The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis

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The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis. / Witney, AG; Treharne, Gareth; Tavakoli, M; Lyons, Antonia; Vincent, K; Scott, DL; Kitas, George.

In: Rheumatology, Vol. 45, No. 8, 20.02.2006, p. 975-981.

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@article{04c746c2c41f429096eb3f252a7a45f6,
title = "The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis",
abstract = "OBJECTIVES: Cost-effectiveness analysis (CEA) is essential for the comparison of treatments for rheumatoid arthritis (RA). CEA centres on accurate measurement of health utility (HU) preferences. Direct measures of HU in RA patients demonstrate weaker correlations with health status (functional disability and pain) than indirect measures. We examined whether demographic and psychosocial factors relate to HU in RA patients. METHODS: HU was measured for 142 RA patients (76% women; mean age 58.75 yr) directly through standard gamble (SG) and time trade-off (TTO), and indirectly on the EuroQol (EQ-5D). Current pain (100 mm visual analogue scale) and recent functional disability (Health Assessment Questionnaire; HAQ) were assessed. A subsample of 48 provided demographic and psychosocial information (education, employment, marital/family status, knowledge about RA, medication beliefs, desirable responding, social support, optimism, and the Hospital Anxiety and Depression Scale; HADS). RESULTS: Direct HU had higher means (SG = 0.88, TTO = 0.86) than indirect HU (EQ-5D = 0.52). HAQ functional disability correlated with SG (r = - 0.28), TTO (r = - 0.31) and EQ-5D (r = - 0.67). Current pain correlated with TTO (r = - 0.19) and EQ-5D (r = - 0.36). HADS depression correlated with TTO (r = - 0.35) and EQ-5D (r = - 0.64); HADS anxiety also correlated with EQ-5D (r = - 0.46). CONCLUSIONS: Demographic and psychosocial factors cannot completely explain either the significant differences between direct and indirect HUs in RA patients or the moderate correlations of direct HUs with health status. Characteristics of the SG and TTO may make them inappropriate for HU assessment and CEA among RA patients.",
keywords = "health utility, rheumatoid arthritis, time trade-off, standard gamble, disability evaluation",
author = "AG Witney and Gareth Treharne and M Tavakoli and Antonia Lyons and K Vincent and DL Scott and George Kitas",
year = "2006",
month = feb,
day = "20",
doi = "10.1093/rheumatology/kel027",
language = "English",
volume = "45",
pages = "975--981",
journal = "Rheumatology",
issn = "1462-0324",
publisher = "Oxford University Press",
number = "8",

}

RIS

TY - JOUR

T1 - The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis

AU - Witney, AG

AU - Treharne, Gareth

AU - Tavakoli, M

AU - Lyons, Antonia

AU - Vincent, K

AU - Scott, DL

AU - Kitas, George

PY - 2006/2/20

Y1 - 2006/2/20

N2 - OBJECTIVES: Cost-effectiveness analysis (CEA) is essential for the comparison of treatments for rheumatoid arthritis (RA). CEA centres on accurate measurement of health utility (HU) preferences. Direct measures of HU in RA patients demonstrate weaker correlations with health status (functional disability and pain) than indirect measures. We examined whether demographic and psychosocial factors relate to HU in RA patients. METHODS: HU was measured for 142 RA patients (76% women; mean age 58.75 yr) directly through standard gamble (SG) and time trade-off (TTO), and indirectly on the EuroQol (EQ-5D). Current pain (100 mm visual analogue scale) and recent functional disability (Health Assessment Questionnaire; HAQ) were assessed. A subsample of 48 provided demographic and psychosocial information (education, employment, marital/family status, knowledge about RA, medication beliefs, desirable responding, social support, optimism, and the Hospital Anxiety and Depression Scale; HADS). RESULTS: Direct HU had higher means (SG = 0.88, TTO = 0.86) than indirect HU (EQ-5D = 0.52). HAQ functional disability correlated with SG (r = - 0.28), TTO (r = - 0.31) and EQ-5D (r = - 0.67). Current pain correlated with TTO (r = - 0.19) and EQ-5D (r = - 0.36). HADS depression correlated with TTO (r = - 0.35) and EQ-5D (r = - 0.64); HADS anxiety also correlated with EQ-5D (r = - 0.46). CONCLUSIONS: Demographic and psychosocial factors cannot completely explain either the significant differences between direct and indirect HUs in RA patients or the moderate correlations of direct HUs with health status. Characteristics of the SG and TTO may make them inappropriate for HU assessment and CEA among RA patients.

AB - OBJECTIVES: Cost-effectiveness analysis (CEA) is essential for the comparison of treatments for rheumatoid arthritis (RA). CEA centres on accurate measurement of health utility (HU) preferences. Direct measures of HU in RA patients demonstrate weaker correlations with health status (functional disability and pain) than indirect measures. We examined whether demographic and psychosocial factors relate to HU in RA patients. METHODS: HU was measured for 142 RA patients (76% women; mean age 58.75 yr) directly through standard gamble (SG) and time trade-off (TTO), and indirectly on the EuroQol (EQ-5D). Current pain (100 mm visual analogue scale) and recent functional disability (Health Assessment Questionnaire; HAQ) were assessed. A subsample of 48 provided demographic and psychosocial information (education, employment, marital/family status, knowledge about RA, medication beliefs, desirable responding, social support, optimism, and the Hospital Anxiety and Depression Scale; HADS). RESULTS: Direct HU had higher means (SG = 0.88, TTO = 0.86) than indirect HU (EQ-5D = 0.52). HAQ functional disability correlated with SG (r = - 0.28), TTO (r = - 0.31) and EQ-5D (r = - 0.67). Current pain correlated with TTO (r = - 0.19) and EQ-5D (r = - 0.36). HADS depression correlated with TTO (r = - 0.35) and EQ-5D (r = - 0.64); HADS anxiety also correlated with EQ-5D (r = - 0.46). CONCLUSIONS: Demographic and psychosocial factors cannot completely explain either the significant differences between direct and indirect HUs in RA patients or the moderate correlations of direct HUs with health status. Characteristics of the SG and TTO may make them inappropriate for HU assessment and CEA among RA patients.

KW - health utility

KW - rheumatoid arthritis

KW - time trade-off

KW - standard gamble

KW - disability evaluation

UR - http://www.scopus.com/inward/record.url?scp=33747869954&partnerID=8YFLogxK

U2 - 10.1093/rheumatology/kel027

DO - 10.1093/rheumatology/kel027

M3 - Article

C2 - 16461437

VL - 45

SP - 975

EP - 981

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - 8

ER -