Determining the Health State Utility Value of Urinary Tract Infections in Women Rajeshwari Kalyanaraman, MBBS, Veronica Demtchouk, MD, Vidya Iyer, MBBS, Danielle Patterson, MD, SM Tufts Medical Center Department of Obstetrics and Gynecology Division of Urogynecology and Pelvic Reconstructive Surgery October 10, 2018
I have no relevant financial disclosures. 2
Introduction • Health State utility values are a unique representation of an individual’s valuation or preference for being in a particular health state and are calculated for various disease process as a quality of life index. • Urinary Tract Infections (UTI) include infections in any part of the urinary system (the kidneys, bladder, or urethra) and affects more than 3 million US cases per year. • To date, health related quality of life estimates for urinary tract Infections have been derived predominantly from men with comorbid conditions 1-3 Stevenson SM, Danzig MR, Ghandour RA, et al. Urol Oncol Semin Orig Investig . 2014;32(8):1172-1177 . Armstrong N, Vale L, Deverill M, et al. BMJ . 2009;338:b1288. Vogel LC, Chlan KM, Zebracki K, et al. J Spinal Cord Med . 2011;34(1):60-66. 3
Objective • Women are significantly more likely to experience UTI than men. Nearly 1 in 3 women will have had at least 1 episode of UTI requiring antimicrobial therapy by the age of 24 years. Almost half of all women will experience 1 UTI during their lifetime 4 • The purpose of our study was to derive the health state utility value for urinary tract infections in women. 4 Foxman B. Am J Med. 2002 Jul 8;113 Suppl 1A:5S-13S .
Materials and methods • Healthy volunteers were approached for study participation after they were confirmed to have had no past episodes of UTI by an attending urogynecologist at our urban academic medical center. • Twenty-five subjects were given a scenario to describe a urinary tract infection. They were instructed to consider this scenario when completing the EuroQol 5 dimensions (EQ-5D) questionnaire and the visual analog scale (VAS). • They then participated in the economic gold standard method, the Standard Gamble (SG) interview. 5
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Results • The median [interquartile range] health state utility value for urinary tract infection varied based on the method used. • EQ-5D - 1.00 [0.124] • VAS – 0.98 [0.10] • SG – 0.90 [0.15] • Spearman correlation showed a weak correlation between the following : • EQ-5D & SG : 0.385 • EQ-5D & VAS : -0.193 • VAS & SG : 0.03 8
Conclusion • Previous studies may have underestimated the health state utility value of urinary tract infections for women. • A value of 0.90 would be appropriate for a female population. 9
References Stevenson SM, Danzig MR, Ghandour RA, et al. Cost-effectiveness of neoadjuvant 1. chemotherapy before radical cystectomy for muscle-invasive bladder cancer. Urol Oncol Semin Orig Investig . 2014;32(8):1172-1177. Armstrong N, Vale L, Deverill M, et al. Surgical treatments for men with benign prostatic 2. enlargement: cost effectiveness study. BMJ . 2009;338:b1288. Vogel LC, Chlan KM, Zebracki K, et al. Long-term outcomes of adults with pediatric-onset spinal 3. cord injuries as a function of neurological impairment. J Spinal Cord Med . 2011;34(1):60-66. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. 4. Am J Med. 2002;113 Suppl 1A:5S-13S. 10
Determining the Health State Utility Value of Urinary Tract Infections in Women Rajeshwari Kalyanaraman, MBBS, Veronica Demtchouk, MD, Vidya Iyer, MBBS, Danielle Patterson, MD, SM Tufts Medical Center Department of Obstetrics and Gynecology Division of Urogynecology and Pelvic Reconstructive Surgery October 10, 2018
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