Ambrish Singh1, Julie A Campbell1, Alison Venn1, Graeme Jones1, Leigh Blizzard1, Andrew J Palmer1,2, Terence Dwyer1,3, Flavia Cicuttini4, Changhai Ding1,4,5, Benny Antony6. 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. 2. Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Australia. 3. Nuffield Department of Obstetrics & Gynaecology, The George Institute for Global Health, University of Oxford, Oxford, UK. 4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia. 5. Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China. 6. Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. Benny.EathakkattuAntony@utas.edu.au.
Abstract
OBJECTIVES: Health state utilities (HSUs) are an input metric for estimating quality-adjusted life-years (QALY) in cost-utility analyses. Currently, there is a paucity of data on association of knee symptoms with HSUs for middle-aged populations. We aimed to describe the association of knee symptoms and change in knee symptoms with SF-6D HSUs and described the distribution of HSUs against knee symptoms' severity. METHODS: Participants (36-49-years) were selected from the third follow-up (completed 2019) of Australian Childhood Determinants of Adult Health study. SF-6D HSUs were generated from the participant-reported SF-12. Association between participant-reported WOMAC knee symptoms' severity, change in knee symptoms over 6-9 years, and HSUs were evaluated using linear regression models. RESULTS: For the cross-sectional analysis, 1,567 participants were included; mean age 43.5 years, female 54%, BMI ± SD 27.18 ± 5.31 kg/m2. Mean ± SD HSUs for normal, moderate, and severe WOMAC scores were 0.820 ± 0.120, 0.800 ± 0.120, and 0.740 ± 0.130, respectively. A significant association was observed between worsening knee symptoms and HSUs in univariable and multivariable analyses after adjustment (age and sex). HSU decrement for normal-to-severe total-WOMAC and WOMAC-pain was - 0.080 (95% CI - 0.100 to - 0.060, p < 0.01) and - 0.067 (- 0.085 to - 0.048, p < 0.01), exceeding the mean minimal clinically important difference (0.04). Increase in knee pain over 6-9 years was associated with a significant reduction in HSU. CONCLUSION: In a middle-aged population-based sample, there was an independent negative association between worse knee symptoms and SF-6D HSUs. Our findings may be used by decision-makers to define more realistic and conservative baseline and ongoing HSU values when assessing QALY changes associated with osteoarthritis interventions.
OBJECTIVES: Health state utilities (HSUs) are an input metric for estimating quality-adjusted life-years (QALY) in cost-utility analyses. Currently, there is a paucity of data on association of knee symptoms with HSUs for middle-aged populations. We aimed to describe the association of knee symptoms and change in knee symptoms with SF-6D HSUs and described the distribution of HSUs against knee symptoms' severity. METHODS:Participants (36-49-years) were selected from the third follow-up (completed 2019) of Australian Childhood Determinants of Adult Health study. SF-6D HSUs were generated from the participant-reported SF-12. Association between participant-reported WOMAC knee symptoms' severity, change in knee symptoms over 6-9 years, and HSUs were evaluated using linear regression models. RESULTS: For the cross-sectional analysis, 1,567 participants were included; mean age 43.5 years, female 54%, BMI ± SD 27.18 ± 5.31 kg/m2. Mean ± SD HSUs for normal, moderate, and severe WOMAC scores were 0.820 ± 0.120, 0.800 ± 0.120, and 0.740 ± 0.130, respectively. A significant association was observed between worsening knee symptoms and HSUs in univariable and multivariable analyses after adjustment (age and sex). HSU decrement for normal-to-severe total-WOMAC and WOMAC-pain was - 0.080 (95% CI - 0.100 to - 0.060, p < 0.01) and - 0.067 (- 0.085 to - 0.048, p < 0.01), exceeding the mean minimal clinically important difference (0.04). Increase in knee pain over 6-9 years was associated with a significant reduction in HSU. CONCLUSION: In a middle-aged population-based sample, there was an independent negative association between worse knee symptoms and SF-6D HSUs. Our findings may be used by decision-makers to define more realistic and conservative baseline and ongoing HSU values when assessing QALY changes associated with osteoarthritis interventions.
Entities:
Keywords:
Health state utility; Osteoarthritis; Population norm; QALY; SF-6D; WOMAC
Authors: Uyen-Sa D T Nguyen; Yuqing Zhang; Yanyan Zhu; Jingbo Niu; Bin Zhang; David T Felson Journal: Ann Intern Med Date: 2011-12-06 Impact factor: 25.391
Authors: Soili Törmälehto; Mika E Mononen; Emma Aarnio; Jari P A Arokoski; Rami K Korhonen; Janne Martikainen Journal: Health Qual Life Outcomes Date: 2018-07-31 Impact factor: 3.186
Authors: David J Hunter; Philippa J A Nicolson; Christopher B Little; Sarah R Robbins; Xia Wang; Kim L Bennell Journal: BMC Musculoskelet Disord Date: 2019-02-13 Impact factor: 2.362
Authors: Aliasghar A Kiadaliri; Carl Johan Lamm; Maria Gerhardsson de Verdier; Gunnar Engström; Aleksandra Turkiewicz; L Stefan Lohmander; Martin Englund Journal: Health Qual Life Outcomes Date: 2016-08-26 Impact factor: 3.186