Utility Scores for Chronic Conditions in a Community-Dwelling Population

Mittmann, Nicole; Trakas, K; Risebrough, Nancy; Liu, Barbara A.

doi:10.2165/00019053-199915040-00004

Cited by 216 publications

(139 citation statements)

References 9 publications

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“…Analysis of a larger data set (N ‫ס‬ 80) of patients with TLE at our center revealed a similar standard deviation of 0.3 (S. Wiebe, unpublished observations). Also, population surveys using the HUI-II, a closely related instrument, produced a similar standard deviation in self-reported epilepsy (19).…”

Section: Discussionmentioning

confidence: 73%

“…In addition, we assessed the self-administered Health Utilities Index Mark III (HUI-III) (18). This generic, multiattribute, utility instrument has been used to obtain health state preferences of epilepsy respondents in general population surveys (19) and in ongoing epilepsy surgery trials (20), but its responsiveness in epilepsy has not yet been assessed. Individual patients answered all questionnaires at the same time.…”

Section: Hrqol Instrumentsmentioning

confidence: 99%

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Changes in Quality of Life in Epilepsy: How Large Must They Be to Be Real?

2001

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Summary:Purpose: The study goal was to assess the magnitude of change in generic and epilepsy-specific health-related quality-of-life (HRQOL) instruments needed to exclude chance or error at various levels of certainty in patients with medically refractory epilepsy.Methods: Forty patients with temporal lobe epilepsy and clearly defined criteria of clinical stability received HRQOL measurements twice, 3 months apart, using the Quality of Life in Epilepsy Inventory-89 and -31 (QOLIE-89 and QOLIE-31), Liverpool Impact of Epilepsy, adverse drug events, seizure severity scales, and the Generic Health Utilities Index (HUI-III). Standard error of measurement and test-retest reliability were obtained for all scales and for QOLIE-89 subscales. Using the Reliable Change Index described by Jacobson and Truax, we assessed the magnitude of change required by HRQOL instruments to be 90 and 95% certain that real change has occurred, as opposed to change due to chance or measurement error.Results: Clinical features, point estimates and distribution of HRQOL measures, and test-retest reliability (all > 0.70) were similar to those previously reported. Score changes of ±13 points in QOLIE-89, ±15 in QOLIE-31, ±6.3 in Liverpool seizure severity-ictal, ±11 in Liverpool adverse drug events, ±0.25 in HUI-III, and ±9.5 in impact of epilepsy exclude chance or measurement error with 90% certainty. These correspond, respectively, to 13, 15, 17, 18, 25, and 32% of the potential range of change of each instrument. Conclusions:Threshold values for real change varied considerably among HRQOL tools but were relatively small for QOLIE-89, QOLIE-31, Liverpool Seizure Severity, and adverse drug events. In some instruments, even relatively large changes cannot rule out chance or measurement error. The relation between the Reliable Change Index and other measures of change and its distinction from measures of minimum clinically important change are discussed.

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Section: Discussionmentioning

confidence: 73%

Section: Hrqol Instrumentsmentioning

confidence: 99%

Changes in Quality of Life in Epilepsy: How Large Must They Be to Be Real?

2001

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“…Therefore, developing valid and reliable methods for assessing the relative impact and distinguishing between chronic diseases is important when establishing program priorities and for estimating the cost and burden that various diseases present [3]. Quality of life is an important indicator in assessing the burden of disease especially for chronic conditions.…”

Section: Introductionmentioning

confidence: 99%

Using Health Utility Index (HUI) for Measuring the Impact on Health-Related Quality of Life (HRQL) Among Individuals with Chronic Diseases

Choi

et al. 2004

The Scientific World JOURNAL

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Quality of life is an important indicator in assessing the burden of disease, especially for chronic conditions. The Health Utilities Index (HUI) is a recently developed system for measuring the overall health status and health-related quality of life (HRQL) of individuals, clinical groups, and general populations.Using the HUI (constructed based on eight attributes: vision, hearing, speech, mobility, dexterity, cognition, emotion, and pain/discomfort) to measure the HRQL for chronic disease patients and to detect possible associations between HUI system and various chronic conditions, this study provides information to improve the management of chronic diseases.This study is of interest to data analysts, policy makers, and public health practitioners involved in descriptive clinical studies, clinical trials, program evaluation, population health planning, and assessments.Based on the Canadian Community Health Survey (CCHS) for 2000-01, the HUI was used to measure the quality of life for individuals living with various chronic conditions (Alzheimer/other dementia, effects of stroke, urinary incontinence, arthritis/rheumatism, bowel disorder, cataracts, back problems, stomach/intestinal ulcers, emphysema/COPD, chronic bronchitis, epilepsy, heart disease, diabetes, migraine headaches, glaucoma, asthma, fibromyalgia, cancers, high blood pressure, multiple sclerosis, thyroid condition, and other remaining chronic diseases). Logistic Regression Model was employed to estimate the associations between the overall HUI scores and various chronic conditions. The HUI scores ranged from 0.00 (corresponding to a state close to death) to 1.00 (corresponding to perfect health); negative scores reflect health states considered worse than death.The mean HUI score by sex and age group indicated the typical quality of life for persons with various chronic conditions. Logistic Regression results showed a strong relationship between low HUI scores (≤ 0.5 and 0.06-1.0) and certain chronic conditions. Age-and sex-adjusted Odds Ratio (OR) and p values showed an effect among individuals diagnosed with each chronic disease on the overall HUI score. Results of this study *Corresponding author. ©2004 with author.746 Mo et al.: Health Utility Index (HUI) TheScientificWorldJOURNAL (2004) 4, 746-757 showed that arthritis/rheumatism, heart disease, high blood pressure, cataracts, and diabetes had a severe impact on HRQL. Urinary incontinence, Alzheimer/other dementia, effects of stroke, cancers, thyroid condition, and back problems have a moderate impact. Food allergy, allergy other than food, asthma, migraine headaches, and other remaining chronic diseases have a relatively mild effect.It is concluded that major chronic diseases with significant health burden were associated with poor HRQL. The HUI scores facilitate the measurement and interpretation of results of health burden and the HRQL for individuals with chronic diseases and can be useful for development of strategies for the prevention and control of chronic diseases.

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“…Health utility value of no incontinence 0.93 [29] Health utility value for SUI 0.71 [29] Health utility value for treatment of de novo urge with anticholinergic medication 0.81 [29] Health utility value for de novo urge after MUS operation 0.74 [29] Health utility value for repeated MUS operation 0.89 [23,29] MUS: Midurethral sling; SUI: Stress urinary incontinence.…”

Section: Probabilitiesmentioning

confidence: 99%

“…Health utility weights can range from 0-1, where 0 represents death and 1 represent perfect health; in theory, it is possible to have a health utility weight below 0 [36]. Since a 1-year time frame was used in this study, the health utilities from Mittmann et al were converted to QALYs [29]. The health utility weight for no postoperative incontinence was 0.93.…”

Section: Probabilitiesmentioning

confidence: 99%

Cell-based Therapy for the Treatment of Female Stress Urinary Incontinence: An Early Cost–Effectiveness Analysis

et al. 2018

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Aim:To perform an early cost-effectiveness analysis of in vitro expanded myoblasts (IVM) and minced myofibers versus midurethral slings (MUS) for surgical treatment of female stress urinary incontinence. Methods: Cost-effectiveness and sensitivity analyses were performed using a decision tree comprising previously published data and expert opinions. Results & conclusion: In the base case scenario, MUS was the cost-effective strategy with a negative incremental cost-effectiveness ratio compared with IVM and a positive incremental cost-effectiveness ratio compared with minced myofibers. However, the sensitivity analysis indicates that IVM may become an alternative providing greater effect at a higher cost. With the possibility of becoming more effective, IVM treatment would be advantageous over MUS given its reduced invasiveness and lower risks of complications. Urinary incontinence (UI) is a common medical condition that has a negative impact on the quality of life of individuals of all ages, racial and ethnic groups. The prevalence of UI is about two-to-four-times higher in women than in men, ranging from 11 to 57% [1]. The most common subtype is stress urinary incontinence (SUI), affecting roughly 50% of any women with UI [2]. SUI describes a condition where there is an involuntary leak of urine when intra-abdominal pressure rises, for example, when coughing, sneezing, laughing or during other physical activity. SUI has not only a severe impact on quality of life but it also places a substantial economic burden on the healthcare system and society [3][4][5]. In the USA, for example, it has been estimated that in 1998, the average direct medical cost of SUI amounted US$5642 per patient, while the indirect workplace expenses were US$4208 [3]. Evidence suggests that these costs have experienced an age-related increase over the last years [5].The clinical management of SUI is complex and may involve conservative treatments, such as pelvic floor muscle training and pharmacotherapy, as well as surgical procedures. Currently, the gold standard for surgical management of SUI in women is the midurethral sling (MUS), which displays a cure rate of 80-95% [6][7][8]. While MUS has a high success rate, 5-20% of the patients will have persisting incontinence thus needing to undergo sling removal and subsequent treatment [9]. The postoperative complications reach as high as 7.2% for erosion and the risk of getting a perioperative urinary tract infection is 17.2% [10]. As an alternative to MUS implantation, with the goal of targeting the underlying etiology rather than relieving the symptoms, cell-based therapies (CBTs) have recently emerged [11]. Among the different modalities of CBT, intraurethral injection of autologous skeletal myoblasts appears as one of the most promising regenerative therapies for SUI [12]. While various large-scale clinical trials are still ongoing, results from the initial clinical studies have shown that these approaches appear to be safe and moderately effective. Remarkably, a recent study has shown ...

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Utility Scores for Chronic Conditions in a Community-Dwelling Population

Abstract: This study provides health economists, researchers and policy-makers with a reference for health utilities of various chronic conditions, different age groups, gender and comorbidities.

Cited by 216 publications

References 9 publications

Changes in Quality of Life in Epilepsy: How Large Must They Be to Be Real?

Changes in Quality of Life in Epilepsy: How Large Must They Be to Be Real?

Using Health Utility Index (HUI) for Measuring the Impact on Health-Related Quality of Life (HRQL) Among Individuals with Chronic Diseases

Cell-based Therapy for the Treatment of Female Stress Urinary Incontinence: An Early Cost–Effectiveness Analysis

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