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15-01-2022 | Review

Health-related quality of life among patients with gallstone disease: a systematic review and meta-analysis of EQ-5D utility scores

Quality of Life Research
Y. ArpithaAnbu Deborah, Madhumitha Haridoss, Meenakumari Natarajan, Vasna Joshua, Bhavani Shankara Bagepally
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Supplementary Information

The online version contains supplementary material available at https://​doi.​org/​10.​1007/​s11136-021-03067-x.
Y. ArpithaAnbu Deborah and Madhumitha Haridoss have contributed equally, and deemed to be lead authors.

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Gallstone disease or cholelithiasis is a chronic illness that usually presents with pain in the abdomen, vomiting and indigestion leading to impaired quality of life. EQ-5D utility score is a validated measure of health-related quality of life (HRQoL). We systematically reviewed the literature and synthesised EQ-5D utility scores among patients with gallstone disease and its improvement on treatment.


We have systematically searched observational studies reporting EQ-5D utility scores of gallstone disease in PubMed, Scopus, and Embase databases, from inception until February 2021. We selected the studies adhering to the PRISMA guidelines. The selected studies were reviewed, and the EQ-5D utility values of pre and post cholecystectomy were pooled using the random-effects model.


From identified 4,817 records of database search, eleven studies predominantly from western countries with 2,189 participants were included for systematic review and meta-analysis. The pooled EQ-5D and visual analogue scores were 0.87 (0.82 to 0.91, I2 = 93.73%) and 83.30 (60.59 to 106.12, I2 = 99.30%) respectively with high heterogeneity. The pooled EQ-5D and EQ-5D visual analogue scores post cholecystectomy treatment were 0.93 (0.91 to 0.95, I2 = 90.17%) and 91.7 (85.99 to 96.35, I2 = 97.93%) respectively. The mean difference between the baseline and post intervention were 0.05 (0.01 to 0.10, I2 = 93.50%) and 10.58 (-8.63 to 29.79, I2 = 98.32%) for EQ-5D and visual analogue scores respectively with high heterogeneity between the studies.


The pooled mean difference indicates improvement in HRQoL after cholecystectomy but with high heterogeneity. Further high-quality studies from Asian countries are required for globally representative quantification and precise estimates of HRQoL among gallstone diseases.

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