Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

A General Population Utility Valuation Study for Metastatic Epidural Spinal Cord Compression Health States

Pahuta, Markian A. MD; Wai, Eugene K. MD, MSc; Werier, Joel MD; van Walraven, Carl MD, MSc; Coyle, Doug PhD§

doi: 10.1097/BRS.0000000000002975
HEALTH SERVICES RESEARCH
Buy
SDC
SLIDE

Study Design. General population utility valuation study.

Objective. This study obtained utility valuations from a Canadian general population perspective for 31 unique metastatic epidural spinal cord compression (MESCC) health states and determined the relative importance of MESCC-related consequences on quality-of-life.

Summary of Background Data. Few prospective studies on the treatment of MESCC have collected quality-adjusted-life-year weights (termed “utilities”). Utilities are an important summative measure which distills health outcomes to a single number that can assist healthcare providers, patients, and policy makers in decision making.

Methods. We recruited a sample of 1138 adult Canadians using a market research company. Quota sampling was used to ensure that the participants were representative of the Canadian population in terms of age, sex, and province of residence. Using the validated MESCC module for the “Self-administered Online Assessment of Preferences” (SOAP) tool, participants were asked to rate six of the 31 MESCC health states, each of which presented varying severities of five MESCC-related dysfunctions (dependent; non-ambulatory; incontinent; pain; other symptoms).

Results. Participants equally valued all MESCC-related dysfunctions which followed a pattern of diminishing marginal disutility (each additional consequence resulted in a smaller incremental decrease in utility than the previous). These results demonstrate that the general population values physical function equal to other facets of quality-of-life.

Conclusion. We provide a comprehensive set of ex ante utility estimates for MESCC health states that can be used to help inform decision making. This is the first study reporting direct utility valuation for a spinal disorder. Our methodology offers a feasible solution for obtaining quality-of-life data without collecting generic health status questionnaire responses from patients.

Level of Evidence: 4

Quality-adjusted-life-year weights (utilities) from metastatic epidural spinal cord compression (MESCC) health state valuations provided by non-patient members of the general population. Participants equally valued all MESCC-related dysfunctions which followed a pattern of diminishing marginal disutility. This is the first study reporting direct utility valuation for a spinal disorder.

Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan

Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada

Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada

§School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.

Address correspondence and reprint requests to Markian A. Pahuta, MD, Department of Orthopaedic Surgery, Henry Ford Health System, 2799 West Grand Blvd, CFP-6, Detroit, MI 48202; E-mail: mark@pahutamd.com

Received 4 October, 2018

Revised 4 December, 2018

Accepted 13 December, 2018

The manuscript submitted does not contain information about medical device(s)/drug(s).

The Hans K. Uthoff Fund grant funds were received in support of this work.

No relevant financial activities outside the submitted work.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (www.spinejournal.com).

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.