Use Of Scores Research Articles

Mapping of the health of the Nation Outcomes Scale (HoNOS) and Positive and Negative Symptom Scale (PANSS) to the EQ-5D-3L in psychosis patients using the PHAMOUS study

ABSTRACT Objectives When health outcomes relevant for economic evaluations are unavailable, algorithms can be developed to map utilities using available clinical outcome measures. This study aims to develop two mapping algorithms estimating EuroQol-5 dimension-3 level (EQ-5D-3 L) utilities using the clinician-rated Health of the Nation Outcome Scores (HoNOS) and Positive and Negative Syndrome Scale (PANNS). Methods A dataset with 2,029 observations of patients with psychotic disorders included EQ-5D-3 L, HoNOS, PANSS item scores, and demographics. Correlations between instruments were evaluated. Least Absolute Shrinkage and Selection Operator (LASSO) regression and random forest (RF) algorithms with various predictor variable sets were applied. Model performance was cross-validated using R-squared and Root Mean Square Error (RMSE). Results High ceiling effects were observed for EQ-5D-3 L, with weak to moderate negative correlations between EQ-5D and HoNOS (r = -0.34) and PANSS (r = -0.27). Overall, LASSO models outperformed RF models, with individual item models performing best for the HoNOS and PANSS, with the best observed RMSEs of 0.241 and 0.231, respectively. Conclusions The HoNOS and PANSS could be mapped onto EQ-5D-3 L utilities but lack accuracy for individual patient predictions. However, in the absence of alternatives, they could adequately predict population-based utility score differences for health economic evaluations.

The societal burden associated with adolescent idiopathic scoliosis: a cross-sectional burden-of-disease study.

In the general population the prevalence of adolescent idiopathic scoliosis (AIS) is 2-3%. There is growing awareness of how AIS affects the quality of life of patients. However, the extent of the societal burden AIS poses remains poorly understood. Therefore, this study aimed to determine the societal burden of AIS. A cross-sectional burden of disease study was conducted using a bottom-up, prevalence-based approach. Patients with AIS or guardians of a child diagnosed with AIS residing in the Netherlands were eligible for inclusion. The survey was distributed between June - December 2022 and was completed once by each participant. Costs were assessed using the institute for Medical Technology Assessment - Medical Consumption and Productivity Cost Questionnaires. The health-related quality of life (HRQoL) was assessed using the EuroQol 5D-5L/EuroQol 5D Youth and the Scoliosis Research Society-22 revised questionnaires. Costs and HRQoL were identified, measured, and valued. Participants (n = 229) were predominantly female (92%), on average 35 years old, and were employed (65%). The societal cost for a patient with AIS in the Netherlands was €12,275 per year. The largest costs were estimated for the healthcare and productivity losses. The mean utility score for adults was 0.7 (SD 0.20). Severe pain was experienced by 10% of the adult participants and 44% reported to experience moderate pain/discomfort. Statistically significant differences between different age groups were present for the sector costs and HRQoL. AIS negatively impacts societal costs and the HRQoL. Reducing the burden that is posed on the productivity sector by AIS and further improving the HRQoL for AIS patients is needed.

Health Utility Values Among Patients With Diabetic Retinopathy, Wet Age-Related Macular Degeneration, and Cataract in Thailand: A Multicenter Survey Using Time Trade-Off, EQ-5D-5L, and Health Utility Index 3

ObjectivesThis study aimed to establish normative health utility data in Thai patients with diabetic retinopathy, wet age-related macular degeneration, and cataract; evaluate the sensitivity of different utility instruments to visual impairment; explore the relationship among these health utility values with the vision-specific quality of life (QoL); and assess the association of baseline characteristics and visual acuity level with health utility values and vision-specific QoL. MethodsThis multicenter cross-sectional survey included 309 patients from tertiary eye centers. We used health utility instruments (time trade-off [TTO], EuroQol five-dimension [EQ-5D-5L], and Health Utility Index 3 [HUI3]) and vision-specific QoL instrument (National Eye Institute Visual Function Questionnaire) for face-to-face interviews. Demographic data and Early Treatment Diabetic Retinopathy Study visual acuity were recorded during the participants ophthalmic visits. Univariable and multivariable mixed-effect models were used to evaluate factors associated with the utility scores. Health utility scores among each type of eye disease were compared. ResultsThe overall mean utility values from the TTO, EQ-5D-5L, and HUI3 were 0.84 ± 0.25, 0.70 ± 0.19, and 0.68 ± 0.26, respectively. The health utility scores obtained from TTO and HUI3 showed a significant response to severe visual impairment or worse. Health utility scores from HUI3 (r = 0.54; P < .01) and EQ-5D-5L (r = 0.43; P < .01) displayed a moderate correlation with the National Eye Institute Visual Function Questionnaire score. There were no significant differences in health utility value among the 3 diseases upon adjusting for the visual acuity level and demographics. ConclusionsVisual acuity level has a greater impact on a patient’s QoL than the type of eye disease. HUI3 and EQ-5D-5L and TTO are suitable for measuring health utility in leading causes of blindness.

An Updated Framework for Modeling White-Tailed Deer (Odocoileus virginianus) Habitat Quality in Illinois, USA.

White-tailed deer (Odocoileus virginianus) are a cervid species found mostly in the Americas. Managing white-tailed deer requires understanding their relationship with the environment, which was characterized by Roseberry and Woolf (Wildlife Society Bulletin 1, 1998, 252) for all counties in Illinois, USA, who incorporated habitat quantity and quality in a deer habitat suitability index. However, this index was based on satellite imagery from 1996 and did not explore the smaller spatial scales used by deer. Our study addressed these gaps by developing a deer land cover utility (LCU) score for each TRS (township, range, and section), township, and county in Illinois based on the methodology outlined in Roseberry and Woolf (Wildlife Society Bulletin 1, 1998, 252) but using data from the National Land Cover Database (2001-2021). These deer LCU scores were validated against minimum deer population data using Bayesian regression with additional covariates relevant to hunting and deer density. These models performed well with Bayesian R 2 values of 0.501 (TRS), 0.5 (township), and 0.969 (county). The regression coefficients for the deer LCU scores were statistically significant (95% credibility interval not containing 0) and positive at the TRS, township, and county levels, reflecting the expected relationship between minimum deer density and deer LCU. Predictions made by these regression models on new data were accurate, with the median absolute difference between the true and predicted values being 0.398 deer/km2 for TRS', 0.085 deer/km2 for townships, and 0.066 deer/km2 for counties. This deer LCU could be used in other studies about deer in Illinois or studies in which deer are a relevant factor such as investigations about deer disease or tick distribution. This modeling approach could also be adapted to different wild species, locations, and/or time periods for which land cover data is available.

Utility analysis of outpatient hypertensive patients with and without comorbidities using the EQ-5D-5L instrument: A study at UPTD Puskesmas Pagerageung, Tasikmalaya Regency, West Java

Hypertension is a chronic condition often requiring lifelong treatment, which can impact patients’ quality of life (QoL) in physical, psychological, and social domains. The presence of comorbid conditions alongside hypertension can further deteriorate QoL. Health utility measurement, particularly in hypertensive patients with comorbidities, is crucial for understanding these compounded effects. This study aims to evaluate and compare the quality of life utility in hypertensive patients with and without comorbidities using the EQ-5D-5L instrument, focusing on how comorbid conditions influence overall QoL. A descriptive observational study with a cross-sectional design was conducted among 100 hypertensive patients treated at UPTD Puskesmas Pagerageung, Tasikmalaya, from January to March 2024. Participants were selected through purposive sampling. The EQ-5D-5L questionnaire was used to assess utility scores, which were calculated using an Indonesian-specific value set. Chi-square and Post Hoc LSD analyses were applied to explore relationships between utility scores and demographic factors such as age, gender, and occupation. The average utility score for hypertensive patients without comorbidities was 0.669, higher than that of patients with comorbid conditions. Specifically, patients with diabetes mellitus, osteoarthritis, gastric conditions, heart disease, and severe comorbidities (e.g., kidney disease, cataracts, stroke) had average scores of 0.578, 0.640, 0.651, 0.537, and 0.148, respectively. Age was significantly associated with utility scores (p = 0.014), whereas gender and occupation showed no significant impact. Hypertensive patients without comorbidities had a better quality of life utility than those with additional health issues. Targeted management of comorbidities is essential to improve the quality of life among hypertensive patients, especially in those facing compounded health challenges.

Cost-effectiveness analysis of implementing the Nagasaki Acute Myocardial Infarction (AMI) secondary prevention clinical pathway

Abstract Background/Introduction Because of the poor prognosis associated with acute coronary syndromes (ACS), intensive low-density lipoprotein cholesterol (LDL-C) management therapy is recommended as early as possible after the onset of ACS, with the goal of lowering plasma LDL-C to &amp;lt;70 mg/dL. In Nagasaki City, a council was formed comprising all hospitals performing percutaneous coronary intervention along with general physicians, and an initiative to manage LDL-C using a region-wide LDL-C management clinical pathway (Figure 1) was launched in July 2022. The rate of intensive statin therapy at discharge increased from 34.5% to 79.8%, and the rate of patients achieving LDL-C &amp;lt;70 mg/dL at discharge increased from 37.2% to 54.6% following the implementation of the clinical pathway. However, the cost-effectiveness of implementing the clinical pathway remains to be determined. Purpose: The purpose of this study was to evaluate the cost-effectiveness of implementing the Nagasaki AMI Secondary Prevention Clinical Pathway. Methods: To evaluate the cost-effectiveness of implementing the clinical pathway compared with no implementation, a lifetime simulation was performed using mathematical models. The models consisted of a decision tree model to model the flow of the clinical pathway (Figure 2) and a Markov model to consider the risks of developing cardiovascular disease (CVD) events. The quality-adjusted life year (QALY) was used as the outcome. Drug costs and treatment costs for each CVD event were included. Drug costs were calculated from actual prescriptions. Treatment costs and utility scores for each event were based on the literature. The risk of each CVD event was calculated using baseline risks estimated using commercial claims data (DeSC Healthcare, Inc.) and patients' LDL-C levels at discharge and 1 month after discharge. LDL-C levels at each time point were set separately for the groups that achieved or did not achieve a discharge LDL-C &amp;lt; 70 mg/dL, for patients with and without implementing the clinical pathway. Results: Implementing the clinical pathway was evaluated as dominant, with an incremental gain of 0.079 QALYs per person and expected cost savings of JPY 103,124 per person. Implementing the clinical pathway was shown to not only provide additional health benefits by preventing CVD, but also to reduce future health care costs. In the analysis with a 10-year time horizon, the result remained dominant, and the same level of cost savings was expected. Conclusions: Implementing the Nagasaki AMI Secondary Prevention Clinical Pathway can be expected to reduce costs, in addition to increasing QALYs by preventing CVD. Further clinical and economic evaluation of long-term follow-up with a collaborative pathway to the general physician after discharge from the hospital is expected.

Multimodal transport route selection: An integrated fuzzy hierarchy risk assessment and multiple criteria decision-making approach

Selecting multimodal transport routes is a complex problem due to the presence of various, often conflicting decision-making attributes, such as transportation cost and time, diverse risks with hierarchical relationships both within and across groups, decision-makers’ preferences, and numerous possible options. To address this problem, a novel decision-making approach is proposed, integrating the best-worst method (BWM), fuzzy hierarchy risk assessment (FHRA), and additive ratio assessment (ARAS). This approach decomposes the route decision-making problem into a hierarchy structure and determines the optimal solution through three distinct phases. In the first phase, BWM assigns relative weights to various criteria within the hierarchical structure, ensuring that the decision-makers’ preferences are accurately reflected. In the second phase, FHRA evaluates qualitative risks from the lowest to the highest hierarchy levels. This process involves calculating risk magnitudes at the lowest hierarchy level and progressively recalculating them as they ascend to the highest level of the hierarchy. The multimodal transport cost-model provides transportation cost and time. In the final phase, ARAS synthesizes all the decision-making data to rank all possible multimodal alternative routes based on utility scores. The realistic case study validates the practical applicability and effectiveness of the proposed approach. The findings indicated that the proposed methodology effectively identify the most appropriate multimodal transport route as the best compromise choice. This study contributes new knowledge regarding a new hybrid decision-making framework that combines multiple criteria decision-making methods with fuzzy hierarchy risk analysis, thereby enhancing the design of transportation plans to align with organizational goals and customer requirements.

Feature Selection as Deep Sequential Generative Learning

Feature selection aims to identify the most pattern-discriminative feature subset. In prior literature, filter (e.g., backward elimination) and embedded (e.g., LASSO) methods have hyperparameters (e.g., top- k , score thresholding) and tie to specific models, thus, hard to generalize; wrapper methods search a feature subset in a huge discrete space and is computationally costly. To transform the way of feature selection, we regard a selected feature subset as a selection decision token sequence and reformulate feature selection as a deep sequential generative learning task that distills feature knowledge and generates decision sequences. Our method includes three steps: (1) We develop a deep variational transformer model over a joint of sequential reconstruction, variational, and performance evaluator losses. Our model can distill feature selection knowledge and learn a continuous embedding space to map feature selection decision sequences into embedding vectors associated with utility scores. (2) We leverage the trained feature subset utility evaluator as a gradient provider to guide the identification of the optimal feature subset embedding; (3) We decode the optimal feature subset embedding to autoregressively generate the best feature selection decision sequence with autostop. Extensive experimental results show this generative perspective is effective and generic, without large discrete search space and expert-specific hyperparameters. The code is available at http://tinyurl.com/FSDSGL .

Cost-effectiveness analysis of simple hysterectomy compared to radical hysterectomy for early cervical cancer: analysis from the GCIG/CCTG CX.5/SHAPE trial.

SHAPE (Simple Hysterectomy And PElvic node assessment) was an international phase III trial demonstrating that simple hysterectomy was non-inferior to radical hysterectomy for pelvic recurrence risk, but superior for quality of life and sexual health. The objective was to conduct a cost-effectiveness analysis comparing simple vs. radical hysterectomy for low-risk early-stage cervical cancer. Markov model compared the costs and benefits of simple vs. radical hysterectomy for early cervical cancer over a 5-year time horizon. Quality-adjusted life years (QALYs) were estimated from health utilities derived from EQ-5D-3L surveys. Sensitivity analyses accounted for uncertainty around key parameters. Monte Carlo simulation estimated complication numbers according to surgical procedure. Simple hysterectomy was more effective and less costly than radical hysterectomy. Average overall costs were $11,022 and $12,533, and average gains were 3.56 and 3.54 QALYs for simple and radical hysterectomy, respectively. Baseline health utility scores were 0.81 and 0.83 for simple and radical hysterectomy, respectively. By year 3, these scores improved for simple hysterectomy (0.82) but not for radical hysterectomy (0.82). Assuming 800 early cervical cancer patients annually in Canada, the model estimated 3 vs. 82 patients with urinary retention, and 49 vs. 86 patients with urinary incontinence persisting 4 weeks after simple vs. radical hysterectomy, respectively. Results were most sensitive to variability in health utilities after surgery, but stable through wide ranges of costs and recurrence estimates. Simple hysterectomy is less costly and more effective in terms of quality-adjusted life expectancy compared to radical hysterectomy for early cervical cancer. ClinicalTrials.gov Identifier: NCT01658930.

Comparing the measurement properties of the EQ-5D-5L, SF-6Dv2, QLU-C10D and FACT-8D among survivors of classical Hodgkin's lymphoma.

This study aimed to evaluate the measurement properties of EQ-5D-5L, SF-6Dv2, QLU-C10D, and FACT-8D in survivors of Classical Hodgkin's Lymphoma (CHL). A cross-sectional, web-based survey was conducted from May to August 2022 to collect data. Chinese value sets were used to estimate the utility scores for EQ-5D-5L, SF-6Dv2, and QLU-C10D, while the Australian value set was used for FACT-8D. The measurement properties assessed included ceiling and floor effects, convergent validity (assessing associations between similar dimensions/utility scores using Spearman's rank correlation and intraclass correlation coefficient), and known-group validity (measures could differentiate health-related quality of life (HRQoL) between risk groups). A total of 534 CHL survivors participated in the survey and completed the questionnaire. All dimensions of EQ-5D-5L, SF-6D (except for vitality), QLU-C10D, and FACT-8D showed ceiling effects, ranging from 18 to 91.6%. The EQ-5D-5L demonstrated the higher ceiling effects compared to other measures, with 33% of patients reporting full health on this scale. All 30 pairs of associations between similar dimensions from the four measures were statistically significant, with correlation coefficients ranging from 0.29 to 0.77. Regarding utility scores, the EQ-5D-5L utility score showed a stronger correlation with SF-6Dv2 than with the other two measures. Statistically significant correlations of utility scores between the four measures were observed. EQ-5D-5L can significantly differentiate HRQoL among all known-groups, while SF-6Dv2, QLU-C10D, and FACT-8D showed a less strong discriminant ability. EQ-5D-5L outperformed SF-6Dv2 in terms of agreement with cancer-specific PRMs and discriminant ability. However, SF-6Dv2 showed stronger associations with similar dimensions of QLU-C10D and FACT-8D, indicating high convergent validity. The generic PBMs are sensitive enough to measure HRQoL in survivors of CHL.

Health-related quality of life of people with depression: pre-post intervention compared with age-matched general population in Vietnam

BackgroundIn Vietnam, there is a paucity of health-related quality of life (HRQoL) research on people with depression as well as a lack of evidence on supported self-management (SSM) intervention for depression on HRQoL. This study aimed to compare the HRQoL of people with depression and age-matched people in the Vietnamese population, evaluate the effects of Tele-SSM intervention on HRQoL, and examine the association between the changes in HRQoL score and mental health well-being (depression, anxiety, and stress).MethodsThis study was a pre- and post-study involving Vietnamese adults aged 18–64 who had depression symptoms (score ≥ 5 points in the PHQ-9). Participants (N = 58) completed Tele-SSM—a supported self-management intervention incorporating cognitive behavioral therapy and non-violent communication and using a task-shifting approach. To compare with the general population, we conducted a 1-to-1 matching by age with an EQ-5D-5L valuation study with a nationally representative sample of the Vietnamese general population.ResultsHRQoL was significantly impaired in people with depression compared to the age-matched general population. Regarding health profile, participants reported the most difficulties in usual activities, pain/discomfort, and anxiety/depression dimensions. Significant improvements were observed in HRQoL scores post-intervention compared to pre-intervention in both EQ-VAS scores (from 59.84 to 79.48) and utility scores (from 0.79 to 0.90). These results remained lower than the age-matched general population (EQ-VAS score = 83.28, utility score = 0.96). Depression was associated with lower HRQoL while controlling for stress, anxiety symptoms and sociodemographic characteristics.ConclusionsThese results indicate that HRQoL is significantly impaired in people with depression and contribute to providing empirical evidence of Tele-SSM intervention in improving HRQoL. Further randomized controlled trials should be conducted to evaluate the effectiveness and cost-effectiveness of the Tele-SSM intervention.

What makes patients tick? Vaccine preferences against tick-borne encephalitis in four European countries

BackgroundWe explored vaccine motivation and preferences for tick-borne encephalitis (TBE) vaccine attributes among participants in TBE-endemic countries in Europe.MethodsAn online survey was conducted among the general public in Austria, Germany, Switzerland, and Sweden. Participants were ≥ 18 years old, open to receiving vaccines, and living in, or regularly traveling to, TBE-endemic regions in the aforementioned countries. Participants were asked about their general vaccine knowledge and motivations for vaccination, before rating the importance of TBE vaccine attributes, such as efficacy, safety, dosing schedule, and booster interval. Thereafter, participants were shown three hypothetical TBE vaccine profiles with different combinations of attributes. Assuming equal efficacy and safety, participants were asked to select their preferred profile from 12 screens as part of a discrete-choice conjoint analysis. Utility scores were calculated to show the importance of each attribute. Data are presented for the overall survey group and by age and gender, using t-tests to compare means.ResultsFor 73% of participants (n = 1003/1379), self-protection was among the top three reasons to get vaccinated. Disease severity, protection of children or family, and advice or recommendation from a doctor/healthcare professional (HCP) were top three reasons for over half of participants. The majority (58–69%) agreed or strongly agreed that they trust their doctor/HCP on the subject of vaccines, they rely on their doctor/HCP’s vaccine knowledge, and they prefer their doctor/HCP to make recommendations on which vaccines they or their families should take. Efficacy and safety were the most important standalone TBE vaccine attributes; however, among TBE vaccine profiles including 3-, 5- and 10-year booster intervals, the 10-year booster interval was the most influential attribute level when choosing a preferred vaccine profile (utility score: 0.58 [standard error: 0.01]). Differences in motivators and preferences were observed between age and gender subgroups.ConclusionThe high level of doctor/HCP reliance highlights the key role doctors/HCPs play in influencing vaccine decision-making. Booster interval was the biggest driver of choice when selecting a hypothetical TBE vaccine profile, with the strongest preference for a 10-year booster interval. These findings could be used to inform TBE vaccination recommendations and in the further development of TBE vaccines.

Examining Disparities in Regional Anesthesia Utilization, Opioid Prescriptions, and Pain Scores Among Patients Who Received Primary or Revision Total Knee Arthroplasty at a Veterans Affairs Medical Center: A Retrospective Cohort Study.

Total knee arthroplasty (TKA) is one of the most performed surgical operations in the United States. Managing postoperative pain after TKA is of vital importance, as it is positively associated with outcome measures related to recovery of function and quality of life. Two commonly used methods to control postoperative pain are regional anesthesia (RA), consisting of a single or a combination of peripheral nerve and epidural blocks, and pain medication, such as opioids. Our retrospective analysis sought to better understand whether revision versus primary TKA impacted previously discovered disparities in perioperative pain management and use of RA at the Atlanta Veterans Affairs Health Care System (AVAHCS). Before data collection, we hypothesized that revision TKA would have a higher proportion of Black and older patients and that revision TKA patients would have lower postoperative pain scores. This was a retrospective analysis of AVAHCS patients who underwent elective unilateral primary or revision TKA surgery between 2014 and 2020. After application of our exclusion criteria, data from 562 patients were analyzed. Data collected included demographics information, type of RA used, and pain scores. Statistical analyses included chi-square test, t-tests, multiple logistic regression, and multiple linear regression, as appropriate to the outcomes of interest. Revision TKA patients were more likely to be Black (P = .018) and younger (P = .023 for <50 years of age group, P = .006 for 50 to 64 years of age compared to the >65 years group). Black patients, compared to White patients, had significantly higher pain scores at baseline (P = .0086) and at 24 hours postsurgery (P = .0037). Older patients (≥50 years old) had significantly higher baseline pain scores (P = .021 for the 50 to 64 years group, P < .01 for the >65 years group) and significantly lower first postanesthesia care unit pain scores (P < .05). Black race (P < .01) and age > 65 years (P < .01) were associated with a significant decrease in total oral morphine equivalents (OME) prescribed at discharge. None of the predictor variables-race, age, type of surgery (primary versus revision), baseline, and first postanesthesia care unit pain scores-were significantly associated with the use of RA in our cohort. Sociodemographic disparities in pain management have been reported in all healthcare systems, including the VAHCS. This moderately sized retrospective study, conducted at a single veterans affairs site, yielded several noteworthy findings. One finding of particular interest was that, despite Black patients reporting higher baseline and 24-hour postoperative pain scores, they were prescribed fewer opioids at discharge. Our results highlight the presence of clinically significant disparities in perioperative TKA pain management, emphasizing the need for continuous investigation and focused mitigation efforts among Veterans.

Health-related quality of life among women and men living with migraine: a Canada-wide cross-sectional study.

Migraine is a prevalent neurologic disorder that affects women more than men. Examining health-related quality of life (HRQoL) by gender can aid decision makers in prioritizing future treatment and prevention programs. We aimed to quantify HRQoL by different levels of migraine disability and by gender. As part of a Canada-wide cross-sectional study, we administered an online survey to employed adults who self-reported a diagnosis of migraine. Migraine disability level was assessed using the Migraine Disability Assessment questionnaire (MIDAS). MIDAS scores were used to categorize respondents as having little to no, mild, moderate, or severe level of migraine-related disability. Physical and mental component summary scores (PCS and MCS) and health utilities were derived from responses to the Veterans Rand 12 Item Health Survey. PCS, MCS, and health utilities were summarized by migraine-related disability levels and gender. Covariate-adjusted linear regressions were used to examine the association between migraine disability level and health utility by gender. A total of 441 participants completed the survey. The sample was predominantly women (60.1%), White race (75.5%), and had a mean age of 37 years. Mean health utility, PCS, and MCS scores were 0.61 (0.22), 45.0 (7.7), and 43.4 (11.0), respectively. All three scores decreased with increased migraine disability level. Gender differences on HRQoL within each migraine disability level were not statistically significant, except in the little to no disability level where women had lower mean MCS scores and health utility relative to men [mean (SD) MCS: women 44.0 (11.3); men 55.1 (8.1), p < 0.001; health utility: women 0.66 (0.18); men 0.81 (0.18), p < 0.001]. Linear regressions showed women with severe migraine-related disability had reduced health utility compared to women with little to no disability [adjusted difference: -0.16 (95%CI -0.24,-0.09)]. Associations among men increased in magnitude with migraine disability level [adjusted differences: mild - 0.16 (95%CI -0.24,-0.09); moderate - 0.18 (95%CI -0.26,-0.10); severe - 0.28 (95%CI -0.37,-0.20)]. Findings contribute to the literature on the association between migraine disability level and HRQoL by examining trends by gender. Model results emphasize the importance of future treatments reducing severe disability due to migraine among both women and men.

Comparing health-related quality of life and utility scores of patients undergoing hemodialysis and continuous ambulatory peritoneal dialysis in Indonesia.

Although both hemodialysis and continuous ambulatory peritoneal dialysis (CAPD) are covered by national healthcare insurance, 98% of kidney failure disease patients are treated with hemodialysis. This study compared the health-related quality of life (HRQoL) and utility scores of patients receiving hemodialysis and CAPD in Indonesia and determined factors associated with HRQoL and utility scores. A cross-sectional study was performed using the Kidney Disease Quality of Life-36 and EQ-5D-5L instruments at six hospitals. Utility scores were presented as SF-6D and EQ-5D scores. Factors associated with the EQ-5D were evaluated using Tobit regressions due to ceiling effects, while the SF-6D and HRQoL were assessed using generalized linear models since the data were not normally distributed. Among the 613 patients, 76% were treated with hemodialysis. After adjusting for sociodemographic characteristics and clinical parameters, CAPD patients reported better HRQoL compared to hemodialysis patients in terms of the SF-6D (p = .038), mental component summary (p = .020), symptoms (p = .005), and effects of kidney disease (p<.001), but no significant differences were reported in EQ-5D (p = .083), physical component summary (p = .323), burden of kidney disease (p = .111), and kidney summary scores (p = .068). Poorer HRQoL and utility scores were likely experienced by older patients who were male, married, with diabetes, treated in Class A hospitals, and with lower education, hemoglobin, and albumin levels. In Indonesia, patients treated with CAPD had better HRQoL and utility scores compared to patients undergoing hemodialysis. Therefore, CAPD should be promoted by healthcare professionals as the first treatment option for patients who are eligible for both hemodialysis and CAPD.

Knowledge, attitude towards, and utilization of friendly health services among school adolescents in the pastoral community of Guji zone, Ethiopia: an institution-based comparative cross-sectional study.

Although sexual and reproductive health for adolescents is a recognized fundamental human right and a critical component of health policy, it is poorly addressed and seldom researched in pastoral communities. The study aimed to determine the status of sexual and reproductive health knowledge, attitudes, and practice among pastoral school adolescents in Ethiopia. An Institution-based comparative study was conducted from Nov. 2020 to Jan. 2021. We conducted a comparative cross-sectional study at four randomly selected high schools. Seven hundred seventy-three adolescent students participated, with 384 from Gorodola and 389 from Wadara districts, Guji zone Ethiopia. The data was collected using 34 self-administered questions and analyzed using descriptive, t-test, and linear regression models. The study found that only 44.2% of all the participants had good knowledge, 46.1% had good attitudes and 35.4% had good utilization of Sexual and Reproductive Health Services. Respondents from Wadara High School had significantly higher mean knowledge scores (49.3% vs. 44.2%, p < 0.01) than those of Gorodola High School. There was no significant difference in mean utilization scores between case and compare (45.08% vs. 37%, p > 0.01). Adolescents who were not communicated on SRH matters, previously utilized FHS, and visited Friendly Health facilities were associated with poor utilization of sexual and reproductive health services. Wadera High School adolescents have better Sexual and reproductive health knowledge and utilization than Gorodola high schools. Community public health care providers in Wadara District explain the outcome through their contributions. Within the context of inherent disadvantage in the school environment setting, there is a need to improve sexual and reproductive health education with a greater emphasis on school girls.

374P Relationship between the Pediatric Outcomes Data Collection Instrument (PODCI) and EQ-5D-3L utility score in Duchenne muscular dystrophy

374P Relationship between the Pediatric Outcomes Data Collection Instrument (PODCI) and EQ-5D-3L utility score in Duchenne muscular dystrophy

A Cost–Utility Analysis of the Use of −125 mm Hg Closed-incision Negative Pressure Therapy in Oncoplastic Breast Surgery

Background: Closed-incision negative pressure therapy (ciNPT) decreases the rate of wound complications in oncoplastic breast surgery (OBS) but at a fiscal cost. Our aim was to examine the cost-utility of ciNPT in OBS. Methods: A literature review was performed to obtain the probabilities and outcomes for the treatment of unilateral breast cancer with OBS with ciNPT versus without. Reported utility scores in the literature were used to calculate quality-adjusted life years (QALYs) for each health state. A decision analysis tree was constructed with rollback analysis to determine the more cost-effective strategy. An incremental cost–utility ratio was calculated. Sensitivity analyses were performed. Results: OBS with ciNPT is associated with a higher clinical effectiveness (QALY) of 33.43 compared to without (33.42), and relative cost increase of $667.89. The resulting incremental cost-utility ratio of $57432.93/QALY favored ciNPT. In one-way sensitivity analysis, ciNPT was the more cost-effective strategy if the cost of ciNPT was less than $1347.02 or if the probability of wound dehiscence without was greater than 8.2%. Monte Carlo analysis showed a confidence of 75.39% that surgery with ciNPT is more cost effective. Conclusion: Despite the added cost, surgery with ciNPT is cost-effective. This finding is a direct result of decreased overall wound complications with ciNPT.

Exploration of preferences among people with COPD to inform resource allocation: a discrete choice experiment study

IntroductionTreatment options for chronic obstructive pulmonary disease (COPD) are numerous but adherence remains a key challenge. We performed a discrete choice experiment (DCE) of patients’ preferences in accessing care for...

EP.12A.46 Age, Health Utility Scores (HUS), and Survival Outcomes in EGFR-Mutated Lung Cancer Patients Receiving 1L TKI Treatment

EP.12A.46 Age, Health Utility Scores (HUS), and Survival Outcomes in EGFR-Mutated Lung Cancer Patients Receiving 1L TKI Treatment