Exploring the impact of changes in neurogenic urinary incontinence frequency and condition-specific quality of life on preference-based outcomes.
OBJECTIVE
Many trials do not measure quality-adjusted life years (QALYs). Therefore, decision analysts often map condition-specific outcomes to preference scores. We estimated the relationship between changes in preference scores and commonly reported condition-specific outcomes in patients with urinary incontinence (UI) due to neurogenic detrusor overactivity.


METHODS
In 59 patients recruited to a neurogenic UI trial, clinical outcomes (UI episodes), condition-specific quality of life (Incontinence Quality of Life Instrument (I-QOL)), and SF-6D preference scores were measured at enrollment and 24 weeks. We used multiple linear regression to estimate the impact on SF-6D scores of 50; 50-99 and 100% reductions in UI episodes and a 10-point improvement in I-QOL.


RESULTS
By 24 weeks, mean (95% CI) daily UI episodes fell by 0.85 (0.04, 1.3) and mean I-QOL scores improved by 18 (12, 24). SF-6D scores increased by 0.03 (0.003, 0.058), due to improvements in role limitations. A > or = 50% reduction in UI episodes was achieved by 49% of patients and corresponded to a 0.09 (0.02, 0.16) SF-6D increase. A > or = 10-point increase in I-QOL was attained by 65% of patients and was associated with a 0.05 (-0.02, 0.12) SF-6D increase.


CONCLUSIONS
These estimates provide preliminary data for decision analysts wishing to map neurogenic UI outcomes to preference scores.
Hollingworth
William
W
Department of Social Medicine, University of Bristol, Canynge Hall, 39 Whatley Rd, Bristol, BS8 2PS, UK. william.hollingworth@bristol.ac.uk
Campbell
Jonathan D
JD
Kowalski
Jonathan
J
Ravelo
Arliene
A
Girod
Isabelle
I
Briggs
Andrew
A
Sullivan
Sean D
SD
D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000523:psychology; D019057:Quality-Adjusted Life Years; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D014549:Urinary Incontinence / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D055815:Young Adult
D019274:Botulinum Toxins, Type A