Which Nontraditional Outcomes Should Be Measured in Healthcare Decision-Making in Schizophrenia? A Systematic Review

Authors

  • Ana Vieta PharmD, MPhil,

    Corresponding author
    1. Ana Vieta, PharmD, MPhil, is Senior Researcher, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Xavier Badia, MD, PhD, is Director, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Enric Álvarez, MD, PhD, is Head of the Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, CiberSam, Barcelona, Spain; and José A. Sacristán, MD, PhD, is Director, Clinical Research Department, Lilly S.A., Madrid, Spain.
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  • Xavier Badia MD, PhD,

    1. Ana Vieta, PharmD, MPhil, is Senior Researcher, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Xavier Badia, MD, PhD, is Director, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Enric Álvarez, MD, PhD, is Head of the Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, CiberSam, Barcelona, Spain; and José A. Sacristán, MD, PhD, is Director, Clinical Research Department, Lilly S.A., Madrid, Spain.
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  • Enric Álvarez MD, PhD,

    1. Ana Vieta, PharmD, MPhil, is Senior Researcher, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Xavier Badia, MD, PhD, is Director, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Enric Álvarez, MD, PhD, is Head of the Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, CiberSam, Barcelona, Spain; and José A. Sacristán, MD, PhD, is Director, Clinical Research Department, Lilly S.A., Madrid, Spain.
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  • José A. Sacristán MD, PhD

    1. Ana Vieta, PharmD, MPhil, is Senior Researcher, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Xavier Badia, MD, PhD, is Director, Health Economics and Outcomes Research Department, IMS, Barcelona, Spain; Enric Álvarez, MD, PhD, is Head of the Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Universitat Autónoma de Barcelona, CiberSam, Barcelona, Spain; and José A. Sacristán, MD, PhD, is Director, Clinical Research Department, Lilly S.A., Madrid, Spain.
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  • Conflict of Interest Statement

  • Ms. Vieta and Dr. Badia report receiving honoraria or consulting fees from Lilly. Dr. Álvarez reports receiving honoraria fees from Lilly for his participation in clinical trials and consulting activities. Dr. Sacristán is an employee of Eli Lilly and Company. The authors have indicated that they have no other conflicts of interest regarding the content of this article.

  • This research was supported by Lilly S.A. (Madrid, Spain).

avieta@imscg.com, with a copy to the Editor: gpearson@uchc.edu

Abstract

PURPOSE:  This article aims to define the utility of nontraditional outcomes (NTOs) in healthcare decision-making in schizophrenia.

DESIGN AND METHODS:  A systematic review of studies published between January 1, 1996, and December 31, 2008, was performed. A 10-point evidence-based utility index (UI) was used to assess the utility of NTOs: high (UI: 7.5–10), medium (UI: ≥5 to <7.5), and low (UI: <5) utility.

FINDINGS:  Of 736 citations identified, 94 met inclusion criteria. One hundred ninety-four NTOs were identified (patient reported outcomes [38.7%] and economic outcomes [61.3%]). Of these, 68 (35.1%) were appropriate for decision making.

PRACTICE IMPLICATIONS:  Numerous NTOs with low utility in schizophrenia are being used for healthcare policy and clinical care by policy makers, managers, and healthcare professionals. Medium and low utility NTOs should be used with caution.

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