de la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, Gemio del Rey IA. Quality-adjusted life years and surgical waiting list: Systematic review of the literature. World J Gastrointest Surg 2024; 16(4): 1155-1164 [PMID: 38690041 DOI: 10.4240/wjgs.v16.i4.1155]
Corresponding Author of This Article
Roberto de la Plaza Llamas, FACS, MD, MSc, PhD, Associate Professor, Chief Physician, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Calle del donante de sangre s/n, Guadalajara 19002, Spain. dlplr@yahoo.es
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is 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 and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Apr 27, 2024; 16(4): 1155-1164 Published online Apr 27, 2024. doi: 10.4240/wjgs.v16.i4.1155
Quality-adjusted life years and surgical waiting list: Systematic review of the literature
Roberto de la Plaza Llamas, Lorena Ortega Azor, Marina Hernández Yuste, Ludovica Gorini, Raquel Aránzazu Latorre-Fragua, Daniel Alejandro Díaz Candelas, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey
Roberto de la Plaza Llamas, Ludovica Gorini, Raquel Aránzazu Latorre-Fragua, Daniel Alejandro Díaz Candelas, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Guadalajara 19002, Spain
Roberto de la Plaza Llamas, Lorena Ortega Azor, Marina Hernández Yuste, Raquel Aránzazu Latorre-Fragua, Farah Al Shwely Abduljabar, Ignacio Antonio Gemio del Rey, Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares 28871, Madrid, Spain
Author contributions: de la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, and Gemio del Rey IA contributed to conception and design of the study, acquisition of data, and analysis and interpretation of data; de la Plaza Llamas R, Ortega Azor L, Hernández Yuste M, Gorini L, Latorre-Fragua RA, Díaz Candelas DA, Al Shwely Abduljabar F, and Gemio del Rey IA drafted the article or made critical revisions to important intellectual content in the manuscript; All authors gave final approval of the version of the article to be published.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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 and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roberto de la Plaza Llamas, FACS, MD, MSc, PhD, Associate Professor, Chief Physician, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Calle del donante de sangre s/n, Guadalajara 19002, Spain. dlplr@yahoo.es
Received: December 28, 2023 Peer-review started: December 28, 2023 First decision: January 16, 2024 Revised: January 26, 2024 Accepted: February 25, 2024 Article in press: February 25, 2024 Published online: April 27, 2024 Processing time: 115 Days and 14.8 Hours
Abstract
BACKGROUND
The quality-adjusted life year (QALY) is a metric that is increasingly used today in the field of health economics to evaluate the value of different medical treatments and procedures. Surgical waiting lists (SWLs) represent a pressing problem in public healthcare. The QALY measure has rarely been used in the context of surgery. It would be interesting to know how many QALYs are lost by patients on SWLs.
AIM
To investigate the relationship between QALYs and SWLs in a systematic review of the scientific literature.
METHODS
The study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. An unlimited search was carried out in PubMed, updated on January 19, 2024. Data on the following variables were investigated and analyzed: Specialty, country of study, procedure under study, scale used to measure QALYs, the use of a theoretical or real-life model, objectives of the study and items measured, the economic value assigned to the QALY in the country in question, and the results and conclusions published.
RESULTS
Forty-eight articles were selected for the study. No data were found regarding QALYs lost on SWLs. The specialties in which QALYs were studied the most in relation to the waiting list were urology and general surgery, with 15 articles each. The country in which the most studies of QALYs were carried out was the United States (n = 21), followed by the United Kingdom (n = 9) and Canada (n = 7). The most studied procedure was organ transplantation (n = 39), including 15 kidney, 14 liver, 5 heart, 4 lung, and 1 intestinal. Arthroplasty (n = 4), cataract surgery (n = 2), bariatric surgery (n = 1), mosaicplasty (n = 1), and septoplasty (n = 1) completed the surgical interventions included. Thirty-nine of the models used were theoretical (the most frequently applied being the Markov model, n = 34), and nine were real-life. The survey used to measure quality of life in 11 articles was the European Quality of Life-5 dimensions, but in 32 articles the survey was not specified. The willingness-to-pay per QALY gained ranged from $100000 in the United States to €20000 in Spain.
CONCLUSION
The relationship between QALYs and SWLs has only rarely been studied in the literature. The rate of QALYs lost on SWLs has not been determined. Future research is warranted to address this issue.
Core Tip: This review determined that the quality-adjusted life years (QALYs) lost on surgical waiting lists (SWLs) have not been evaluated in the literature. The relationship between QALYs and SWLs has been described mainly in organ transplantation and in experimental models. The willingness-to-pay per QALY gained ranged from $100000 in the United States to €20000 in Spain. Future research should address this question, as the information recorded is likely to be of value to health systems that are planning investments aimed at reducing SWLs and cutting costs.
