Health state utilities in patients with diabetic retinopathy, diabetic macular oedema and age-related macular degeneration: a systematic review

Background Health state utility values (HSUVs) are important in the assessment of the cost effectiveness of new interventions. In the case of visual conditions, models generally tend have tended to be built around a set of health states defined by visual acuity (VA). The aim of this review was to assess the impact of VA on HSUVs in patients with diabetic retinopathy, diabetic macular oedema or age-related macular degeneration. Methods A systematic literature search was undertaken in major bibliographic databases to identify articles reporting on the relationship between HSUVs and vision. Data were extracted for population characteristics, visual levels and estimated utilities. Evidence from reported statistical models, where available, was considered in the evaluation of vision in the better-seeing eye and the worse-seeing eye. Due to the heterogeneity of included studies, a narrative synthesis was undertaken. Results Of the 17 relevant studies, 9 studies had data that could be used in the analysis of the impact of vision on HSUVs. Visual loss was associated with a marked impact on health utilities. However, the relationship was not comparable between conditions or by measure of HSUVs. Key results included the finding that overall, self-rated time-trade off estimates were more likely to discriminate between different VA levels than EQ-5D values. Additionally, a stronger correlation was observed between HSUVs and better-seeing eye VA compared to worse-seeing eye VA. Conclusions Visual acuity has a significant impact on HSUVs. Nevertheless, care must be taken in the interpretation and use of estimates in cost-effectiveness models due to differences in measures and population diversity

Exploring the role of acculturation in brand choice: a new perspective for targeting Indians living in the UK

Indians are the largest UK ethnic minority, contributing significantly to the UK economy. Although this group's considerable spending power makes them of interest to marketing practitioners, greater insight into their consumer behaviour is required. An understanding of the influence of cultural factors on preferences and behaviour is a priority. This qualitative article considers how consumer acculturation affects the brand preferences of British Indian consumers. Berry's acculturation taxonomy and Mendoza's Cultural Life Style Inventory underpin the organisation of the data collection. The findings reveal distinctive brand choice patterns for individuals from different acculturation categories. Separated individuals use more of the ethnic brands than host brands; most integrated individuals are familiar with both ethnic and host brands; whereas assimilated individuals have a much narrower brand understanding, being familiar mainly with the host brands. The implications for researchers and practitioners are explored