F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA.
F.I. Proctor Foundation, University of California, San Francisco, San Francisco, California, USA; Department of Ophthalmology, University of California, San Francisco, San Francisco, California, USA.
Am J Ophthalmol. 2019 Dec;208:47-55. doi: 10.1016/j.ajo.2019.06.005. Epub 2019 Jun 13.
To investigate time trade-off (TTO) utility values in patients with noninfectious uveitis and determine whether patient demographics and clinical characteristics are associated with utility scores.
Time trade-off utility analysis.
Setting: A tertiary care uveitis center in San Francisco, California, USA.
One hundred and four consecutive adults with noninfectious uveitis, enrolled between November 2016 and February 2017.
TTO utility values, as collected by an interviewer-guided survey. Information regarding general health, ocular symptoms, and religion was also collected and medical record review was conducted to record anatomic location of uveitis, disease activity, visual acuity, and treatments. Multivariable regression analysis with backward selection was used to identify variables associated with TTO values.
Median TTO score was 0.975 (interquartile range [IQR]: 0.8-1.0), corresponding to trading a median 1.28 years of remaining life for healthy eyes (IQR: 0-6.29). Regression analysis revealed that worse eye visual acuity, >6 months of oral corticosteroid use, and current antidepressant use were associated with lower TTO scores (P = .008, P = .006, P = .008, respectively), controlling for age and sex. In particular, patients who had been taking oral corticosteroids for more than 6 months, regardless of dose, were 10.5 times more likely to trade 20% or more years of remaining life (TTO ≤0.8) than patients not taking oral corticosteroids (95% confidence interval: 2.3, 48.1; P = .002).
Patients with noninfectious uveitis had measurable, though modest, reductions in quality of life, as assessed by TTO, and these decreases were significantly associated with visual acuity in the worse eye and long-term oral corticosteroid use.
调查非感染性葡萄膜炎患者的时间权衡(TTO)效用值,并确定患者的人口统计学和临床特征是否与效用评分相关。
时间权衡效用分析。
地点:美国加利福尼亚州旧金山的一家三级护理葡萄膜炎中心。
2016 年 11 月至 2017 年 2 月期间连续招募的 104 名非感染性葡萄膜炎成年患者。
通过访谈者指导的调查收集 TTO 效用值。还收集了有关一般健康、眼部症状和宗教信仰的信息,并进行了病历回顾,以记录葡萄膜炎的解剖位置、疾病活动、视力和治疗情况。采用向后选择的多变量回归分析来识别与 TTO 值相关的变量。
中位 TTO 评分为 0.975(四分位距 [IQR]:0.8-1.0),相当于用中位数 1.28 年的剩余寿命换取健康的眼睛(IQR:0-6.29)。回归分析显示,较差的眼部视力、>6 个月的口服皮质类固醇使用和当前使用抗抑郁药与较低的 TTO 评分相关(P=0.008、P=0.006、P=0.008,分别),控制年龄和性别。特别是,无论剂量如何,口服皮质类固醇使用超过 6 个月的患者与未使用口服皮质类固醇的患者相比,更有可能交易 20%或更多的剩余寿命(TTO≤0.8)(95%置信区间:2.3,48.1;P=0.002)。
非感染性葡萄膜炎患者的生活质量有可衡量的、尽管适度的下降,这是通过 TTO 评估的,这些下降与较差眼的视力和长期口服皮质类固醇使用显著相关。