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Quality of life measured by EQ-5D at different treatment time points for coronary artery disease: protocol for a systematic review and meta-analysis
  1. Elaine Lum1,2,
  2. Victoria McCreanor3,4,
  3. Nan Luo5,
  4. Nicholas Graves1
  1. 1Health Services & Systems Research, Duke-NUS Medical School, Singapore
  2. 2School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
  3. 3Jamieson Trauma Institute, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, Brisbane, Queensland, Australia
  4. 4Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
  5. 5Saw Swee Hock School of Public Health, National University of Singapore, Singapore
  1. Correspondence to Dr Elaine Lum; elaine_lum{at}


Introduction Cardiovascular disease is estimated to affect 423 million people globally. It caused 18 million deaths in 2017 and is projected to cost US$1 trillion by 2030 worldwide. Coronary artery disease (CAD) is the most common type of cardiovascular disease; CAD treatments can affect patients’ quality of life. Valuations of quality of life or health utilities are important for economic evaluations to ascertain relative health benefit when comparing treatments, and can be expected to change for individuals over time. The purpose of this systematic review is to estimate the quality of life of patients with CAD reported through the EuroQol 5 Dimension (EQ-5D) questionnaire, from short to longer term time points following different treatments.

Methods and analysis PubMed, Embase, Web of Science, the Cochrane Database of Systematic Reviews and the EuroQol website will be systematically searched from January 2003–March 2020. Published, peer-reviewed, English language studies assessing quality of life of patients with CAD using the EQ-5D will be included. One researcher will conduct the search; two researchers will independently screen titles and abstracts for potential inclusion. Full texts of potentially eligible studies will be retrieved for a second round of independent screening against inclusion and exclusion criteria by two researchers. The final list of included studies will be assessed for risk of bias using the RoB 2 and Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS-I) tools for randomised and non-randomised studies, respectively. Data extraction will be done by one researcher, with data extraction for a random 10% of included studies checked by a second researcher. Mean utility weights for individual studies will be combined using random effects model meta-analyses. A model will be run separately for each time point and treatment. Treatment time points of interest include baseline, 30 days, 6 months, 12–24 months and more than 24 months. Subgroup analysis of patients with diabetes who received interventional treatments—coronary artery bypass graft or percutaneous coronary intervention with or without stents, will be conducted for the same selected time points.

Ethics and dissemination Ethics approval is not required for systematic reviews. Results of the review will be disseminated via publication in a peer-reviewed journal.

  • coronary heart disease
  • quality in health care
  • health economics

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors The systematic review was conceptualised by all authors. EL drafted the protocol, which was critically reviewed by VM, NL and NG. All protocol authors read, provided feedback, and approved the final manuscript. Database searches will be completed by EL; articles will be screened for inclusion and exclusion by EL and VM; data extraction will be led by EL. Data analyses will be done by EL and VM, and reviewed by NL and NG. The guarantor of the review is NG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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