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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2015

Open Access 01-12-2015 | Research Article

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

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

Published in: Health and Quality of Life Outcomes | Issue 1/2015

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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.
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Metadata
Title
Health state utilities associated with major clinical events in the context of secondary hyperparathyroidism and chronic kidney disease requiring dialysis
Authors
Evan W. Davies
Louis S. Matza
Gavin Worth
David H. Feeny
Jacqueline Kostelec
Steven Soroka
David Mendelssohn
Philip McFarlane
Vasily Belozeroff
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2015
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-015-0266-9

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