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

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...

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Autores principales: Davies, Evan W., Matza, Louis S., Worth, Gavin, Feeny, David H., Kostelec, Jacqueline, Soroka, Steven, Mendelssohn, David, McFarlane, Philip, Belozeroff, Vasily
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487205/
https://www.ncbi.nlm.nih.gov/pubmed/26122041
http://dx.doi.org/10.1186/s12955-015-0266-9
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author Davies, Evan W.
Matza, Louis S.
Worth, Gavin
Feeny, David H.
Kostelec, Jacqueline
Soroka, Steven
Mendelssohn, David
McFarlane, Philip
Belozeroff, Vasily
author_facet Davies, Evan W.
Matza, Louis S.
Worth, Gavin
Feeny, David H.
Kostelec, Jacqueline
Soroka, Steven
Mendelssohn, David
McFarlane, Philip
Belozeroff, Vasily
author_sort Davies, Evan W.
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12955-015-0266-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-44872052015-07-02 Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis Davies, Evan W. Matza, Louis S. Worth, Gavin Feeny, David H. Kostelec, Jacqueline Soroka, Steven Mendelssohn, David McFarlane, Philip Belozeroff, Vasily Health Qual Life Outcomes Research Article 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12955-015-0266-9) contains supplementary material, which is available to authorized users. BioMed Central 2015-06-30 /pmc/articles/PMC4487205/ /pubmed/26122041 http://dx.doi.org/10.1186/s12955-015-0266-9 Text en © Davies et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Davies, Evan W.
Matza, Louis S.
Worth, Gavin
Feeny, David H.
Kostelec, Jacqueline
Soroka, Steven
Mendelssohn, David
McFarlane, Philip
Belozeroff, Vasily
Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title_full Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title_fullStr Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title_full_unstemmed Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title_short Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
title_sort health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487205/
https://www.ncbi.nlm.nih.gov/pubmed/26122041
http://dx.doi.org/10.1186/s12955-015-0266-9
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