Health-related quality of life in Parkinson's disease: systematic review and meta-analysis of EuroQol (EQ-5D) utility scores

INTRODUCTION

Evaluating the Health-related quality of life (HRQoL) of individuals with Parkinson's disease (PD) holds significant importance in clinical and research settings. The EQ-5D is a widely recognized tool for comprehensive measurement of HRQoL using utility values. This study aims to systematically review and synthesize EQ-5D utility values from existing literature on patients with PD and their caregivers.

METHODS

We conducted a systematic search for studies that provided EQ-5D utility scores for patients with PD, using PubMed-Medline, Scopus, and Embase and selected the studies. The selected studies underwent systematic review, including an assessment of their quality. We performed a meta-analysis using a random-effect model and conducted a meta-regression analysis to investigate sources of heterogeneity among the studies.

RESULTS

The search result of 13,417 articles that were reviewed, 130 studies with 33,914 participants were selected for systematic review, and 79 studies were included for meta-analysis. The pooled EQ-5D utility values and visual analog score (VAS) among PD were 62.72% (60.53-64.93, I2 = 99.56%) and 0.60 (0.55-0.65, I2 = 99.81%), respectively. The pooled scores for caregivers' EQ-VAS and EQ-5D utility were 70.10% (63.99-76.20, I2 = 98.25%) and 0.71 (0.61-0.81, I2 = 94.88%), respectively. Disease duration (P < 0.05) showed a negative correlation with EQ-5D utility values on meta-regression.

CONCLUSION

The pooled utility values of PD and their caregivers help to understand their HRQoL and aid in conducting health economics research. The negative association between disease duration and utility values highlights the evolving nature of HRQoL challenges, suggesting the need for appropriate long-term disease management.

Ocular chlamydial infections. Clinicomicrobiological correlation

We report the results of conjunctival scrapings done in 234 eyes of 127 patients presenting with acute, chronic, or recurrent conjunctivitis. Although some patients had the classic features of superior pannus, Herbert's pits, conjunctival follicles, and tarsal distortions, others presented in a more subtle fashion mimicking allergic, viral, and bacterial diseases of the eyes. These scrapings were subjected to rapid diagnostic techniques and culture studies for the identification of chlamydial infections. The correlation between the clinical and laboratory diagnosis was studied. Of the 127 patients, 44 were culture positive for Chlamydia. Of these, only 19 had been clinically suspected to have chlamydial ocular disease, whereas the others were diagnosed to have bacterial, viral, allergic, or other diseases. This higher rate of Chlamydia detection is probably a reflection of endemicity of this infection in India. This article highlights the possible underdiagnosis of chlamydial ocular disease in the outpatient department and emphasizes the importance of microbiological evaluation in patients with atypical or chronic ocular surface disease.