Preferences for Fractures and Other Glucocorticoid-Associated Adverse Effects among Rheumatoid Arthritis Patients

Abstract

Relative to their current health, RA patients assigned low preference values to many glucocorticoid adverse events, particularly those associated with chronic fracture outcomes. Results varied with the preference measure used, indicating that methodological attributes of preference determinations must be considered in clinical decision making.

An updated systematic review of Health State Utility Values for osteoporosis related conditions

“…7 http://www.medscinet.com/IcurosTest/default.aspx. 8 Merlino et al [52] study fractures among rheumatoid arthritis patients, and also find that utility states for a hypothetical hip fracture were lower among those had not experienced an osteoporotic fracture than for those who had previously experienced a fracture. However, sample sizes are small.…”

A meta-analysis demonstrates no significant differences between patient and population preferences

“…This process left 94 articles eligible for data entry. Thirty-one articles were excluded because they reported only patient preferences (n 5 14) [22][23][24][25][26][27][28][29][30][31][32][33][34][35], population preferences (n 5 14) [36][37][38][39][40][41][42][43][44][45][46][47][48][49], or proxy preferences (n 5 3) [50][51][52]. Two articles reported mixed patient and proxy preferences and compared these with population preferences [53,54].…”

Methods for Measuring Temporary Health States for Cost-Utility Analyses

“…Stroke and stroke prophylaxis [35] Fractures, infection, peptic ulcer, pneumonia [36] Hormone replacement therapy, osteoporosis prevention [37,38] a Time traded from end of life is discounted to the present value of that time. duration of the temporary health state to calculate the change in QALYs associated with the temporary health state.…”

“…In this approach, the respondent is asked for the amount of time he or she is willing to spend sleeping in a non-restful state compared with time spent in a temporary health state. [36,37] This approach avoids the need for discounting. As with all variations of the TTO, it allows for investigator discretion in the description of the health states, and thus domains can be customized for temporary health states.…”