MP75-06 DETERMINING QUALITY OF LIFE EFFECT ON RISK AVERSION ON OBSTRUCTIVE VOIDING USING HEALTH UTILITIES

Charles H. Schlaepfer; Samuel Hansen; Dan Shane; Bradley A. Erickson

doi:10.1097/01.JU.0001008676.21744.5f.06

INTRODUCTION AND OBJECTIVE: Health utilities are generic quality of life (QOL) measures that can help describe overall health status. Unlike disease-specific QOL instruments, generic utilities allow for comparison of different disease states and between disease specific health interventions. We sought to identify the health utility of benign prostatic hypertrophy (BPH) and urethral stricture disease (USD). Our hypothesis was the lack of medical treatment and risk of retention with USD would lower perceived quality of life. METHODS: An a priori determined, representative sample of adult men were recruited by Qualtrics™ to review standardized scenarios describing the typical patient with BPH and USD (Figure 1), monocular blindness (MB), binocular (complete) blindness (BB), and osteoarthritis (OA). Four HUs were used to measure disease impact on QOL: visual analog scale (0 (death) – 100 (perfect health)), standard gamble (SG; accepted risk of death during intervention to cure condition), time-trade off (years (out of 20) willing to trade for disease cure), and willingness-to-pay (% of annual salary paid for cure). SG data were normalized to risk of death for MB cure. Data three (+/-) standard deviations from mean were eliminated and then compared. RESULTS: A total of 182 men met inclusion criteria. The quality adjusted life year (QALY) for USD was reduced by 39% (0.61 QALY 0.22-0.95) and for BPH by 34% (0.66 QALY 0.25-0.95). QOL for both were better than BB (0.52) and worse than OA (0.86). BPH was equivalent to MB (0.67), while USD was worse (p<0.001). BPH QOL was significantly better than USD (p<0.001). To achieve a cure, respondents accepted a 0.8%/5.6% increased risk of death, 5.5/6.0 years sacrificed, and 37%/41% of their annual income for BPH and USD respectively (Figure 2). CONCLUSIONS: BPH and USD were significant detriments to health utility independently and as compared to other health conditions. The lack of medical therapy and retention risk were significantly worse QOL than medically controlled obstructive voiding symptoms which were equivalent to MB.

MP75-06 DETERMINING QUALITY OF LIFE EFFECT ON RISK AVERSION ON OBSTRUCTIVE VOIDING USING HEALTH UTILITIES

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