Health-related quality of life with herpes zoster: systematic review and analysis of individual patient data from 9 cohorts
Bibliographic record
Abstract
Abstract Background Herpes zoster (HZ), or shingles, is a painful rash caused by reactivation of latent varicella zoster virus infection. To better inform health economic evaluation of interventions against HZ, we synthesised evidence from studies measuring the health-related quality of life (HRQoL) of patients with HZ using the EuroQol EQ-5D instrument. Methods We systematically reviewed the scientific literature up to 31st October 2024 to identify all studies of HRQoL with HZ from PubMed and Web of Science. We obtained individual-level data from cohorts measuring HRQoL using the EQ-5D. We fit a survival model to the duration of the disutility period, and a mixture distribution to capture changes in HRQoL during the disutility period, to estimate the quality-adjusted life years (QALY) lost due to HZ by age. Results We identified 22 studies reporting a measure of HRQoL with HZ. Of these, 13 studies, covering 16 patient cohorts, measured HRQoL using the EQ-5D tool. We included individual patient data from 9 of these 16 cohorts (1,345 patients) in our quantitative synthesis. We estimated the disutility period for HZ to range between 121 (95% credible interval [CrI]: 112-134) days for 50-year-olds to 193 (163-226) days for 90-year-olds. We estimated the QALY loss due to an HZ episode to range from 0.095 (0.086 – 0.104) at 50 years to 0.146 (0.124 – 0.172) at 90 years of age. Conclusions This study is the first to derive a QALY loss estimate for HZ through a systematic review of the literature and analysis of individual patient data. Longer follow-up studies for HZ patients will be important in the future to robustly capture the effect of long-term sequelae and may potentially lead to a higher estimated QALY loss.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.075 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.017 |
| Bibliometrics | 0.013 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".