HEALTH UTILITY VALUES MEASURED BY EQ-5D IN PATIENTS WITH POST-STROKE HEMIPLGIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
SOOBIN JANG, PhD1, PYUNG-WHA KIM, M.S.2, Mi Mi Ko, PhD2, Chunhoo Cheon, Ph.D.3, Hyein Jeong, Ph.D.3.
1Assistant Professor, Kyung Hee University, Seoul, Korea, Republic of, 2Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
1Assistant Professor, Kyung Hee University, Seoul, Korea, Republic of, 2Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
OBJECTIVES: Hemiplegia are the most prevalent and functionally debilitating sequelae of stroke, yet no systematic review has synthesized EQ-5D utility values specifically in this population. This study aimed to provide consolidated utility estimates for use in cost-utility analyses and health technology assessments.
METHODS: A systematic review was conducted across six databases (PubMed, EMBASE, Cochrane, Web of Science, CINAHL, KoreaMed) up to June 2025. Studies reporting EQ-5D utility in patients with confirmed post-stroke hemiplegia or hemiparesis were eligible. Inclusion required explicit statement of hemiplegia in eligibility criteria, or confirmation of unilateral motor paralysis from baseline characteristics. A random-effects meta-analysis (DerSimonian-Laird) was performed, with subgroup analysis by geographic region (Asia vs. non-Asia). Risk of bias was assessed using RoB 2 for RCTs and the Newcastle-Ottawa Scale for cohort studies.
RESULTS: Eleven studies were included in the systematic review: eight RCTs, two retrospective cohorts, and one pre-post trial, conducted across eight countries. Three studies were excluded from meta-analysis as they did not report EQ-5D utility index values. Eight studies (N=479) were included in the meta-analysis. The pooled baseline EQ-5D utility was 0.61 (95% CI: 0.55-0.66), with substantial heterogeneity (I²=90.9%, p<0.001). Subgroup analysis revealed lower utility in Asian studies (k=4; 0.54 [0.43-0.65]) than non-Asian studies (k=4; 0.65 [0.56-0.74]), with markedly reduced within-subgroup heterogeneity (I²=0.9%), suggesting geographic region as a primary source of variability. Two RCTs were rated high risk of bias; the remainder had some concerns or low risk.
CONCLUSIONS: The pooled EQ-5D utility of 0.61 in post-stroke hemiplegia provides a reference value for economic evaluations. The Asia-non-Asia disparity highlights the need for region-specific utility values in cost-utility modelling, particularly for Asian healthcare systems.
METHODS: A systematic review was conducted across six databases (PubMed, EMBASE, Cochrane, Web of Science, CINAHL, KoreaMed) up to June 2025. Studies reporting EQ-5D utility in patients with confirmed post-stroke hemiplegia or hemiparesis were eligible. Inclusion required explicit statement of hemiplegia in eligibility criteria, or confirmation of unilateral motor paralysis from baseline characteristics. A random-effects meta-analysis (DerSimonian-Laird) was performed, with subgroup analysis by geographic region (Asia vs. non-Asia). Risk of bias was assessed using RoB 2 for RCTs and the Newcastle-Ottawa Scale for cohort studies.
RESULTS: Eleven studies were included in the systematic review: eight RCTs, two retrospective cohorts, and one pre-post trial, conducted across eight countries. Three studies were excluded from meta-analysis as they did not report EQ-5D utility index values. Eight studies (N=479) were included in the meta-analysis. The pooled baseline EQ-5D utility was 0.61 (95% CI: 0.55-0.66), with substantial heterogeneity (I²=90.9%, p<0.001). Subgroup analysis revealed lower utility in Asian studies (k=4; 0.54 [0.43-0.65]) than non-Asian studies (k=4; 0.65 [0.56-0.74]), with markedly reduced within-subgroup heterogeneity (I²=0.9%), suggesting geographic region as a primary source of variability. Two RCTs were rated high risk of bias; the remainder had some concerns or low risk.
CONCLUSIONS: The pooled EQ-5D utility of 0.61 in post-stroke hemiplegia provides a reference value for economic evaluations. The Asia-non-Asia disparity highlights the need for region-specific utility values in cost-utility modelling, particularly for Asian healthcare systems.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR55
Topic
Economic Evaluation, Patient-Centered Research, Study Approaches
Topic Subcategory
Health State Utilities
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)