Smith Kenneth J, Tsevat Joel, Ness Roberta B, Wiesenfeld Harold C, Roberts Mark S
Section of Decision Sciences and Clinical Systems Modeling, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Sex Transm Dis. 2008 Mar;35(3):307-11. doi: 10.1097/OLQ.0b013e31815b07dd.
Quality of life utilities for health states associated with pelvic inflammatory disease (PID) have been estimated but not directly measured. Utilities for PID could have important implications on the cost-effectiveness of interventions to prevent and manage this disease.
We obtained, in women with versus without a history of PID, visual analogue scale (VAS) and time-tradeoff (TTO) valuations for 5 PID-associated health states: ambulatory PID treatment, hospital PID treatment, ectopic pregnancy, chronic pelvic pain, and infertility. Subjects read brief scenarios describing the medical, functional, and social activity effects typically associated with each state, then gave valuations in the order above.
Health state valuations were obtained from 56 women with and 150 women without a PID history. Subjects with a PID history had significantly lower mean valuations (P <0.05) on the VAS for ectopic pregnancy (0.55 vs. 0.63), pelvic pain (0.45 vs. 0.53), and infertility (0.53 vs. 0.66) but not on the TTO; VAS differences remained significant when controlling for demographic and childbearing characteristics. VAS and TTO valuations were similar in women with versus without a history of PID for the ambulatory and hospital PID treatment health states.
PID has substantial impact on utility. In addition, some PID-related health states are valued less by women who have experienced PID, which could affect cost-effectiveness analyses of PID treatments when examined from the societal versus patient perspective.
已对与盆腔炎(PID)相关健康状态的生活质量效用进行了估计,但尚未直接测量。PID的效用可能对预防和管理该疾病的干预措施的成本效益具有重要影响。
我们获取了有或无PID病史女性对5种与PID相关健康状态的视觉模拟量表(VAS)和时间权衡(TTO)估值:门诊PID治疗、住院PID治疗、异位妊娠、慢性盆腔疼痛和不孕症。受试者阅读描述每种状态通常相关的医疗、功能和社会活动影响的简短情景,然后按上述顺序给出估值。
从56名有PID病史的女性和150名无PID病史的女性中获得了健康状态估值。有PID病史的受试者对异位妊娠(0.55对0.63)、盆腔疼痛(0.45对0.53)和不孕症(0.53对0.66)的VAS平均估值显著较低(P<0.05),但TTO估值无差异;在控制人口统计学和生育特征后,VAS差异仍然显著。对于门诊和住院PID治疗健康状态,有或无PID病史的女性的VAS和TTO估值相似。
PID对效用有重大影响。此外,一些与PID相关的健康状态在有PID经历的女性中估值较低,从社会与患者角度审视时,这可能会影响PID治疗的成本效益分析。