Current standard values of health utility scores for evaluating costeffectiveness in liver disease:A meta-analysis

BACKGROUND Health utility assessments have been developed for various conditions,including chronic liver disease.Health utility scores are required for socio-economic evaluations,which can aid the distribution of national budgets.However,the standard health utility assessment scores for specific health conditions are largely unknown.AIM To summarize the health utility scores,including the EuroQOL 5-dimensions 5-levels(EQ-5D-5L),EuroQol-visual analogue scale,short from-36(SF-36),RAND-36,and Health Utilities Index(HUI)-Mark2/Mark3 scores,for the normal population and chronic liver disease patients.METHODS A systematic literature search of PubMed and MEDLINE,including the Cochrane Library,was performed.Meta-analysis was performed using the RevMan software.Multiple means and standard deviations were combined using the StatsToDo online web program.RESULTS The EQ-5D-5L and SF-36 can be used for health utility evaluations during antiviral therapy for hepatitis C.HUI-Mark2/Mark3 indicated that the health utility scores of hepatitis B patients are roughly 30% better than those of hepatitis C patients.CONCLUSION The EQ-5D-5L is the most popular questionnaire for health utility assessments.Health assessments that allow free registration would be useful for evaluating health utility in patients with liver disease.

Health-related quality of life in patients that have undergone liver resection:A systematic review and meta-analysis

BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.

Maturation of robotic liver resection during the last decade:A systematic review and meta-analysis

BACKGROUND Minimally invasive hepatectomy techniques have developed rapidly since 2000.Pure laparoscopic liver resection(LLR)has become the primary approach for managing liver tumors and procuring donor organs for liver transplantation.Robotic liver resection(RLR)has emerged during the last decade.The technical status of RLR seems to be improving.AIM To conduct a systematic review and meta-analysis comparing the short-term clinical outcomes of LLR and RLR over two 5-year periods.METHODS A systematic literature search was performed using PubMed and Medline,including the Cochrane Library.The following inclusion criteria were set for the meta-analysis:(1)Studies comparing LLR vs RLR;and(2)Studies that described clinical outcomes,such as the operative time,intraoperative bleeding,intraoperative conversion rate,and postoperative complications.RESULTS A total of 25 articles were included in this meta-analysis after 40 articles had been subjected to full-text evaluations.The studies were divided into early(n=14)and recent(n=11)groups.In the recent group,the operative time did not differ significantly between LLR and RLR(P=0.70),whereas in the early group the operative time of LLR was significantly shorter than that of RLR(P<0.001).CONCLUSION The initial disadvantages of RLR,such as its long operation time,have been overcome during the last 5 years.The other clinical outcomes of RLR are comparable to those of LLR.The cost and quality-of-life outcomes of RLR should be evaluated in future studies to promote its routine clinical use.