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Research ArticleArticle

Health State Utilities and Disease Duration in Systemic Sclerosis: Is There an Association?

Adam J.N. Raymakers, Nicole W. Tsao, Carlo A. Marra, Philip J. Clements and Dinesh Khanna
The Journal of Rheumatology October 2016, 43 (10) 1832-1837; DOI: https://doi.org/10.3899/jrheum.160162
Adam J.N. Raymakers
From the Collaboration for Outcomes Research and Evaluation (CORE), Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia; School of Pharmacy, Memorial University of Newfoundland, St. John’s, Newfoundland, Canada; University of Michigan, Ann Arbor, Michigan; Division of Rheumatology, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, USA.
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Nicole W. Tsao
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Carlo A. Marra
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Philip J. Clements
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Dinesh Khanna
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  • For correspondence: khannad{at}med.umich.edu
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Article Figures & Data

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  • Boxplot of HSUV scores by measure. SF-6D, n = 211. SG, n = 222. TTO, n = 222. VAS, n = 222. HSUV: health state utility value; SF-6D: Short Form 6D; SG: standard gamble; TTO: time tradeoff; VAS: visual analog scale.
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    Figure 1.

    Boxplot of HSUV scores by measure. SF-6D, n = 211. SG, n = 222. TTO, n = 222. VAS, n = 222. HSUV: health state utility value; SF-6D: Short Form 6D; SG: standard gamble; TTO: time tradeoff; VAS: visual analog scale.

Tables

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    Table 1.

    Study participant characteristics (n = 223).

    VariableValue
    Age, yrs, mean (SD)50.9 (15.5)
    Female, %84.30
    Disease duration, yrs, mean (SD)7.37 (7.85)
    Alcohol use, %48
    Marital status, married, %58.80
    Education, %
      Less than high school graduate4.10
      High school graduate12.70
      Postsecondary education83.20
    Income, %, US$/year
      < 25,00019.90
      25,000 to 50,00016.80
      50,000 to 75,00014.90
      > 75,00048.40
    Insurance type, %
      Private56.70
      Medicare/Medi-Cal24.30
      Medicare + private12.40
      None1.40
    Ethnicity, %
      White71.70
      Black/African American6.30
      Asian12.10
      More than one2.20
      Unknown6.30
    SSc type, n (%)
      Localized SSc1 (0.46)
      Diffuse SSc90 (41.29)
      Limited SSc112 (51.38)
      Sine SSc4 (2.29)
      Overlap10 (4.59)
    • SSc: systemic sclerosis.

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    Table 2.

    Regression coefficients and 95% CI of univariate analyses with each HSUV measure as the outcome. Values are coefficient (95% CI).

    VariableSGTTOSF-6DVAS
    Duration, cont.0.004 (0.0001–0.008)0.004 (−0.001 to 0.009)0.002 (−0.001 to 0.004)−0.001 (−0.005 to 0.002)
    Duration, > 1 yr*0.015 (−0.06 to 0.089)0.051 (−0.043 to 0.144)0.056 (0.012–0.101)0.008 (−0.058 to 0.075)
    Duration, > 2 yrs*0.076 (0.009–0.142)0.084 (0–0.167)0.036 (−0.005 to 0.076)0.033 (−0.027 to 0.092)
    Age, yrs−0.001 (−0.003 to 0.001)−0.001 (−0.003 to 0.002)0.0002 (−0.001 to 0.001)−0.002 (−0.004 to −0.0001)
    Sex−0.037 (−0.121 to 0.046)0.028 (−0.077 to 0.133)−0.009 (−0.058 to 0.040)0.014 (−0.059 to 0.087)
    Income0.014 (−0.013 to 0.042)0.012 (−0.022 to 0.047)0.031 (0.016–0.046)0.028 (0.005–0.052)
    Education0.022 (−0.003 to −0.046)0.028 (−0.003 to 0.059)0.018 (0.003–0.032)0.008 (−0.015 to 0.030)
    SSc type†−0.089 (−0.152 to −0.026)−0.120 (−0.199 to −0.041)−0.04 (−0.076 to −0.004)−0.035 (−0.091 to 0.021)
    mRSS, cont.−0.005 (−0.009 to −0.002)−0.007 (−0.011 to −0.003)−0.003 (−0.005 to −0.001)−0.004 (−0.007 to 0)
    HAQ-DI−0.092 (−0.133 to −0.049)−0.161 (−0.212 to −0.111)−0.106 (−0.127 to −0.086)−0.106 (−0.141 to −0.070)
    CES-D−0.001 (−0.015 to −0.005)−0.014 (−0.020 to −0.008)−0.015 (−0.017 to 0.013)−0.015 (−0.019 to −0.011)
    FACIT Fatigue Scale−0.005 (−0.007 to −0.003)−0.009 (−0.011 to −0.006)−0.008 (−0.009 to −0.007)−0.007 (−0.009 to −0.005)
    Ethnicity−0.033 (−0.103 to 0.037)−0.038 (−0.126 to 0.050)−0.068 (−0.108 to −0.028)−0.037 (−0.099 to 0.024)
    Marital status**0.019 (−0.043 to 0.081)−0.014 (−0.092 to 0.064)0.018 (−0.018 to 0.054)0.004 (−0.050 to 0.059)
    • ↵* For these variables, the variable is equal to 1 if the condition is met.

    • ↵† SSc type is equal to 0 for lcSSc and equal to 1 for dcSSc.

    • ↵** Marital status is equal to 1 if married and 0 if otherwise. Significant data are in bold face (p < 0.05). HSUV: health state utility value; SG: standard gamble; TTO: time tradeoff; SF-6D: Short Form 6D; VAS: visual analog scale; cont.: continuous variable; SSc: systemic sclerosis; mRSS: modified Rodnan skin score; HAQ-DI: Health Assessment Questionnaire–Disability Index; CES-D: Center for Epidemiologic Studies Depression Scale; FACIT: Functional Assessment of Chronic Illness Therapy.

    • View popup
    Table 3.

    Regression coefficients for primary and subgroup analyses with 95% CI for disease duration in multivariate analyses with each HSUV measure as the outcome. Adjusted for age, sex, mRSS, education, CES-D, and HAQ-DI.

    VariablesSGTTOSF-6DVAS
    Coeff95% CICoeff95% CICoeff95% CICoeff95% CI
    Primary analysis
      Duration*0.0040.00004–0.0070.0007−0.004 to 0.0050.001−0.0002 to 0.0030.002−0.005 to 0.0009
      Duration > 2 yrs**0.0720.010–0.1380.072−0.009 to 0.1530.0370.014–0.0680.061−0.017 to 0.089
    Subgroup analysis
      Patients with dcSSc only
        Duration*0.005−0.004 to 0.014−0.006−0.017 to 0.0040.002−0.002 to 0.0060.001−0.005 to 0.006
        Duration > 2 yrs**0.062−0.056 to 0.1800.039−0.105 to 0.1830.033−0.007 to 0.0730.056−0.021 to 0.133
      Patients with lcSSc only
        Duration*0.030−0.001 to 0.0070.003−0.002 to 0.0080.002−0.00002 to 0.004−0.003−0.007 to 0.0003
        Duration > 2 yrs**0.1090.029–0.1880.1180.015–0.2200.0610.018–0.1040.038−0.046 to 0.123
    • ↵* Disease duration modeled as continuous variable.

    • ↵** Disease duration modeled as categorical variable (equal to 1 if greater than 2 yrs). Significant data are in bold face (p < 0.05). HSUV: health state utility value; mRSS: modified Rodnan skin score; CES-D: Center for Epidemiologic Studies Depression Scale; HAQ-DI: Health Assessment Questionnaire–Disability Index; SG: standard gamble; TTO: time tradeoff; SF-6D: Short Form 6D; VAS: visual analog scale; Coeff: regression coefficient; SSc: systemic sclerosis; dcSSc: diffuse cutaneous SSc; lcSSc: limited cutaneous SSc.

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Vol. 43, Issue 10
1 Oct 2016
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Health State Utilities and Disease Duration in Systemic Sclerosis: Is There an Association?
Adam J.N. Raymakers, Nicole W. Tsao, Carlo A. Marra, Philip J. Clements, Dinesh Khanna
The Journal of Rheumatology Oct 2016, 43 (10) 1832-1837; DOI: 10.3899/jrheum.160162

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Health State Utilities and Disease Duration in Systemic Sclerosis: Is There an Association?
Adam J.N. Raymakers, Nicole W. Tsao, Carlo A. Marra, Philip J. Clements, Dinesh Khanna
The Journal of Rheumatology Oct 2016, 43 (10) 1832-1837; DOI: 10.3899/jrheum.160162
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Keywords

QUALITY OF LIFE
DISEASE DURATION
SYSTEMIC SCLEROSIS
UTILITY SCORE
HEALTH STATE UTILITY VALUES
STANDARD GAMBLE

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Keywords

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  • UTILITY SCORE
  • HEALTH STATE UTILITY VALUES
  • STANDARD GAMBLE

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