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A Systematic Review of Utility Score Assessments in the Breast Surgery Cost-Analysis Literature

  • Health Services Research and Global Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Surgery for breast cancer can have significant impact on patient quality-of-life. Cost-utility analysis provides a way to analyze the economic impact of a surgical procedure with the change in a patient’s quality of life. Utility scores are used in these analyses to quantify the impact on quality of life. We undertook a systematic review of the literature on breast cancer surgical procedures to compile a repository of utility scores and to assess gaps in the current literature.

Methods

Following PRISMA guidelines, a systematic review was performed for studies reporting utility scores for breast surgery and breast reconstruction. The health states and utility scores were extracted and grouped into seven procedural categories based on oncologic and reconstructive methods. Mean utility score and ranges were calculated and reported for each procedural category.

Results

Nineteen articles met the inclusion criteria assessing 118 health states. Most utility scores were obtained from healthcare professionals. Breast-conserving therapy yielded the highest mean utility score at 0.79, whereas mastectomy yielded a mean utility score of 0.75. Among reconstruction health states, implant reconstruction had a lower score than autologous reconstruction (0.64 implant vs. latissimus dorsi 0.69 and TRAM/DIEP 0.71). No utility scores were found associated with oncoplasty or nipple-sparing mastectomy procedures.

Conclusions

A reliable body of utility scores is important in enabling future cost-utility and value-based analysis comparisons for breast surgical oncology. Additional work is needed to obtain health state assessments from the patient perspective, as well as assessment of more modern surgical and reconstructive approaches.

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Authors and Affiliations

  1. Tufts University School of Medicine, Boston, MA, USA

    Alexander Y. Yoon MS, Andrew J. Seto BS & Abhishek Chatterjee MD, MBA

  2. Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Laura Bozzuto MD

  3. Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, USA

    Carla S. Fisher MD

  4. Department of Surgery, Tufts Medical Center, Boston, MA, USA

    Abhishek Chatterjee MD, MBA

Authors
  1. Alexander Y. Yoon MS
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  2. Laura Bozzuto MD
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Correspondence to Alexander Y. Yoon MS.

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Yoon, A.Y., Bozzuto, L., Seto, A.J. et al. A Systematic Review of Utility Score Assessments in the Breast Surgery Cost-Analysis Literature. Ann Surg Oncol 26, 1190–1201 (2019). https://doi.org/10.1245/s10434-019-07160-x

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  • DOI: https://doi.org/10.1245/s10434-019-07160-x

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