Health Values of Patients With Chronic Hepatitis C Infection

[Guest guest]

Health Values of Patients With Chronic Hepatitis C Infection

E. Sherman, MD, PhD; N. Sherman, DPA; Chenier, PhD;

Tsevat, MD, MPH

Arch Intern Med. 2004;164:2377-2382.

Background Patients with hepatitis C virus (HCV) infection report a

reduction in health status, but it is not known how they value their state

of health. We assessed health utilities directly from patients with HCV

infection.

Methods One hundred twenty-four patients with chronic HCV infection

representing a cross section of disease severity were administered a

disease-specific version of the Medical Outcomes Study 36-Item Short-Form

Health Survey, the Beck Depression Inventory, and 3 direct health value

measures, including the Rating Scale, Time Trade-off (TTO), and Standard

Gamble (SG). Correlation among measures and factor analysis was performed.

Results The mean modified Medical Outcomes Study 36-Item Short-Form Health

Survey scores were lower than normative population values, particularly on

the Physical Component Summary scale. This scale was poorly correlated with

the Rating Scale, TTO, and SG scores among HCV-infected subjects. The mean ±

SE TTO score was 0.83 ± 0.02, and the mean ± SE SG score was 0.79 ± 0.02.

The TTO and SG scores failed to show significant variability in relation to

disease activity as determined by serum alanine aminotransferase level,

histologic stage, and presence of decompensated liver disease. The Beck

Depression Inventory was significantly inversely correlated with the TTO and

SG.

Conclusions Although quality of life is compromised in patients with

chronic HCV infection, patient-derived health utilities are not strongly

associated with health status or clinical measures. Utility measures

obtained from patients with HCV differ significantly from previous surrogate

measures of health values. Such differences in utilities could affect

decision analyses and cost-effectiveness analyses of treatment interventions

for individuals with HCV infection.

Author Affiliations: Hepatology and Liver Transplant Medicine Section,

Division of Digestive Diseases, Department of Medicine, and Institute for

Health Policy and Health Services Research, University of Cincinnati College

of Medicine, Cincinnati, Ohio.

[Guest guest]

Health Values of Patients With Chronic Hepatitis C Infection

E. Sherman, MD, PhD; N. Sherman, DPA; Chenier, PhD;

Tsevat, MD, MPH

Arch Intern Med. 2004;164:2377-2382.

Background Patients with hepatitis C virus (HCV) infection report a

reduction in health status, but it is not known how they value their state

of health. We assessed health utilities directly from patients with HCV

infection.

Methods One hundred twenty-four patients with chronic HCV infection

representing a cross section of disease severity were administered a

disease-specific version of the Medical Outcomes Study 36-Item Short-Form

Health Survey, the Beck Depression Inventory, and 3 direct health value

measures, including the Rating Scale, Time Trade-off (TTO), and Standard

Gamble (SG). Correlation among measures and factor analysis was performed.

Results The mean modified Medical Outcomes Study 36-Item Short-Form Health

Survey scores were lower than normative population values, particularly on

the Physical Component Summary scale. This scale was poorly correlated with

the Rating Scale, TTO, and SG scores among HCV-infected subjects. The mean ±

SE TTO score was 0.83 ± 0.02, and the mean ± SE SG score was 0.79 ± 0.02.

The TTO and SG scores failed to show significant variability in relation to

disease activity as determined by serum alanine aminotransferase level,

histologic stage, and presence of decompensated liver disease. The Beck

Depression Inventory was significantly inversely correlated with the TTO and

SG.

Conclusions Although quality of life is compromised in patients with

chronic HCV infection, patient-derived health utilities are not strongly

associated with health status or clinical measures. Utility measures

obtained from patients with HCV differ significantly from previous surrogate

measures of health values. Such differences in utilities could affect

decision analyses and cost-effectiveness analyses of treatment interventions

for individuals with HCV infection.

Author Affiliations: Hepatology and Liver Transplant Medicine Section,

Division of Digestive Diseases, Department of Medicine, and Institute for

Health Policy and Health Services Research, University of Cincinnati College

of Medicine, Cincinnati, Ohio.

[Guest guest]

Health Values of Patients With Chronic Hepatitis C Infection

E. Sherman, MD, PhD; N. Sherman, DPA; Chenier, PhD;

Tsevat, MD, MPH

Arch Intern Med. 2004;164:2377-2382.

Background Patients with hepatitis C virus (HCV) infection report a

reduction in health status, but it is not known how they value their state

of health. We assessed health utilities directly from patients with HCV

infection.

Methods One hundred twenty-four patients with chronic HCV infection

representing a cross section of disease severity were administered a

disease-specific version of the Medical Outcomes Study 36-Item Short-Form

Health Survey, the Beck Depression Inventory, and 3 direct health value

measures, including the Rating Scale, Time Trade-off (TTO), and Standard

Gamble (SG). Correlation among measures and factor analysis was performed.

Results The mean modified Medical Outcomes Study 36-Item Short-Form Health

Survey scores were lower than normative population values, particularly on

the Physical Component Summary scale. This scale was poorly correlated with

the Rating Scale, TTO, and SG scores among HCV-infected subjects. The mean ±

SE TTO score was 0.83 ± 0.02, and the mean ± SE SG score was 0.79 ± 0.02.

The TTO and SG scores failed to show significant variability in relation to

disease activity as determined by serum alanine aminotransferase level,

histologic stage, and presence of decompensated liver disease. The Beck

Depression Inventory was significantly inversely correlated with the TTO and

SG.

Conclusions Although quality of life is compromised in patients with

chronic HCV infection, patient-derived health utilities are not strongly

associated with health status or clinical measures. Utility measures

obtained from patients with HCV differ significantly from previous surrogate

measures of health values. Such differences in utilities could affect

decision analyses and cost-effectiveness analyses of treatment interventions

for individuals with HCV infection.

Author Affiliations: Hepatology and Liver Transplant Medicine Section,

Division of Digestive Diseases, Department of Medicine, and Institute for

Health Policy and Health Services Research, University of Cincinnati College

of Medicine, Cincinnati, Ohio.

[Guest guest]

Health Values of Patients With Chronic Hepatitis C Infection

E. Sherman, MD, PhD; N. Sherman, DPA; Chenier, PhD;

Tsevat, MD, MPH

Arch Intern Med. 2004;164:2377-2382.

Background Patients with hepatitis C virus (HCV) infection report a

reduction in health status, but it is not known how they value their state

of health. We assessed health utilities directly from patients with HCV

infection.

Methods One hundred twenty-four patients with chronic HCV infection

representing a cross section of disease severity were administered a

disease-specific version of the Medical Outcomes Study 36-Item Short-Form

Health Survey, the Beck Depression Inventory, and 3 direct health value

measures, including the Rating Scale, Time Trade-off (TTO), and Standard

Gamble (SG). Correlation among measures and factor analysis was performed.

Results The mean modified Medical Outcomes Study 36-Item Short-Form Health

Survey scores were lower than normative population values, particularly on

the Physical Component Summary scale. This scale was poorly correlated with

the Rating Scale, TTO, and SG scores among HCV-infected subjects. The mean ±

SE TTO score was 0.83 ± 0.02, and the mean ± SE SG score was 0.79 ± 0.02.

The TTO and SG scores failed to show significant variability in relation to

disease activity as determined by serum alanine aminotransferase level,

histologic stage, and presence of decompensated liver disease. The Beck

Depression Inventory was significantly inversely correlated with the TTO and

SG.

Conclusions Although quality of life is compromised in patients with

chronic HCV infection, patient-derived health utilities are not strongly

associated with health status or clinical measures. Utility measures

obtained from patients with HCV differ significantly from previous surrogate

measures of health values. Such differences in utilities could affect

decision analyses and cost-effectiveness analyses of treatment interventions

for individuals with HCV infection.

Author Affiliations: Hepatology and Liver Transplant Medicine Section,

Division of Digestive Diseases, Department of Medicine, and Institute for

Health Policy and Health Services Research, University of Cincinnati College

of Medicine, Cincinnati, Ohio.