诱发与类风湿关节炎不同晨僵持续时间相关的健康状态效用。

Elicitation of health state utilities associated with differing durations of morning stiffness in rheumatoid arthritis.

机构信息

Mundipharma International Limited, Cambridge Science Park, Cambridge, UK.

出版信息

J Med Econ. 2012;15(6):1192-200. doi: 10.3111/13696998.2012.712927. Epub 2012 Aug 9.

DOI:10.3111/13696998.2012.712927

PMID:22804691

Abstract

OBJECTIVE

Specific symptoms of rheumatoid arthritis (RA), including joint stiffness and functional disability, are most severe in the morning. 'Morning stiffness' has a negative impact on health-related quality-of-life (HRQoL); however, how HRQoL is correlated to morning stiffness duration is unknown. The objective of this study was to obtain population-based utility values associated with different durations of morning stiffness in RA.

DESIGN AND METHODS

The time-trade-off (TTO) approach was used to elicit utility values for four different health states (HS), which differed in morning stiffness duration. One hundred and nine members of the UK general public rated each HS in individual face-to-face interviews with trained investigators. TTO scores were converted into utility values. Visual Analog Scale (VAS) scores were obtained to validate TTO scores.

RESULTS

On a scale of 0 (death) to 1 (full health), a mean utility value of 0.45±0.29 was elicited for ∼3 h of morning stiffness (anchor HS), 0.50±0.28 for 2-3 h of morning stiffness (HS1), 0.61±0.25 for 1-2 h of morning stiffness (HS2) and 0.78±0.20 for <1 h of morning stiffness (HS3). The difference between each HS was statistically significant (p<0.01). Mean VAS utility scores followed the same trend. Utility incrementally increased with each HS associated with a shorter duration of morning stiffness. Limitations of this research include potential bias from the TTO method due to the discounting effect of time, scale compatibility, and loss aversion.

CONCLUSIONS

The UK population-based utility values show a reduction in morning stiffness duration in RA is associated with improved HRQoL. Despite the impact of morning stiffness on HRQoL, it is rarely evaluated and little is known as to how it is affected by current treatments. The results of this study can be applied in future cost-utility analyses of healthcare interventions which target an improvement in morning stiffness duration for RA patients.

摘要

目的

类风湿关节炎（RA）的特定症状，包括关节僵硬和功能障碍，在早晨最为严重。“晨僵”对健康相关生活质量（HRQoL）有负面影响；然而，晨僵持续时间与 HRQoL 之间的相关性尚不清楚。本研究的目的是获得与 RA 晨僵不同持续时间相关的基于人群的效用值。

设计和方法

使用时间权衡（TTO）方法来获取四个不同健康状况（HS）的效用值，这些 HS 在晨僵持续时间上有所不同。109 名英国普通公众在经过培训的调查员的个别面对面访谈中对每个 HS 进行了评分。TTO 分数转换为效用值。获得视觉模拟量表（VAS）评分以验证 TTO 评分。

结果

在 0（死亡）到 1（完全健康）的量表上，对晨僵约 3 小时（锚定 HS）的平均效用值为 0.45±0.29，晨僵 2-3 小时（HS1）的平均效用值为 0.50±0.28，晨僵 1-2 小时（HS2）的平均效用值为 0.61±0.25，晨僵<1 小时（HS3）的平均效用值为 0.78±0.20。每个 HS 之间的差异具有统计学意义（p<0.01）。平均 VAS 效用评分也呈现出相同的趋势。随着与晨僵持续时间较短相关的每个 HS 的增加，效用逐渐增加。本研究的局限性包括 TTO 方法因时间贴现效应、量表兼容性和损失厌恶而产生的潜在偏差。