title: The disutility of chronic gout.
abstract: BACKGROUND
  Gout is a chronic painful inflammatory arthritis. Data regarding the impact of gout on health-related quality of life, however, are limited.
  
  
  METHODS
  We interviewed patients with chronic stable gout. Health status was measured by using the Short Form 36 (SF-36) physical component summary (PCS) and physical component summary (MCS) and the Health Assessment Questionnaire-Disability Index (HAQ-DI). Direct preference-based measures included a health rating scale (RS), the time tradeoff (TTO), and standard gamble (SG) for one's current health state with gout and current health state without gout; indirect preference-based measures included the SF-6D and the EQ-5D. Disutilities for gout were assessed by subtracting preference scores for current health states with gout from those for current health without gout and were compared between patients ranking gout as their top health concern versus the rest of the patients.
  
  
  RESULTS
  Of the 80 interviewees, 72 (90%) were male, 55 (69%) were Caucasian, and the mean (SD) age was 60 (11) years. The mean SF-36 PCS and MCS scores were 38.9 and 48.6, respectively. The mean (SD) SF-6D score was 0.68 (0.13) and the mean (SD) EQ-5D score was 0.73 (0.23). The mean (SD) RS disutility for gout was 0.05 (0.12), the mean TTO disutility was 0.03 (0.12), and the mean SG disutility was 0.02 (0.11). The RS disutilities of subject patients who ranked gout as their top concern (n = 17) trended towards being statistically significantly larger than those of the remaining patients, P = 0.06 but their TTO and SG disutilities were similar to those of the remaining patients.
  
  
  CONCLUSIONS
  Although physical functioning of patients with gout is often compromised, patients with chronic stable gout do not assign a large disutility to gout per se. Still, patients who rank their gout as their top health concern tend to assign greater RS disutility to gout than do other patients.
authors.affiliation: Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, 1000 Veteran Avenue, Los Angeles, CA 90095, USA. dkhanna@mednet.ucla.edu
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.forename: Mansoor
authors.initials: M
authors.lastname: Ahmed
authors.forename: Dustin
authors.initials: D
authors.lastname: Yontz
authors.forename: Shaari S
authors.initials: SS
authors.lastname: Ginsburg
authors.forename: Grace S
authors.initials: GS
authors.lastname: Park
authors.forename: Anthony
authors.initials: A
authors.lastname: Leonard
authors.forename: Joel
authors.initials: J
authors.lastname: Tsevat
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006073:Gout; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011788:Quality of Life; D011795:Surveys and Questionnaires