The importance of accounting for the uncertainty around the preference-based health-related quality-of-life measures value sets: a systematic review

Preference-based measures of health-related quality-of-life including, but not limited to, the EQ-5D, HUI2 and the SF-6D have been increasingly used in calculations of quality-adjusted life years for cost effectiveness analyses. However, the uncertainty around the measures' value sets is commonly ignored in economic evaluation. There are several types of uncertainties, including methodological, structural, and parameter uncertainties, with the latter being the focus of this review paper. The objective is to highlight the gap in the literature regarding the existence of uncertainty in the value sets, focusing mainly on the EQ-5D and SF-6D. To the best of the authors' knowledge, this is the first systematic review revolving around uncertainty. After searching extensively for studies involving uncertainties in all preference-based measures, the results showed that uncertainty has been approached through different means, while parameter uncertainty has been ignored in most, if not all, cases. These findings suggest that uncertainty should be accounted for when using preference-based measures in economic evaluations. Ignoring this additional information could impact misleadingly on policy decisions.