Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

Evan W. Davies; Louis S. Matza; Gavin Worth; David H. Feeny; Jacqueline Kostelec; Steven Soroka; David Mendelssohn; Philip McFarlane; Vasily Belozeroff

doi:10.1186/s12955-015-0266-9

Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

Evan W. Davies, Louis S. Matza, Gavin Worth, David H. Feeny, Jacqueline Kostelec, Steven Soroka, David Mendelssohn, Philip McFarlane, Vasily Belozeroff

Medicine

Research output: Contribution to journal › Article › peer-review

35 Citations (Scopus)

Abstract

Background: Patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) who require dialysis are at increased risk for cardiovascular events and bone fractures. To assist in economic evaluations, this study aimed to estimate the disutility of these events beyond the impact of CKD and SHPT. Methods: A basic one-year health state was developed describing CKD and SHPT requiring dialysis. Further health states added acute events (cardiovascular events, fractures, and surgical procedures) or chronic post-event effects. Acute health states described a year including an event, and chronic health states described a year subsequent to an event. General population participants in Canada completed time trade-off interviews from which utilities were derived. Pairwise comparisons were made between the basic state and event, and between comparable health states. Results: A total of 199 participants (54.8% female; mean age=46.3 years) completed interviews. Each health state had ≥130 valuations. The mean (SD) utility of the basic health state was 0.60 (0.34). For acute events, mean utility differences versus the basic state were: myocardial infarction, -0.06; unstable angina, -0.05; peripheral vascular disease (PVD) with amputation, -0.33; PVD without amputation, -0.11; heart failure, -0.14; stroke, -0.30; hip fracture, -0.14; arm fracture, -0.04; parathyroidectomy, +0.02; kidney transplant, +0.06. Disutilities for chronic health states were: stable angina, -0.09; stroke, -0.27; PVD with amputation, -0.30; PVD without amputation, -0.12; heart failure, -0.14. Conclusions: Cardiovascular events and fractures were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of CKD and SHPT.

Original language	English
Article number	90
Journal	Health and Quality of Life Outcomes
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/s12955-015-0266-9
Publication status	Published - Jun 30 2015

Bibliographical note

Funding Information:
Funding for this study was provided by Amgen, Inc., Thousand Oaks, CA, USA. Two of the authors (GW, VB) are employees of Amgen, but their input into the conceptualization and interpretation of this study represented their own opinions rather than those of the company. Three of the authors (ED, LM, JK) are employees of Evidera, a company that received funding from Amgen for this research. The other authors (DF, SS, DM, PM) received funding from Amgen for time spent on this research. The authors would like to thank Karen Malley for statistical programming; Loni Ajagbe, David Hengerer, Jessica Jordan, Erin Klepeis, Amanda Landrian, Mary Kay Margolis, Kelly McDaniel, Ann Peyser, and Anna Tate for assistance with data collection; Katie D. Stewart for protocol review, literature searching, and manuscript review; Ingela Wiklund and Lorraine Boyle for consultation; and Amara Tiebout for production assistance.

Publisher Copyright:
© 2015 Davies et al.

ASJC Scopus Subject Areas

Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1186/s12955-015-0266-9

Cite this

Davies, E. W., Matza, L. S., Worth, G., Feeny, D. H., Kostelec, J., Soroka, S., Mendelssohn, D., McFarlane, P., & Belozeroff, V. (2015). Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis. Health and Quality of Life Outcomes, 13(1), Article 90. https://doi.org/10.1186/s12955-015-0266-9

Davies, EW, Matza, LS, Worth, G, Feeny, DH, Kostelec, J, Soroka, S, Mendelssohn, D, McFarlane, P & Belozeroff, V 2015, 'Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis', Health and Quality of Life Outcomes, vol. 13, no. 1, 90. https://doi.org/10.1186/s12955-015-0266-9

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abstract = "Background: Patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) who require dialysis are at increased risk for cardiovascular events and bone fractures. To assist in economic evaluations, this study aimed to estimate the disutility of these events beyond the impact of CKD and SHPT. Methods: A basic one-year health state was developed describing CKD and SHPT requiring dialysis. Further health states added acute events (cardiovascular events, fractures, and surgical procedures) or chronic post-event effects. Acute health states described a year including an event, and chronic health states described a year subsequent to an event. General population participants in Canada completed time trade-off interviews from which utilities were derived. Pairwise comparisons were made between the basic state and event, and between comparable health states. Results: A total of 199 participants (54.8% female; mean age=46.3 years) completed interviews. Each health state had ≥130 valuations. The mean (SD) utility of the basic health state was 0.60 (0.34). For acute events, mean utility differences versus the basic state were: myocardial infarction, -0.06; unstable angina, -0.05; peripheral vascular disease (PVD) with amputation, -0.33; PVD without amputation, -0.11; heart failure, -0.14; stroke, -0.30; hip fracture, -0.14; arm fracture, -0.04; parathyroidectomy, +0.02; kidney transplant, +0.06. Disutilities for chronic health states were: stable angina, -0.09; stroke, -0.27; PVD with amputation, -0.30; PVD without amputation, -0.12; heart failure, -0.14. Conclusions: Cardiovascular events and fractures were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of CKD and SHPT.",

author = "Davies, {Evan W.} and Matza, {Louis S.} and Gavin Worth and Feeny, {David H.} and Jacqueline Kostelec and Steven Soroka and David Mendelssohn and Philip McFarlane and Vasily Belozeroff",

note = "Funding Information: Funding for this study was provided by Amgen, Inc., Thousand Oaks, CA, USA. Two of the authors (GW, VB) are employees of Amgen, but their input into the conceptualization and interpretation of this study represented their own opinions rather than those of the company. Three of the authors (ED, LM, JK) are employees of Evidera, a company that received funding from Amgen for this research. The other authors (DF, SS, DM, PM) received funding from Amgen for time spent on this research. The authors would like to thank Karen Malley for statistical programming; Loni Ajagbe, David Hengerer, Jessica Jordan, Erin Klepeis, Amanda Landrian, Mary Kay Margolis, Kelly McDaniel, Ann Peyser, and Anna Tate for assistance with data collection; Katie D. Stewart for protocol review, literature searching, and manuscript review; Ingela Wiklund and Lorraine Boyle for consultation; and Amara Tiebout for production assistance. Publisher Copyright: {\textcopyright} 2015 Davies et al.",

year = "2015",

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doi = "10.1186/s12955-015-0266-9",

language = "English",

volume = "13",

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T1 - Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

AU - Davies, Evan W.

AU - Matza, Louis S.

AU - Worth, Gavin

AU - Feeny, David H.

AU - Kostelec, Jacqueline

AU - Soroka, Steven

AU - Mendelssohn, David

AU - McFarlane, Philip

AU - Belozeroff, Vasily

N1 - Funding Information: Funding for this study was provided by Amgen, Inc., Thousand Oaks, CA, USA. Two of the authors (GW, VB) are employees of Amgen, but their input into the conceptualization and interpretation of this study represented their own opinions rather than those of the company. Three of the authors (ED, LM, JK) are employees of Evidera, a company that received funding from Amgen for this research. The other authors (DF, SS, DM, PM) received funding from Amgen for time spent on this research. The authors would like to thank Karen Malley for statistical programming; Loni Ajagbe, David Hengerer, Jessica Jordan, Erin Klepeis, Amanda Landrian, Mary Kay Margolis, Kelly McDaniel, Ann Peyser, and Anna Tate for assistance with data collection; Katie D. Stewart for protocol review, literature searching, and manuscript review; Ingela Wiklund and Lorraine Boyle for consultation; and Amara Tiebout for production assistance. Publisher Copyright: © 2015 Davies et al.

PY - 2015/6/30

Y1 - 2015/6/30

N2 - Background: Patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) who require dialysis are at increased risk for cardiovascular events and bone fractures. To assist in economic evaluations, this study aimed to estimate the disutility of these events beyond the impact of CKD and SHPT. Methods: A basic one-year health state was developed describing CKD and SHPT requiring dialysis. Further health states added acute events (cardiovascular events, fractures, and surgical procedures) or chronic post-event effects. Acute health states described a year including an event, and chronic health states described a year subsequent to an event. General population participants in Canada completed time trade-off interviews from which utilities were derived. Pairwise comparisons were made between the basic state and event, and between comparable health states. Results: A total of 199 participants (54.8% female; mean age=46.3 years) completed interviews. Each health state had ≥130 valuations. The mean (SD) utility of the basic health state was 0.60 (0.34). For acute events, mean utility differences versus the basic state were: myocardial infarction, -0.06; unstable angina, -0.05; peripheral vascular disease (PVD) with amputation, -0.33; PVD without amputation, -0.11; heart failure, -0.14; stroke, -0.30; hip fracture, -0.14; arm fracture, -0.04; parathyroidectomy, +0.02; kidney transplant, +0.06. Disutilities for chronic health states were: stable angina, -0.09; stroke, -0.27; PVD with amputation, -0.30; PVD without amputation, -0.12; heart failure, -0.14. Conclusions: Cardiovascular events and fractures were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of CKD and SHPT.

AB - Background: Patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) who require dialysis are at increased risk for cardiovascular events and bone fractures. To assist in economic evaluations, this study aimed to estimate the disutility of these events beyond the impact of CKD and SHPT. Methods: A basic one-year health state was developed describing CKD and SHPT requiring dialysis. Further health states added acute events (cardiovascular events, fractures, and surgical procedures) or chronic post-event effects. Acute health states described a year including an event, and chronic health states described a year subsequent to an event. General population participants in Canada completed time trade-off interviews from which utilities were derived. Pairwise comparisons were made between the basic state and event, and between comparable health states. Results: A total of 199 participants (54.8% female; mean age=46.3 years) completed interviews. Each health state had ≥130 valuations. The mean (SD) utility of the basic health state was 0.60 (0.34). For acute events, mean utility differences versus the basic state were: myocardial infarction, -0.06; unstable angina, -0.05; peripheral vascular disease (PVD) with amputation, -0.33; PVD without amputation, -0.11; heart failure, -0.14; stroke, -0.30; hip fracture, -0.14; arm fracture, -0.04; parathyroidectomy, +0.02; kidney transplant, +0.06. Disutilities for chronic health states were: stable angina, -0.09; stroke, -0.27; PVD with amputation, -0.30; PVD without amputation, -0.12; heart failure, -0.14. Conclusions: Cardiovascular events and fractures were associated with lower utility scores, suggesting a perceived decrease in quality of life beyond the impact of CKD and SHPT.

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Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis

Abstract

Bibliographical note

ASJC Scopus Subject Areas

UN SDGs

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