PIN77 Elicitation of Health-Related Quality of Life Concepts Associated With Cytomegalovirus in Transplant Recipients

Abstract

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.

Cytomegalovirus Management in Solid Organ Transplant Recipients: A Pre-COVID-19 Survey From the Working Group of the European Society for Organ Transplantation

“…Cytomegalovirus (CMV) is one of the most important opportunistic viral pathogens in the solid organ transplant (SOT) setting (1)(2)(3); CMV infection and disease (defined as evidence of infection with attributable symptoms (4)) can cause adverse outcomes for allograft and recipient survival, increase the cost of transplantation, and negatively impact health-related quality of life (1)(2)(3).…”

Evaluation of Two Different CMV-Immunoglobulin Regimens for Combined CMV Prophylaxis in High-Risk Patients following Lung Transplant

“…In addition, indirect effects can lead to severe complications such as other secondary opportunistic infections, post-transplantation lymphoproliferative disorder (PTLD), graft dysfunction and failure, acute rejection, transplant and nontransplant vascular disease, new-onset diabetes, or bronchiolitis obliterans syndrome (BOS) [ 5 ]. Besides the clinical impact, CMV infection increases healthcare resource use and hospitalization costs and negatively impacts the patient’s quality of life compared with those without CMV disease [ 6 , 7 ].…”