scholarly journals The valuation of outcomes for the temporary and chronic health states associated with Chlamydia trachomatis infection

2021 ◽  
Author(s):  
Chidubem Okeke Ogwulu ◽  
Louise Jackson ◽  
Philip Kinghorn ◽  
Tracy E Roberts
Keyword(s):  
Ectopic Pregnancy ◽  
Chlamydia Infection ◽  
Economic Evaluations ◽  
Health State ◽  
Health States ◽  
Chronic Health ◽  
Chlamydia Trachomatis Infection ◽  
Face To Face ◽  
Health State Utility Values ◽  
And Control

Background: Eliciting health-state utility values (HSUVs) for some diseases is complicated by the mix of associated temporary (THSs) and chronic health states (CHSs). This study uses one such disease, chlamydia infection, to explore the challenges. The objectives were to: 1) Define a set of health-state descriptions related to chlamydia and 2) Derive HSUVs for these health states (both temporary and chronic). Methods: HSUVs were elicited for seven health states (five THSs and two CHSs) depicting the symptoms of chlamydia, developed using evidence from the literature and clinical experts. The chained time trade-off (TTO) and visual analogue scale (VAS) were applied to THSs while conventional TTO was applied to the CHSs. Ectopic pregnancy was used as the anchor for the chained TTO approach. The study sampled from three different population groups and the survey was administered face-to-face. Results: One hundred participants were assessed with an interview completion rate of 100%. Mean TTO utilities were consistently higher than VAS scores. The aggregated mean chained TTO results for the THS ranged from 0.46 (SD, 0.24) for ectopic pregnancy, to 0.77 (SD 0.21) for cervicitis. Conclusions: Chained TTO was shown to be feasible in this population and the resulting HSUVs could have implications for economic evaluations for chlamydia prevention and control. Methodological challenges included the development of health-state descriptions, the selection, and the duration of appropriate anchor state.

Estimating Utility Values for Health States of DFU Patients Using EQ-5D-5L and cTTO

2021 ◽  
pp. 153473462110143
Author(s):  
Morteza Arab-Zozani ◽  
Hossein Safari ◽  
Zoha Dori ◽  
Somayeh Afshari ◽  
Hosein Ameri ◽  
...  
Keyword(s):  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Economic Modeling ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
The Mean ◽  
The Difference ◽  
Diabetes Center ◽  
Health State Utility Values

Health-state utility values of diabetic foot ulcer (DFU) patients are necessary for clinical praxis and economic modeling. The purpose of this study was to estimate utility values in DFU patients using the EuroQol-5-dimension-5-level (EQ-5D-5L) and composite time trade-off (cTTO). The EQ-5D-5L and cTTO were used for estimating utility values. Data were collected from 228 patients referred to the largest governmental diabetes center in the South of Iran, Yazd province. When appropriate, independent sample t-test or analysis of variance test was used to test the difference in the utility values in each of the demographic and clinical characteristics of the patients. Finally, the BetaMix was used to identify predictors of the utility values. The means of EQ-5D-5L and cTTO values were 0.55( SD 0.21) and 0.67( SD 0.23), respectively. Anxiety and pain were the most common problems reported by the patients. The difference between the mean EQ-5D-5L values was significant for age, grade of ulcer, number of comorbidities, and having complications. In addition, variables of gender, age, grade of ulcer, and having complications were significant predictors of the EQ-5D-5L. The difference between the mean cTTO values was significant for age, employment status, grade of ulcer, number of comorbidities, and having complications. Moreover, variables of gender, age, grade of ulcer, number of comorbidities, and developing complications were significant predictors of cTTO. The current study provided estimates of utility values for DFU patients for clinical praxis and economic modeling. These estimates, similar to utilities reported in other studies, were low. Identifying strategies to decrease anxiety/depression and pain in patients is important to improve the utility values.

scholarly journals NCOG-36. FIRST HEALTH UTILITIES OF GLIOBLASTOMA PATIENTS USING TTFIELDS TREATMENT

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii137-ii137
Author(s):  
Gordon Chavez ◽  
Christina Proescholdt
Keyword(s):  
Population Sample ◽  
National Health System ◽  
Medical Decision ◽  
Economic Evaluations ◽  
Health State ◽  
High Quality ◽  
Health States ◽  
Tumor Treating Fields ◽  
Health State Utilities ◽  
The Uk

Abstract BACKGROUND Despite the importance of Health State Utilities for health policy and medical decision making, there are no publications that provide high quality utility values estimated from glioblastoma multiforme (GBM) patients. Published health economic evaluations for GBM treatments rely on utilities determined by Garside et al. (2007), which used the standard gamble method in healthy panel members of the UK National Health System. There are no published utilities for GBM estimated from a general population sample, and there are no utility estimates whatsoever for Tumor Treating Fields (TTFields) users. METHODS We designed a study to remedy this major deficit by eliciting utilities directly from GBM patients using the EuroQol 5-Dimension (EQ-5D) survey. The EQ-5D is a widely used and NICE-recommended tool for the estimation of health state utilities. The survey is composed of a questionnaire that asks patients to specify their health state along 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. Statistical models provided by EuroQol’s network of researchers convert this data into health state utility estimates. RESULTS The EQ-5D questionnaire is administered to active patients using TTFields treatment during the study duration, allowing the elicitation of health preference measures for different glioblastoma health states based on: progression status (progressed vs. non-progressed), current treatments (TTFields only vs. TTFields + others) and time-from-diagnosis (0-12 months vs. > 12 months) CONCLUSION These results are important for understanding the patient preferences using TTFields treatment and communicating these preferences to decision makers. This study is the first to provide direct, high quality utility measures in glioblastoma patients using TTFields treatment.

scholarly journals Valuation of the EQ-5D-3L in Russia

2021 ◽  
Author(s):  
Vitaly Omelyanovskiy ◽  
Nuriya Musina ◽  
Svetlana Ratushnyak ◽  
Tatiana Bezdenezhnykh ◽  
Vlada Fediaeva ◽  
...  
Keyword(s):  
Health Problems ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Computer Assisted ◽  
Health State ◽  
Primary Analysis ◽  
Health States ◽  
Value Set ◽  
Model Combining ◽  
Life Years

Abstract Purpose The most widely used generic questionnaire to estimate the quality of life for yielding quality-adjusted life years in economic evaluations is EQ-5D. Country-specific population value sets are required to use EQ-5D in economic evaluations. The aim of this study was to establish an EQ-5D-3L value set for Russia. Methods A representative sample aged 18+ years was recruited from the Russia`s general population. Computer-assisted face–to–face interviews were conducted based on the standardized valuation protocol using EQ-Portable Valuation Technology. Population preferences were elicited utilizing both composite time trade-off (cTTO) and discrete choice experiment (DCE) techniques. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. Results A total of 300 respondents who successfully completed the interview were included in the primary analysis. 120 (40.0%) respondents reported no health problems of any dimension, and 56 (18.7%) reported moderate health problems in one dimension of the EQ‐5D‐3L. Median self-rated health using EQ‐VAS was 80 with IQR 70–90. Comparing cTTO and DCE-predicted values for 243 health states resulted in a similar pattern. This supports the use of hybrid models. The predicted value based on the preferred model for the worst health state “33333” was −0.503. Mobility dimension had the most significant impact on the utility decrement, and anxiety/depression had the lowest decrement. Conclusion Determining a Russian national value set may be considered the first step towards promoting cost-utility analysis use to increase comparability among studies and improve the transferability of healthcare decision-making in Russia.

Burden and health state utility values of eating disorders: results from a population-based survey

2019 ◽  
pp. 1-8
Author(s):  
Long Khanh-Dao Le ◽  
Cathrine Mihalopoulos ◽  
Lidia Engel ◽  
Stephen Touyz ◽  
David Alejandro González-Chica ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Binge Eating ◽  
Health State Utility ◽  
Economic Evaluations ◽  
Health State ◽  
Life Questionnaire ◽  
Healthy Weight ◽  
Utility Values ◽  
Life Years ◽  
Health State Utility Values

Abstract Background There are no published estimates of the health state utility values (HSUVs) for a broad range of eating disorders (EDs). HSUVs are used in economic evaluations to determine quality-adjusted life years or as a measure of disorder burden. The main objective of the current study is to present HSUVs for a broad range of EDs based on DSM-5 diagnoses. Methods We used pooled data of two Health Omnibus Surveys (2015 and 2016) including representative samples of individuals aged 15 + years living in South Australia. HSUVs were derived from the SF-6D (based on the SF-12 health-related quality of life questionnaire) and analysed by ED classification, ED symptoms (frequency of binge-eating or distress associated to binge eating) and weight status. Multiple linear regression models, adjusted for socio-demographics, were used to test the differences of HSUVs across ED groups. Results Overall, 18% of the 5609 individuals met criteria for ED threshold and subthreshold. EDs were associated with HSUV decrements, especially if they were severe disorders (compared to non-ED), binge ED: −0.16 (95% CI −0.19 to −0.13), bulimia nervosa: −0.12, (95% CI −0.16 to −0.08). There was an inverse relationship between distress related binge eating and HSUVs. HSUVs were lower among people with overweight/obese compared to those with healthy weight regardless of ED diagnosis. Conclusions EDs were significantly associated with lower HSUVs compared to people without such disorders. This study, therefore, provides new insights into the burden of EDs. The derived HSUVs can also be used to populate future economic models.

Methods for obtaining health state utility values: generic preference-based measures of health

2016 ◽  
Author(s):  
John Brazier ◽  
Julie Ratcliffe ◽  
Joshua A. Salomon ◽  
Aki Tsuchiya
Keyword(s):  
Health State Utility ◽  
Health State ◽  
Multiattribute Utility ◽  
Health States ◽  
Utility Values ◽  
Published Evidence ◽  
State Classification ◽  
Health State Utility Values ◽  
Generic Measures ◽  
Health State Classification

This chapter describes the six most widely used generic preference-based measures of health (GPBMs) (also known as multiattribute utility scales): EQ-5D, SF-6D, HUI, AQoL, 15D, and QWB. GPBMs have become the most widely used method for obtaining health state utility values. They contain a health state classification with multilevel dimensions that together describe a universe of health states and a set of values (where full health = 1 and dead = 0) for each health state obtained by eliciting the preferences (typically) of members of the general population. These measures are reviewed in terms of their content, methods of valuation, the scores they generate, and the possible reasons for the differences found. Their performance is reviewed using published evidence on their validity across conditions, and the implications for their use in policy making discussed. The chapter also reviews the generic measures available for use in populations of children and adolescents.

scholarly journals The estimation of health state utility values in rare diseases: overview of existing techniques

2020 ◽  
Vol 36 (5) ◽  
pp. 469-473
Author(s):  
Michela Meregaglia ◽  
Elena Nicod ◽  
Michael Drummond
Keyword(s):  
Rare Diseases ◽  
Ethical Issues ◽  
Health State Utility ◽  
Health State ◽  
Health States ◽  
Promising Alternative ◽  
Utility Values ◽  
Life Threatening ◽  
Pros And Cons ◽  
Health State Utility Values

There are several techniques for estimating health state utility values, each of which presents pros and cons in the context of rare diseases (RDs). Direct approaches (e.g. standard gamble and time trade-off) may be too demanding for patients with RDs, since most of them affect young children or cause cognitive impairment. The alternatives are using “vignettes” that describe hypothetical health states for the general public, which may not reflect the heterogeneous manifestations of RDs, or multi-attribute utility instruments (i.e. indirect techniques), such as EQ-5D, which may be less sensitive in capturing the specificities of RDs. The “rule of rescue” approach is a promising alternative in RDs, since it prioritizes identifiable patients with life-threatening or disabling conditions. However, it raises measurement challenges and ethical issues. Furthermore, the literature reports on relevant implications of choosing a technique over others for health technology assessment, which should be considered in relation to individual RDs.

scholarly journals Comparison of online and face-to-face valuation of the EQ-5D-5L using composite time trade-off

2020 ◽  
Author(s):  
Ruixuan Jiang ◽  
James Shaw ◽  
Axel Mühlbacher ◽  
Todd A. Lee ◽  
Surrey Walton ◽  
...  
Keyword(s):  
Task Engagement ◽  
Health State ◽  
Health States ◽  
Trade Off ◽  
Face To Face ◽  
Random Intercept ◽  
Trade Offs ◽  
Trading Patterns ◽  
Value Sets ◽  
Better Than

Abstract Objective The aim of this study was to compare online, unsupervised and face-to-face (F2F), supervised valuation of EQ-5D-5L health states using composite time trade-off (cTTO) tasks. Methods The official EuroQol experimental design and valuation protocol for the EQ-5D-5L of 86 health states were implemented in interviewer-assisted, F2F and unsupervised, online studies. Validity of preferences was assessed using prevalence of inconsistent valuations and expected patterns of TTO values. Respondent task engagement was measured using number of trade-offs and time per task. Trading patterns such as better-than-dead only was compared between modes. Value sets were generated using linear regression with a random intercept (RILR). Value set characteristics such as range of scale and dimension ranking were evaluated between modes. Results Five hundred one online and 1,134 F2F respondents completed the surveys. Mean elicited TTO values were higher online than F2F when compared by health state severity. Compared to F2F, a larger proportion of online respondents did not assign the poorest EQ-5D-5L health state (i.e., 55555) the lowest TTO value ([Online] 41.3% [F2F] 12.2%) (p < 0.001). A higher percentage of online cTTO tasks were completed in 3 trade-offs or fewer ([Online] 15.8% [F2F] 3.7%), (p < 0.001). When modeled using the RILR, the F2F range of scale was larger than online ([Online] 0.600 [F2F] 1.307) and the respective dimension rankings differed. Conclusions Compared to F2F data, TTO tasks conducted online had more inconsistencies and decreased engagement, which contributed to compromised data quality. This study illustrates the challenges of conducting online valuation studies using the TTO approach.

scholarly journals A systematic review of health state utility values for thyroid cancer

2020 ◽  
Author(s):  
Rachel Houten ◽  
Nigel Fleeman ◽  
Eleanor Kotas ◽  
Angela Boland ◽  
Tosin Lambe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Cancer ◽  
Cost Effectiveness ◽  
Differentiated Thyroid Cancer ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
Sf 36 ◽  
Health State Utility Values ◽  
Eortc Qlq

Abstract Purpose Health state utility values are commonly used to inform economic evaluations and determine the cost-effectiveness of an intervention. The aim of this systematic review is to summarise the utility values available to represent the health-related quality of life (HRQoL) of patients with thyroid cancer. Methods Eight electronic databases were searched from January 1999 to April 2019 for studies which included assessment of HRQoL for patients with thyroid cancer. Utility estimates derived from multiple sources (EuroQol questionnaire 5-dimension (EQ-5D), time trade-off [TTO] and standard gamble [SG] methods) were extracted. In addition, utility estimates were generated by mapping from SF-36 and EORTC QLQ-30 to the EQ-5D-3L UK value set using published mapping algorithms. Results Searches identified 33 eligible studies. Twenty-six studies reported HRQoL for patients with differentiated thyroid cancer and seven studies for patients with general thyroid cancer. We identified studies which used different methods and tools to quantify the HRQoL in patients with thyroid cancer, such as the EQ-5D-3L, SF-36, EORTC QLQ-30 and SG and TTO techniques to estimate utility values. Utility estimates range from 0.205 (patients with low-risk differentiated thyroid cancer) to utility values approximate to the average UK population (following successful thyroidectomy surgery and radioiodine treatment). Utility estimates for different health states, across thyroid cancer sub-types and interventions are presented. Conclusion A catalogue of utility values is provided for use when carrying out economic modelling of thyroid cancer; by including mapped values, this approach broadens the scope of health states that can be considered within cost-effectiveness modelling.

scholarly journals EQ-5D-3L health state utility values in transfusion-dependent thalassemia patients in Malaysia: a cross-sectional assessment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Asrul Akmal Shafie ◽  
Irwinder Kaur Chhabra ◽  
Jacqueline Hui Yi Wong ◽  
Noor Syahireen Mohammed
Keyword(s):  
Iron Overload ◽  
Public Hospitals ◽  
Health State Utility ◽  
Economic Evaluations ◽  
Health State ◽  
Utility Value ◽  
Cross Sectional ◽  
Utility Values ◽  
Health State Utility Values ◽  
Chelating Therapy

Abstract Purpose There is a gap of information describing the health state utility values (HSUVs) of transfusion-dependent thalassemia (TDT) patients in Malaysia. These values are useful in the assessment of health-related quality of life (HRQoL), economic evaluations and provide guidance to disease management decisions. The objective of this study was to estimate and derive HSUVs associated with the treatment and complications of TDT patients in Malaysia using the EQ-5D-3L instrument. Methods A cross-sectional survey using the EQ-5D-3L instrument was conducted between May to September 2018 across various public hospitals in Malaysia. Using a multi-stage sampling, patients diagnosed with TDT and receiving iron chelating therapy were sampled. The findings on the EQ-5D-3L survey were converted into utility values using local tariff values. A two-part model was used to examine and derive the HSUVs associated with the treatment and complications of iron overload in TDT. Results A total of 585 patients were surveyed. The unadjusted mean (SD) EQ-5D-3L utility value for TDT patients were 0.893 (0.167) while mean (SD) EQ VAS score was 81.22 (16.92). Patients who had more than two iron overload complications had a significant decline in HRQoL. Patients who were on oral monotherapy had a higher utility value of 0.9180 compared to other regimen combinations. Conclusion Lower EQ-5D-3L utility values were associated with patients who developed iron overload complications and were on multiple iron chelating agents. Emphasizing compliance to iron chelating therapy to prevent the development of complications is crucial in the effort to preserve the HRQoL of TDT patients.

scholarly journals EQ-5D-3L Health State Utility Values in Transfusion-dependent thalassemia Patients in Malaysia: A Cross-sectional Assessment

2020 ◽  
Author(s):  
Asrul Akmal Shafie ◽  
Irwinder Kaur Chhabra ◽  
Jacqueline Hui Yi Wong ◽  
Noor Syahireen Mohammed
Keyword(s):  
Iron Overload ◽  
Public Hospitals ◽  
Health State Utility ◽  
Economic Evaluations ◽  
Health State ◽  
Utility Value ◽  
Cross Sectional ◽  
Utility Values ◽  
Health State Utility Values ◽  
Chelating Therapy

Abstract Purpose: There is a gap of information describing the health state utility values (HSUVs) of Transfusion-dependent Thalassemia (TDT) patients in Malaysia. These values are useful in the assessment of health-related quality of life (HRQoL), economic evaluations and provide guidance to disease management decisions. The objective of this study was to estimate and derive HSUVs associated with the treatment and complications of TDT patients in Malaysia using the EQ-5D-3L instrument.Methods: A cross-sectional survey using the EQ-5D-3L instrument was conducted between May to September 2018 across various public hospitals in Malaysia. Using a multi-stage sampling, patients diagnosed with TDT and receiving iron chelating therapy were sampled. The findings on the EQ-5D-3L survey were converted into utility values using local tariff values. A two-part model was used to examine and derive health state utility values associated with the treatment and complications of iron overload in TDT. Results: A total of 585 patients were surveyed. The unadjusted mean (SD) EQ-5D-3L utility value for TDT patients were 0.893 (0.167) while mean (SD) EQ VAS score was 81.22 (16.92). Patients who had more than two iron overload complications had a significant decline in HRQoL. Patients who were on oral monotherapy had a higher utility value of 0.9180 compared to other regimen combinations.Conclusion: Lower EQ-5D-3L utility values were associated with patients who developed iron overload complications and were on multiple iron chelating agents. Emphasizing compliance to iron chelating therapy to prevent the development of complications is crucial in the effort to preserve the HRQoL of TDT patients.

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