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.
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.
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.
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.
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.

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

We carried out a systematic review and meta-analysis of epidemiologic studies on the association between occupational exposure to glyphosate and risk of non-Hodgkin lymphoma (NHL) and multiple myeloma (MM).
We conducted a systematic search of the literature, and identified 18 relevant publications, from which we extracted results from seven non-overlapping studies of NHL and three of MM. We performed random-effects meta-analyses for ever-exposure to glyphosate, dose-response, and risk of specific NHL subtypes.
The meta-relative risk (RR) of NHL was 1.03 (95% confidence interval [CI] 0.86-1.21), that of MM was 1.04 (95% CI 0.67-1.41). The meta-RR of NHL for highest category of exposure was 1.49 (95% CI 0.37-2.61; 3 studies). The meta-RR for diffuse large B-cell lymphoma (DLBCL) was 1.31 (95% CI 0.93-1.75); that for follicular lymphoma was 0.82 (95% CI 0.93-1.70), and that for chronic lymphocytic leukemia was 0.85 (95% CI 0.20-1.49). There was indication of publication bias for studies on NHL.
Our meta-analysis provided no overall evidence of an increased risk for both NHL and MM in subjects occupationally exposed to glyphosate. In secondary analyses we detected a small increase in risk for the category with highest level of exposure as well as for DLBCL. The evidence of publication bias suggests caution in the interpretation of the results.
Sono state condotte una revisione sistematica e una meta-analisi degli studi epidemiologici sull’associazione tra esposizione professionale a glifosato e rischio di linfoma non Hodgkin (NHL) e mieloma multiplo (MM).
È stata effettuata una ricerca sistematica della letteratura che ha portato all’identificazione di 18 pubblicazioni rilevanti, da cui sono stati estratti i risultati di sette studi indipendenti sul NHL e tre sul MM. È stata effettuata una meta-analisi con modello ad effetti casuali per esposizione a glifosato, inclusi i risultati su dose-risposta e su sottotipi specifici di NHL.
Il rischio relativo (RR) della meta-analisi per NHL è risultato pari a 1,03 (intervallo di confidenza al 95% [CI] 0,86-1,21), e quello per MM pari a 1,04 (IC al 95% 0,67-1,41). Il RR per NHL nella più alta categoria di esposizione è risultato pari a 1,49 (IC 95% 0,37-2,61; 3 studi). Il RR per linfoma diffuso a grandi cellule B (DLBCL) è risultato pari a 1,31 (IC 95% 0,93-1,75); quello per il linfoma follicolare pari a 0,82 (IC 95% 0,93-1,70) e quello per la leucemia linfatica cronica pari a 0,85 (IC 95% 0,20-1,49). Si è riscontrata un’indicazione di bias di pubblicazione negli studi su NHL.
In generale, questa meta-analisi non ha fornito la prova di un aumento del rischio sia per NHL che per MM in soggetti esposti professionalmente a glifosato. In analisi secondarie è stato evidenziato un leggero aumento del rischio per la categoria con il più alto livello di esposizione e per DLBCL. L’evidenza di un bias di pubblicazione suggerisce cautela nell’interpretazione dei risultati.

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