Impact of chronic liver disease and cirrhosis on health utilities using SF-6D and the health utility index

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Original Articles

Impact of chronic liver disease and cirrhosis on health utilities using SF-6D and the health utility index

Amy A. Dan 1 2, Jillian B. Kallman 1 2, Ragini Srivastava 1, Zahra Younoszai 1, Amy Kim 1, Zobair M. Younossi 1 2 *

1Center for Liver Diseases, Inova Fairfax Hospital, Falls Church, VA2Outcomes Research Program, Inova Fairfax Hospital, Falls Church, VA

email: Zobair M. Younossi (zobair.younossi@...)

*Correspondence to Zobair M. Younossi, Center for Liver Diseases at Inova Fairfax Hospital, 3289 Woodburn Road, Suite 375, ndale, VA 22003-6800

Telephone: ; FAX:

Abstract

Assessment of health-related quality of life (HRQL) and health utilities have become important aspects of clinical research. Patient-derived utility adjustments are frequently used in economic analysis. Although HRQL has been frequently studied among patients with liver disease, extensive data on the health utilities of patients with liver disease are not available. Recently, SF-6D has been developed to obtain utility scores from the widely used Short Form 36 questionnaire. To assess health utilities of patients with chronic liver disease using 2 utility assessments [sF-6D and Health Utility Index 2 (HUI-2)], a total of 140 patients were identified from our Liver Disease Quality of Life Database with HRQL data available, as well as clinical and demographic data. Of the 140 patients, 42% were female, had a mean age of 49.4 years (standard deviation = ±11.2) 36% had hepatitis B virus (HBV), 29% had hepatitis C (HCV), 24% had cholestatic liver disease, and 11% had another liver disease (for example, nonalcoholic steatohepatitis). Bivariate analyses indicated that HBV patients had the highest health status as measured by all of SF-6D and HUI-2 subscales and the overall SF-6D and HUI-2 utility measures, whereas patients with HCV and cholestatic liver disease had similar scores, and those with other liver diseases had the poorest quality of life. When controlling for the effects of gender, age, and cirrhosis, impact of chronic liver disease diagnosis on utility scores persisted only for the SF-6D, with HCV patients having significantly poorer health than HBV patients. In conclusion, SF-6D provides not only a generic assessment of HRQL but also a utility score that can be used for economic analysis of patients with chronic liver disease. Liver Transpl 14:321-326, 2008. © 2008 AASLD.

Received: 18 June 2007; Accepted: 2 October 2007

Digital Object Identifier (DOI)10.1002/lt.21376