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Health state utilities for economic evaluation of bariatric surgery: a comprehensive systematic review and meta-analysis


Xia, Q and Campbell, JA and Ahmad, H and Si, L and de Graaff, B and Otahal, P and Palmer, AJ, Health state utilities for economic evaluation of bariatric surgery: a comprehensive systematic review and meta-analysis, Obesity Reviews, 21, (8) Article e13028. ISSN 1467-7881 (2020) [Refereed Article]

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Copyright 2020 World Obesity Federation. This is the peer reviewed version of the following article, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

DOI: doi:10.1111/obr.13028


Health state utilities (HSUs) are health economic metrics that capture and assess health-related quality of life (HRQoL). They are essential in health-economic evaluations when calculating quality-adjusted life years. We investigated published studies reporting bariatric surgery-related HSUs elicited through direct or indirect (multiattribute utility instrument [MAUI]) patient-reported methods (PROSPERO registration number: CRD42019131725). Mean HSUs for different time points and HSU changes over time (where feasible) were meta-analysed using random-effects models. Of the 950 potentially relevant identified studies, n = 28 (2004-2018) qualified for data extraction, with n = 85 unique HSUs elicited mainly from the EQ-5D (88%). Most (75%) studies were published after 2013. The follow-up duration varied between studies and was often limited to 12 months. The pooled mean HSU was 0.72 (0.67-0.76) at baseline/presurgery (n = 18) and 0.84 (0.79-0.89) one-year postsurgery (n = 11), indicating a 0.11 (0.09-0.14) utility unit increment. EQ-5D showed the similar results. This positive difference can be partially explained by BMI and/or co-morbidities status improvement. This study provides a valuable summary of HSUs to future bariatric surgery-related cost-utility models. However, more well-designed higher-quality bariatric-related HSU studies are expected for future reviews to improve the available evidence. We suggest that researchers select an MAUI that is preferentially sensitive to the study population.

Item Details

Item Type:Refereed Article
Keywords:EQ-5D, health state utilities, meta-analysis, multiattribute utility instruments, weight loss surgery
Research Division:Economics
Research Group:Applied economics
Research Field:Health economics
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Xia, Q (Miss Qing Xia)
UTAS Author:Campbell, JA (Dr Julie Campbell)
UTAS Author:Ahmad, H (Mr Hasnat Ahmad)
UTAS Author:Si, L (Mr Lei Si)
UTAS Author:de Graaff, B (Dr Barbara de Graaff)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:138093
Year Published:2020
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2020-03-24
Last Modified:2021-03-19

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