thyroid cancer. We identified studies which used different methods and tools to quantify the HRQoL in patients with thyroid cancer, such as the EQ-5D-3L, SF-36, EORTC QLQ-30 and SG and TTO techniques to estimate utility values. Utility estimates range from 0.205 (patients with low-risk differentiated thyroid cancer) to utility values approximate to the average UK population (following successful thyroidectomy surgery and radioiodine treatment). Utility estimates for different health states, across thyroid cancer sub-types and interventions are presented.ConclusionA catalogue of utility values is provided for use when carrying out economic modelling of thyroid cancer; by including mapped values, this approach broadens the scope of health states that can be considered within cost-effectiveness modelling.
| S-EPMC7952343 | biostudies-literature
Project description:Objectives Thus far, some empirical studies have investigated the association between oral health and loneliness as well as social isolation. However, a systematic review and meta-analysis is lacking synthesizing this evidence. Hence, our purpose was to close this knowledge gap. Design Systematic review and meta-analysis. Setting and Participants Observational studies examining the association between oral health and loneliness or social isolation were included. Disease-specific samples were excluded. Methods We searched three electronic databases (PubMed, PsycINFO, CINAHL), and did an additional hand search. Data extraction covered methods, sample characteristics and main findings. To evaluate study quality/risk of bias, the NIH tool was used. Study selection, data extraction and assessment of study quality were each conducted by two reviewers. Results Seven studies were included in our current work. Several cross-sectional studies and one longitudinal study reported an association between poorer oral health and higher loneliness as well as higher social isolation. The quality of the studies was mostly fair, with two studies of high quality. The pooled OR was 1.47 (95% CI 1.24–1.75) among the studies with adult samples. Conclusion Most of the included studies demonstrated an association between oral health and loneliness or social isolation. There is a lack of high quality studies on these associations; in particular, future studies should use longitudinal data to clarify the directionality between oral health and loneliness or social isolation. Prospero registration number CRD42021268116. Electronic Supplementary Material Supplementary material is available for this article at 10.1007/s12603-022-1806-8 and is accessible for authorized users.
| S-EPMC9166168 | biostudies-literature
Project description:ObjectiveSocial isolation and loneliness are associated with increased mortality and higher health care spending in older adults. Hearing loss is a common condition in older adults and impairs communication and social interactions. The objective of this review is to summarize the current state of the literature exploring the association between hearing loss and social isolation and/or loneliness.Data sourcesPubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library.Review methodsArticles were screened for inclusion by 2 independent reviewers, with a third reviewer for adjudication. English-language studies of older adults with hearing loss that used a validated measure of social isolation or loneliness were included. A modified Newcastle-Ottawa Scale was used to assess the quality of the studies included in the review.ResultsOf the 2495 identified studies, 14 were included in the review. Most of the studies (12/14) were cross-sectional. Despite the heterogeneity of assessment methods for hearing status (self-report or objective audiometry), loneliness, and social isolation, most multivariable-adjusted studies found that hearing loss was associated with higher risk of loneliness and social isolation. Several studies found an effect modification of gender such that among women, hearing loss was more strongly associated with loneliness and social isolation than among men.ConclusionsOur findings that hearing loss is associated with loneliness and social isolation have important implications for the cognitive and psychosocial health of older adults. Future studies should investigate whether treating hearing loss can decrease loneliness and social isolation in older adults.
| S-EPMC8292986 | biostudies-literature
Project description:INTRODUCTION:Increasingly, assessment of healthcare technologies and interventions requires the assessment of both costs and utilities. Health state utility values (HSUVs) are measured using a range of generic and condition-specific measures. While reviews have identified that generic measures of HSUVs may lack validity in adults with conditions that result in physical disability, there is little information available on the methods used to obtain HSUVs in children and adolescents with disabilities. The objectives of this systematic review are to describe the methods used to obtain HSUVs, including mode of administration and psychometric properties, and provide summary statistics for HSUVs among children and adolescents with disabilities. METHODS AND ANALYSIS:The following databases will be searched from inception for English-language studies of any design: PubMed, PsychInfo, Medline, Scopus, CINAHL Plus, Econlit and EMBASE databases. Two reviewers will independently screen titles, abstracts and full text articles for studies reporting HSUVs and/or data on the psychometric properties of preference-based measures for children and adolescents with disabilities aged up to 19 years. Two reviewers will independently extract data items including descriptors of the study methods and sample, instruments used to capture HSUVs, summary statistics for HSUVs and items relating to the quality of reporting. A descriptive summary of results from included studies and summary statistics for HSUVs will be presented. If sufficient data is identified, we will pool summary statistics for HSUVs according to the method used to obtain the HSUV using a random effects model. In addition, we will explore the determinants of the HSUVs using a meta-regression. ETHICS AND DISSEMINATION:Ethical approval will not be required as no original data will be collected as part of this review. The completed review will be submitted for publication in a peer-reviewed journal and presentation at conferences. PROSPERO REGISTRATION NUMBER:CRD42018086574.
| S-EPMC5855280 | biostudies-literature
Project description:Background:The prospective associations between social isolation, loneliness, and health behaviors are uncertain, despite the potential importance of these relationships over time for outcomes including mortality. Purpose:To examine the associations between baseline social isolation, baseline loneliness, and engagement in health behaviors over 10 years among older adults. Methods:Data were from 3,392 men and women aged ≥52 years in the English Longitudinal Study of Ageing from 2004/2005 to 2014/2015. Modified Poisson regression was specified to estimate relative risks (RRs) and 95% confidence intervals for the associations between baseline social isolation, baseline loneliness, and consistent weekly moderate-to-vigorous physical activity, consistent five daily fruit and vegetable servings, daily alcohol drinking at any time point, smoking at any time point, and a consistently overweight/obese body mass index over the follow-up (all yes vs. no). Models were population weighted and adjusted for sociodemographic factors, health indicators, and depressive symptoms, with mutual adjustment for social isolation and loneliness. Results:Socially isolated participants were less likely than non-isolated participants to consistently report weekly moderate-to-vigorous physical activity (RR = 0.86; 0.77-0.97) or five daily fruit and vegetable servings (RR = 0.81; 0.63-1.04). They were less likely to be consistently overweight or obese (RR = 0.86; 0.77-0.97) and more likely to smoke at any time point (RR = 1.46; 1.17-1.82). Loneliness was not associated with health behaviors or body mass index in adjusted models. Among smokers, loneliness was negatively associated with successful smoking cessation over the follow-up (RR = 0.31; 0.11-0.90). Conclusions:Social isolation was associated with a range of health-related behaviors, and loneliness was associated with smoking cessation over a 10 year follow-up in older English adults.
| S-EPMC6377432 | biostudies-literature
Project description:BACKGROUND:A growing number of studies suggest that social isolation and loneliness are associated with premature mortality and are more prevalent among people with mental illness than in the general population, outlining many potential paths to disease still to be elucidated. The purpose of this meta-analysis is to examine the relationship between loneliness, social isolation, and established cardiovascular/metabolic risk factors and disorders, especially in severe mental illness, and to account for potential heterogeneity in the literature. METHODS/DESIGN:Studies that report measures of loneliness and/or social isolation along with cardiovascular/metabolic risk factors will be identified. PubMed, EMBASE (through Ovid SP), Scopus, and PsycINFO (through Ovid SP) will be searched, along with citation lists of retrieved articles and the Cochrane Database of Systematic Reviews. Grey literature will be searched using Google Scholar. Data will be extracted from eligible studies for a random effects meta-analysis. For each study, a summary effect size, heterogeneity, risk of bias, publication bias, and the effect of categorical and continuous moderator variables will be determined. DISCUSSION:This proposed systematic review and meta-analysis will identify and synthesise evidence to determine if there is an association between loneliness, social isolation, and cardiovascular/metabolic risk factors, with a special focus on severe mental illnesses. The results will help determine links and promising avenues of further research. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42018111911.
| S-EPMC7199368 | biostudies-literature