Utility indices in patients with the obstructive sleep apnea syndrome.
BACKGROUND
Utility indices are used in cost-effectiveness analyses as a measure of quality of life reflecting the patient's preference for a given health state on a scale anchored at 0 (corresponding to death) to 1 (perfect health). It is uncertain which utility instruments are most suitable for application in patients with the obstructive sleep apnea syndrome (OSA).


OBJECTIVE
To compare utility indices obtained in OSA patients by various instruments.


METHODS
In 66 untreated OSA patients (median Epworth score 12, apnea/hypopnea index, AHI, 57/h), five different utility instruments were employed. In 34 OSA patients, changes in utility after 4 months of continuous positive airway pressure (CPAP) were retrieved from published SF-36 data.


RESULTS
In 66 OSA patients, median (quartiles) utility indices were: standard gamble 0.97 (0.89; 0.99); time trade-off 0.94 (0.81; 0.99); EuroQol questionnaire (EQ-5D) 0.92 (0.83; 1.00); Euro-thermometer visual analog scale 0.80 (0.70; 0.90); SF-36 questionnaire (SF-6D) 0.75 (0.69; 0.85; p < 0.05 SF-6D and Euro-thermometer utility vs. other indices). Different utility indices were poorly correlated among each other and with AHI and Epworth scores. SF-6D utility after 4 months of CPAP had changed by 0.04 (0.02; 0.12, p = 0.026).


CONCLUSIONS
Utility indices measured by different instruments vary largely and some indices reflect the impaired quality of life in OSA poorly. Interpretation of cost-effectiveness analyses should account for the utility instrument used.
Schmidlin
Martina
M
Pulmonary Divisions, University Hospital of Zurich, Zurich, Switzerland.
Fritsch
Karsten
K
Matthews
Felix
F
Thurnheer
Robert
R
Senn
Oliver
O
Bloch
Konrad E
KE
D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life / Q000523:psychology*; D020181:Sleep Apnea, Obstructive / Q000523:psychology*