Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Int Urogynecol J. 2023 Aug;34(8):1831-1835. doi: 10.1007/s00192-023-05468-7. Epub 2023 Feb 8.
Health state utility values estimate an individual's valuation of their health-related quality of life. Despite prevalence of recurrent urinary tract infections (rUTIs), the health state utility value of rUTIs is unknown. The primary aim was to determine the utility value of rUTIs using the standard gamble (SG). The secondary aim was to compare the SG utility value with that derived from the EuroQol 5 dimensions (EQ-5D) and visual analog scale (VAS). We hypothesized that a utility value would be successfully derived from the SG and would differ from that derived using the EQ-5D and VAS.
Nonpregnant, adult English-speaking female patients with a diagnosis of rUTI were recruited and completed the EQ-5D, VAS, and SG (n = 25). Utility values were evaluated using Wilcoxon signed-rank tests and Spearman's rho correlation.
Health state utility values varied depending on the assessment tool used: EQ-5D 0.76 (IQR 0.52), VAS 0.70 (IQR 0.30), and SG 0.85 (IQR 0.25). There were differences between VAS and the other two assessment methods (p<0.001), as well as between EQ-5D and SG (p=0.013). Spearman correlation demonstrated a moderately positive correlation between EQ-5D and VAS values (r(25) = 0.59, p=0.0019).
Our data suggest that 0.85 reflects the true health state utility value of rUTIs among nonpregnant adult English-speaking women. The utility value for recurrent UTIs is worse (lower) than that previously published for nonrecurrent UTIs, reflecting the ability of the SG to convey the compounding impact of recurrent disease. In this study, neither the EQ-5D nor the VAS produced results consistent with those found using the SG, which suggests limited validity in this population.
健康状态效用值评估个体对其与健康相关的生活质量的估值。尽管复发性尿路感染（rUTI）的患病率很高，但 rUTI 的健康状态效用值尚不清楚。主要目的是使用标准博弈（SG）确定 rUTI 的效用值。次要目的是比较 SG 效用值与 EuroQol 5 维度（EQ-5D）和视觉模拟量表（VAS）得出的效用值。我们假设可以从 SG 成功推导出效用值，并且与使用 EQ-5D 和 VAS 得出的效用值不同。
招募了患有 rUTI 诊断的非妊娠、成年、英语为母语的女性患者，并完成了 EQ-5D、VAS 和 SG（n=25）。使用 Wilcoxon 符号秩检验和 Spearman rho 相关性评估效用值。
健康状态效用值因使用的评估工具而异：EQ-5D 0.76（IQR 0.52），VAS 0.70（IQR 0.30）和 SG 0.85（IQR 0.25）。VAS 与其他两种评估方法之间存在差异（p<0.001），以及 EQ-5D 和 SG 之间存在差异（p=0.013）。Spearman 相关性表明 EQ-5D 和 VAS 值之间存在中度正相关（r(25)=0.59，p=0.0019）。
我们的数据表明，0.85 反映了非妊娠成年英语女性 rUTI 的真实健康状态效用值。复发性 UTIs 的效用值比以前公布的非复发性 UTIs 更差（更低），反映了 SG 传达复发性疾病复合影响的能力。在这项研究中，EQ-5D 和 VAS 都没有产生与 SG 结果一致的结果，这表明在该人群中有效性有限。
