One Thousand Health-Related Quality-of-Life Estimates

Tengs, Tammy O.; Wallace, Amy E.

doi:10.1097/00005650-200006000-00004

Cited by 604 publications

(398 citation statements)

References 27 publications

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“…Large-scale studies have used questionnaires to establish utility values for a variety of health states. Arthritis has consistently been shown to have a utility value near 0.7 [30][31][32][33]. Knee and hip arthroplasties have been shown to increase quality of life weightings close to normal values.…”

Section: Effectivenessmentioning

confidence: 99%

Cost-effectiveness Analysis of Core Decompression

SooHoo

Vyas

Manunga

et al. 2006

The Journal of Arthroplasty

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Core decompression is widely used to treat the early stages of osteonecrosis of the hip. The purpose of this analysis is to assist orthopedic surgeons in judging whether currently available data support the use of core decompression as cost-effective. A decision model was created for the treatment of osteonecrosis of the femoral head. Literature review was used to identify possible outcomes and their probability after initial treatment with either observation or core decompression. This model demonstrates core decompression must delay the need for total hip arthroplasty for a minimum of 5 years to maintain an incremental cost-effectiveness ratio lower than $50 000 per quality-adjusted life year gained. Treatment options with ratios higher than $50 000 per quality-adjusted life year are generally considered to have limited cost-effectiveness. This study demonstrates that core decompression has the potential to be a highly cost-effective alternative if it is leads to a delay in the need for total hip arthroplasty of 5 years or longer.

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Section: Effectivenessmentioning

confidence: 99%

Cost-effectiveness Analysis of Core Decompression

SooHoo

Vyas

Manunga

et al. 2006

The Journal of Arthroplasty

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“…The effectiveness of each procedure or health state is measured in utility units that incorporate subjective measures of wellness or quality of life [11]. Each health state in the model is assigned a utility value along a continuum of 1.0 equaling perfect health and 0.0 equaling death based on quality of wellbeing index scores [9,10,23,24,26]. The utility for each health state then is multiplied by the number of years a patient experiences that health state and is reported in QALY.…”

Section: Introductionmentioning

confidence: 99%

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Courville

Hecht

Tosteson

2011

Clinical Orthopaedics &Amp; Related Research

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Background Total ankle arthroplasty (TAA) implantation is increasing, as the potential for pain relief and restoration of function and risks are compared with those for ankle fusion. A previous analysis with a simple decision tree suggested TAA was cost-effective compared with ankle fusion. However, reevaluation is warranted with the availability of newer, more costly implants and longer-term patient followup data. Questions/purposes Considering all direct medical costs regardless of the payer, we determined if TAA remains a cost-effective alternative to ankle fusion when updated evidence is considered. Patients and Methods Using a Markov model, we evaluated expected costs and quality-adjusted life years (QALY) for a 60-year-old hypothetical cohort with endstage ankle arthritis treated with either TAA or ankle fusion. Costs were estimated from 2007 diagnosis-related group (DRG) and current procedural terminology (CPT) codes for each procedure. Rates were extracted from the literature. The incremental cost-effectiveness ratio (ICER), a measure of added cost divided by QALY gained for TAA relative to ankle fusion, was estimated. To identify factors affecting the value of TAA, sensitivity analyses were performed on all variables.

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“…Strength of preference estimates via the VAS were close to TTO values. The scores by all three methods were generally in the range of those for serious medical problems, such as stroke, heart attack, and cancer (30). Furthermore, quality-of-life scores are similar to those for major depression but slightly higher than for disorders involving psychoses (bipolar disorder and schizophrenia).…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, quality-of-life scores are similar to those for major depression but slightly higher than for disorders involving psychoses (bipolar disorder and schizophrenia). In a comprehensive review paper, Tengs and Wallace (30) reported median quality-of-life scores for an episode of depression and of severe bipolar disorder or schizophrenia of .77 and .65, respectively.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Health-Related Quality-of-Life Utilities Among Persons With Posttraumatic Stress Disorder

Doctor¹,

Zoellner²,

Feeny³

2011

Psychiatric Services

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Objectives This study had two objectives: to elicit preferences for current health in a sample of persons with posttraumatic stress disorder (PTSD ) in order to establish quality-of-life estimates for this disorder and to identify symptoms and problems that predict these estimates. Methods The authors used the standard gamble (SG), time tradeoff (TTO), and visual analog scale (VAS) methods for quality-of-life estimation at baseline among 184 individuals with chronic PTSD who were participating in a multisite clinical trial. Descriptive statistics were used to characterize quality-of-life estimates for the sample. A linear mixed-effects regression model was conducted to evaluate predictors of quality of life. Results The modal participant was a single, white female (77%). The mean±SD age of the sample was 37.31±11.33. On a scale where full health is 1.0 and death is 0.0, mean quality-of-life estimates for living with PTSD were .87±.25, .66±.28, and .64±.20 for SG, TTO, and VAS, respectively. Linear mixed-effects model regression revealed that elicitation method (SG, TTO, and VAS), arousal (a symptom of PTSD), and endorsement of anxiety or depressive symptoms were the strongest predictors of lower quality-of-life scores. Avoidance and re-experiencing of trauma were not predictive of reduced quality of life. Conclusions Significant decrements in health-related quality of life were found among persons seeking treatment for PTSD. Although arousal and anxiety and depressive symptoms were predictive of quality-of-life estimates, avoidance and re-experiencing were not. These findings identify targets for symptom resolution that may improve quality of life among persons with PTSD.

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One Thousand Health-Related Quality-of-Life Estimates

Abstract: This comprehensive review of QOL data should lead to more consistent use of QOL weights and thus more comparable cost-effectiveness analyses.

Cited by 604 publications

References 27 publications

Cost-effectiveness Analysis of Core Decompression

Cost-effectiveness Analysis of Core Decompression

Is Total Ankle Arthroplasty A Cost-effective Alternative to Ankle Fusion?

Predictors of Health-Related Quality-of-Life Utilities Among Persons With Posttraumatic Stress Disorder

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