Document Detail


Utility-based outcomes made easy: the number needed per quality-adjusted life year gained. An observational cohort study of tumor necrosis factor blockade in inflammatory arthritis from Southern Sweden.
MedLine Citation:
PMID:  20506121     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To introduce a novel, simple, utility-based outcome measure, the number needed per quality-adjusted life year (QALY) gained (NNQ), and to apply it in clinical practice in anti-tumor necrosis factor (anti-TNF)-treated patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and spondylarthritis (SpA). METHODS: The NNQ is the number of patients one has to treat in order to gain 1 QALY. It is calculated as the inverted value of the utility gain (area under the curve) over 1 year in a cohort subjected to an intervention. EuroQol Index utility data from the South Swedish Arthritis Treatment register were used. RESULTS: Patients with RA (n = 1,001), PsA (n = 241), and SpA (n = 255) were eligible for the study. First, second, and third treatment courses were studied. For RA, NNQ was 4.5, 6.4, and 5.2 for first, second, and third courses, respectively. For PsA and SpA, NNQ was 4.2-4.5, irrespective of treatment order. Treatment groups with <50 patients were not analyzed. During the study period 2002-2007, there were no secular trends of utility gains. CONCLUSION: The NNQ is an easily derived and understandable utility-based outcome measure that may be useful for stakeholders and decision makers as well as for clinicians. It was readily applied in this study of TNF blockade across 3 arthritis diagnoses. NNQ varied little over diagnoses and treatment course order, with a possible exception in second treatment course in RA.
Authors:
Anders Gülfe; Lars Erik Kristensen; Tore Saxne; Lennart T H Jacobsson; Ingemar F Petersson; Pierre Geborek
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Arthritis care & research     Volume:  62     ISSN:  2151-4658     ISO Abbreviation:  Arthritis Care Res (Hoboken)     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-08     Completed Date:  2010-10-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101518086     Medline TA:  Arthritis Care Res (Hoboken)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1399-406     Citation Subset:  IM    
Affiliation:
Lund University, Sweden. anders.gulfe@med.lu.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Antirheumatic Agents / pharmacology,  therapeutic use
Arthritis, Psoriatic / drug therapy*,  epidemiology,  pathology
Arthritis, Rheumatoid / drug therapy*,  epidemiology,  pathology
Biological Products / therapeutic use
Cohort Studies
Female
Humans
Male
Middle Aged
Outcome Assessment (Health Care)* / standards
Quality-Adjusted Life Years*
Spondylarthritis / drug therapy*,  epidemiology,  pathology
Sweden / epidemiology
Treatment Outcome
Tumor Necrosis Factor-alpha / antagonists & inhibitors*,  physiology
Chemical
Reg. No./Substance:
0/Antirheumatic Agents; 0/Biological Products; 0/Tumor Necrosis Factor-alpha

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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