RS1: OUTCOME ASSESSMENT IN PEDIATRIC ASTHMA: A COMPARISON OF SYMPTOM-FREE TIME AND MULTI-ATTRIBUTE SCALE

Abstract

INTRODUCTION: Most current asthma outcome measures are either not sensitive enough to detect changes caused by interventions or not broad enough to cover all health domains affected by the disease. OBJECTIVE: To develop a comprehensive measure of health outcomes for children with asthma that is in compliance with the recommendations of the U.S. Panel on Cost-Effectiveness in Health and Medicine, and compare health outcomes estimated with that measure to those estimated with the symptom-free day, the most commonly used measure. METHODS: 1) Develop a multi-attribute Pediatric Asthma Health Outcome Measure, PAHOM, that assesses the impact of asthma on children's symptoms, emotions, and physical activity; 2) Collect data on preference weights (Ui) for asthma health states from 101 adults using the standard gamble technique; 3) Collect data on the incidence of health states (Pi) from 72 children with asthma using PAHOM calendar; and 4) Calculate the expected utility by summing all of (Ui*Pi). The expected utility can be used as a proxy of health outcome if it is assumed that health outcomes of these children are constant for the remaining life years. RESULTS: On a scale ranging from zero to one, where perfect health had a score of one, the average utility of pediatric asthma patients in the study was 0.900 when measured with the PAHOM, compared to 0.955 when measured with a symptom-free day. CONCLUSION: PAHOM, a more comprehensive measure of health outcomes than symptom-free day measure, provides lower estimates of average utility of asthma pediatric asthma patients.