The burden of neuropathic pain: A systematic review and meta-analysis of health utilities
The burden of neuropathic pain: A systematic review and meta-analysis of health utilities
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DOI：
10.1016/j.pain.2010.02.034
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发表时间：
2010-05-01
期刊：
影响因子：
7.4
通讯作者：
Taylor, Rod S.
中科院分区：
文献类型：
--
作者：
Doth, Alissa H.;Hansson, Per T.;Taylor, Rod S.
神经性疼痛 (NeuP) 患者的健康相关生活质量 (HRQoL) 显着低于普通人群。本系统评价和荟萃分析的目的是检验 NeuP 与低水平健康效用相关的假设。对电子数据库（MEDLINE、EMBASE、Cochrane Library 和 CINAHL）进行了结构化检索。还审查了检索到的报告的参考列表。报告 NeuP 中效用单指数测量（基于偏好）的研究也包括在内。使用随机效应荟萃分析来汇总 NeuP 条件下的 EQ-5D 指数效用估计值。使用元回归检查效用和预定义因素（NeuP 状况、患者年龄、性别、疼痛持续时间和严重程度以及效用评分方法）的关联。该评价纳入了 24 项报告 NeuP 患者健康效用价值的研究。各项研究的加权汇总效用评分各不相同，背部手术失败综合征的平均值为 0.15，带状疱疹后神经痛和糖尿病神经病变的平均值为 0.61。尽管各项研究之间存在显着的异质性（P < 0.0001），但我们发现，随着患者和研究特征的变化，效用几乎没有变化。唯一的例外是神经性疼痛严重程度增加与效用降低之间存在显着关系（P < 0.0001）。这项研究证实了这样的假设：NeuP 患者的效用较低，因此 HRQoL 也较低。然而，非 NeuP 合并症的贡献仍不清楚。神经性疼痛的严重程度成为 NeuP 对健康产生负面影响的主要预测因素。 (C) 2010 年国际疼痛研究协会。由 Elsevier B.V. 出版。保留所有权利。
Patients with neuropathic pain (NeuP) experience substantially lower health-related quality of life (HRQoL) than the general population. The aim of this systematic review and meta-analysis is to test the hypothesis that NeuP is associated with low levels of health utility. A structured search of electronic databases (MEDLINE, EMBASE, Cochrane Library and CINAHL) was undertaken. Reference lists of retrieved reports were also reviewed. Studies reporting utility single-index measures (preference based) in NeuP were included. Random effects meta-analysis was used to pool EQ-5D index utility estimates across NeuP conditions. The association of utilities and pre-defined factors (NeuP condition, patient age, sex, duration and severity of pain and method of utility scoring) was examined using meta-regression. Twenty-four studies reporting health utility values in patients with NeuP were included in the review. Weighted pooled utility score across the studies varied from a mean of 0.15 for failed back surgery syndrome to 0.61 for post-herpetic neuralgia and diabetic neuropathy. Although there was substantial heterogeneity (P < 0.0001) across studies, we found little variation in utility as a function of patient and study characteristics. The single exception was a significant relationship (P < 0.0001) between increasing neuropathic pain severity and a reduction in utility. This study confirms the hypothesis that patients with NeuP experience low utilities and therefore low HRQoL. However, the contribution of non-NeuP co-morbidity remains unclear. Neuropathic pain severity emerged as a primary predictor of the negative health impact of NeuP. (C) 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.