ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 93

Health State Utilities in Systemic Sclerosis: Results From the UCLA Scleroderma Quality of Life Study

Mohsen Sadatsafavi1, Dinesh Khanna2, Paul Maranian3, Daniel Furst4, Amir Khakban1 and Carlo A. Marra1, 1Pharm Sciences, Univ of British Columbia, Vancouver, BC, Canada, 2Division of Rheumatology, University of Michigan Medical Center, Ann Arbor, MI, 3Division of Rheumatology, UCLA Medical School, Los Angeles, CA, 4David Geffen School of Medicine, Div of Rheumatology, University of California at Los Angeles, Los Angeles, CA

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Epidemiology and Health Services Research: Epidemiology and Outcomes of Rheumatic Disease I

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Health state utility values (HSUVs) are used as weightings for quality-adjusted life years (QALYs) in economic analyses. It is not clear whether available instruments yield similar results or what domains of health are contributing to the overall score in a sample of patients with systemic sclerosis (SSc).

Methods:

Our study included 223 individuals with rheumatologist-confirmed SSc from one academic center. An interviewer administered direct heath state utilities including the Time Trade Off (TTO), Visual Analogue Scale (VAS), and Standard Gamble (SG). We calculated the Short Form 6D from SF-36. Other clinical and health services variables were also collected.

Results:  The mean age of the SSc sample was 51 years (SD 15) with the majority being female (84%).  Mean (SD) health state utility values were 0.65 (0.13) for the SF-6D, 0.76 (0.28) for the TTO, 0.84 (0.22) for the SG, and 0.67 (0.19) for the VAS (P = 0.02).  These measures are moderately correlated and appear to discriminate across measures of disease severity and function such as the physician’s global assessment, digital tip ulcer count, swollen joint count, and tender joint count. Most HSUV measures show a monotonic descending relationship with measures of increased severity.

Conclusion:   Different methods to generate HSUVs appear to provide different estimates, which have important implications for economic analysis. However, all of the methods appear to display construct validity with respect to clinical and health services variables.

Table 1.   Discriminant ability of health state utility value measures.

Disease Severity Measure

Category

SG

TTO

VAS

SF6D

Mean (SD)

Physician’s Global Assessment (0-10)

< 2

.90(.16)

.85(.22)

.75(.15)

.72(.13)

2-6

.82(.25)

.74(.30)

.63(.20)

.63(.12)

>6

.80(.24)

.67(.31)

.63(.20)

.59(.10)

Digital Tip Ulcers

< 0

.84(.22)

.76(.29)

.67(.19)

.65(.13)

0- 1

.85(.26)

.82(.30)

.63(.21)

.64(.14)

>1

.88(.21)

.85(.22)

.84(.12)

.75(.19)

Rodnan score

< 2

.83(.25)

.77(.28)

.69(.20)

.66(.13)

2-13

.89(.16)

.81(.25)

.68(.19)

.66(.13)

>13

.78(.27)

.66(.33)

.63(.19)

.63(.11)

Tender joint count

< 0

.86(.21)

.79(.26)

.68(.19)

.67(.13)

0- 1

.68(.37)

.55(.38)

.61(.27)

.62(.07)

>1

.83(.24)

.72(.32)

.63(.19)

.62(.13)

Swollen joint count

< 0

.85(.22)

.77(.28)

.67(.19)

.65(.13)

0- 1

.62(.44)

.54(.45)

.59(.26)

.55(.17)

>1

.88(.17)

.80(.26)

.72(.17)

.72(.14)

Disclosure:

M. Sadatsafavi,
None;

D. Khanna,
None;

P. Maranian,
None;

D. Furst,
None;

A. Khakban,
None;

C. A. Marra,
None.

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