EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.

Department of Experimental and Clinical Pharmacology Medical University of Warsaw ul Banacha 1b 02 097 Warsaw Poland

Department of Health Economics Centre for Public Health Medical University of Vienna Kinderspitalgasse 15 1 1090 Vienna Austria

Department of Health Economics Corvinus University of Budapest Fővám tér 8 1093 Budapest Hungary

Department of Health Economics Corvinus University of Budapest Fővám tér 8 1093 Budapest Hungary Department of Rheumatology Flór Ferenc County Hospital Semmelweis tér 1 2143 Kistarcsa Hungary

Department of Public Health Academic Medical Center University of Amsterdam Amsterdam Public Health Research Institute Meibergdreef 9 22660 1100 DD Amsterdam The Netherlands

Department of Social Pharmacy and Pharmacoeconomics Faculty of Pharmacy Medical University Sofia Bulgaria

Doctoral School of Business and Management Corvinus University of Budapest Fővám tér 8 1093 Budapest Hungary Sandoz Hungária Kft Bartók Béla u 43 47 1134 Budapest Hungary Department of Health Economics Corvinus University of Budapest Fővám tér 8 1093 Budapest Hungary

Institute for Economic Research Kardeljeva ploščad 17 1000 Ljubljana Slovenia

Institute of Rheumatology Na Slupi 4 Prague 128 00 Czech Republic

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$a Zrubka, Zsombor $u Doctoral School of Business and Management, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary. Sandoz Hungária Kft, Bartók Béla u. 43-47, 1134, Budapest, Hungary. Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., 1093, Budapest, Hungary.

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$a EQ-5D studies in musculoskeletal and connective tissue diseases in eight Central and Eastern European countries: a systematic literature review and meta-analysis / $c Z. Zrubka, F. Rencz, J. Závada, D. Golicki, VP. Rupel, J. Simon, V. Brodszky, P. Baji, G. Petrova, A. Rotar, L. Gulácsi, M. Péntek,

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$a EQ-5D is becoming the preferred instrument to measure health-state utilities involved in health technology assessment. The objective of this study is to assess the state of EQ-5D research in musculoskeletal disorders in 8 Central and Eastern European countries and to provide a meta-analysis of EQ-5D index scores. Original research articles published in any language between Jan 2000 and Sept 2016 were included, if they reported any EQ-5D outcome from at least two musculoskeletal patients from Austria, Bulgaria, the Czech Republic, Hungary, Poland, Romania, Slovakia, or Slovenia. Risk of bias was assessed with the Cochrane Collaboration's tool. Twenty-nine articles (5992 patients) were included on rheumatoid arthritis (n = 7), osteoporosis (n = 5), chronic pain (n = 5), osteoarthritis (n = 4), ankylosing spondylitis (n = 2), psoriatic arthritis (n = 2), total hip replacement (n = 2), and scleroderma (n = 2). Low back pain was under-represented, while studies in neck pain, systemic lupus erythematosus, gout, and childhood disorders were lacking. EQ-5D index scores were reported in 24 studies, while the version of the instrument and the value-set was not specified in 41% and 46% of the articles, respectively. Meta-analysis was performed on 24 disease states involving 6876 observation points. Intervention effect was reported in 22 subgroups, out of which risk of bias was low in 41%. This review provides recommendations to improve reporting standards of EQ-5D results and highlights potential areas for future research. Coordinated research in conditions with greatest public health impact as well as a development of a regional value-set could provide locally relevant health-state utilities that are transferable among countries within the region.

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$a Rupel, Valentina Prevolnik $u Institute for Economic Research, Kardeljeva ploščad 17, 1000, Ljubljana, Slovenia.

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