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J Gastrointest Surg. 2018 May;22(5):894-905. doi: 10.1007/s11605-018-3671-7. Epub 2018 Jan 23.

Health State Utility Values for Ileostomies and Colostomies: a Systematic Review and Meta-Analysis.

Dossa F1,2,3,4, Josse J1, Acuna SA1,2,3,4, Baxter NN5,6,7,8,9.

Author information

1
Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada.
2
Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
3
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
4
Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada.
5
Division of General Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada. BaxterN@smh.ca.
6
Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. BaxterN@smh.ca.
7
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. BaxterN@smh.ca.
8
Department of Surgery, St. Michael's Hospital, Toronto, ON, Canada. BaxterN@smh.ca.
9
Division of General Surgery, St. Michael's Hospital, 040-16 Cardinal Carter Wing, 30 Bond Street, Toronto, ON, M5B 1W8, Canada. BaxterN@smh.ca.

Abstract

BACKGROUND:

Ileostomies and colostomies may affect the quality of life of patients after colorectal surgery; however, the impact has been difficult to quantify using questionnaire-based measures. Utilities reflect patient preferences for health states and provide an alternate method of quality of life assessment. We aimed to systematically review the literature on utilities for ileostomy and colostomy health states.

METHODS:

We searched MEDLINE, EMBASE, and EBM Reviews (to August 16, 2017) to identify studies reporting utilities for colostomies or ileostomies using direct or indirect, preference-based elicitation tools. We categorized utilities based on elicitation group (patients with stoma, patients without stoma, healthcare providers, general population) and tool. We pooled utilities using random effects models to determine mean utilities for each elicitation group and tool.

RESULTS:

We identified ten studies reporting colostomy utilities and three studies reporting ileostomy utilities. Utilities were most commonly obtained using direct elicitation measures administered to individuals with an understanding of the health state. Patients with stomas and providers gave high utility ratings for the colostomy state (range 0.88-0.92 and 0.86-0.92, respectively, using direct elicitation tools). Ileostomy utilities obtained from patients following surgery and from providers also demonstrated high values placed on the ileostomy health state (range 0.88-1.0).

CONCLUSIONS:

Following stoma surgery, values placed on quality of life are similar to those obtained from patients with conditions such as asthma and allergies or individuals of similar age without chronic conditions. This confirms the findings of questionnaire-based studies, which report minimal long-term decrements to overall quality of life among stomates.

KEYWORDS:

Quality of life; Stoma; Utilities

PMID:
29363020
DOI:
10.1007/s11605-018-3671-7

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