OBJECTIVES: Clostridium difficile infection (CDI) can lead to several complications from mild diarrhoea to toxic megacolon. The objectives of this study were to: 1) evaluate standard Time trade-off (TTO) and chain TTO techniques for eliciting utility of CDI-related chronic and temporary health states; 2) compare those values with those from Healthcare Professional (HCP) EQ-5D valuation; 3) evaluate methods of calculating utilities for health states worse than death (WTD). METHODS: Ten health state vignettes were developed from literature with input from HCPs. Participants from the UK public were interviewed: 50 for the pilot and 100 for the main study. Each participant provided sociodemographic information, ranking of health states by preference and responses to a Computer-Assisted Personal Interview TTO protocol for all states considered. HCPs provided EQ-5D data. Methods to apprehend the impact of extreme negative utilities were appraised: truncation and monotonic transformation. RESULTS: Temporary health state utilities ranged from (mean and (/) median from non transformed method; mean and median (/) from monotonically transformed method): -2.70/0.7;0.39/0.6 for mild diarrhoea to -32.50/-1.1; -0.23/-0.5 for colectomy. Chronic health state ranged from: -2.37/0.5; 0.35/0.5 for chronic diarrhoea to -7.98/0;-0.13/0 for chronic renal failure. Population valuations were more severe for most health states when compared with HCP values. CONCLUSIONS: While transformation has an important impact on results, nowadays there is no reliable measure of utilities for CDI-health states. The proportion of participants judging health states as WTD was unexpectedly high; questioning the suitability of face-to-face TTO interview in this disease area. The monotonic transformation was convenient but lacks theoretical grounding. Other methods like Lead Time trade-off could add value to similar research.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.