The responsiveness and validity of the CAMPHOR Utility Index

Abstract

The aim of the present study was to validate and determine the mininal important difference (MID) and responsiveness of the Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) Utility Index, a new tool enabling cost utility analyses.CAMPHOR, 6-min walking test (6MWT) and New York Heart Association (NYHA) data for 869 pulmonary hypertension patients (545 (63%) female; mean¡SD age 56.6¡15.4 yrs) from three centres were analysed. Utility was correlated with 6MWT data and calculated by NYHA class to assess validity. Effect sizes were calculated for those with two CAMPHOR assessments. Distribution and anchor-based MIDs were calculated. Analyses were carried out in patients receiving bosentan in order to determine whether or not those remaining in NYHA class III following treatment improved.The Utility Index distinguished between adjacent NYHA classes and correlated with 6MWT results. CAMPHOR subscales and utility were as responsive as the 6MWT (effect sizes ranged 0.31-0.69 for the CAMPHOR and 0.16-0.34 for the 6MWT). The within-group MID for the Utility Index was estimated to be ,0.09. Patients remaining in NYHA class III experienced, on average, a significant improvement (CAMPHOR Utility Index and functioning), which exceeded the MID.The CAMPHOR Utility Index is valid and responsive to change. Patients can experience significant and important improvements even if they do not improve on the basis of traditional outcomes, such as NYHA functional class.

Replacement therapy for iron deficiency improves exercise capacity and quality of life in patients with cyanotic congenital heart disease and/or the Eisenmenger syndrome

“…This is a questionnaire designed specifically for patients with PAH and was selected because a significant proportion of cyanotic CHD patients have PAH [15]. It has been validated in patients with PAH and has good reproducibility, excellent internal consistency and is more sensitive to changes in clinical status compared to other non-specific QoL instruments [16].…”

Oral anticoagulants for primary prevention, treatment and secondary prevention of venous thromboembolic disease, and for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis and cost-effectiveness analysis

“…For the VTE-related chronic health states, we used estimates from the study by Lenert and Soetikno,89 who elicited preferences in 30 volunteers and 30 medicine physicians with mild/moderate PTS and severe PTS, and the study of Meads et al,93 who used the Cambridge Pulmonary Hypertension Outcome Review utility index 94 to estimate a utility value for CTPH from 308 patients (see Table 14). Further chronic VTE-related chronic health-state utilities extracted from the literature are reported in Table 17.…”

Economic Analysis of Rivaroxaban for the Treatment and Long-Term Prevention of Venous Thromboembolism in Portugal

“…The starting point in the modelling of utility was the population norm value of 0.825 (SD 0.17, n = 3395) established in the landmark UK EQ-5D survey, 34 which was used as an anchor point in this evaluation. The values used in the analysis were applied either as multipliers to the population norm value (DVT, PE, PTS, EC bleed and IC bleed) 35,36 or as straight values when derived using the EQ-5D or comparable methods (post-IC bleed and CTEPH) 37,38 (Table 2). A disutility associated with warfarin was not applied in the base-case, but was tested in a sensitivity analysis (0.988).…”