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Association between knee symptoms, change in knee symptoms over 6-9 years, and SF-6D health state utility among middle-aged Australians


Singh, A and Campbell, JA and Venn, A and Jones, G and Blizzard, L and Palmer, AJ and Dwyer, T and Cicuttini, F and Ding, C and Antony, B, Association between knee symptoms, change in knee symptoms over 6-9 years, and SF-6D health state utility among middle-aged Australians, Quality of Life Research, 30, (9) pp. 2601-2613. ISSN 0962-9343 (2021) [Refereed Article]

Copyright Statement

Copyright 2021 The Authors, under exclusive licence to Springer Nature Switzerland AG

DOI: doi:10.1007/s11136-021-02859-5


Objectives: Health state utilities (HSUs) are an input metric for estimating quality-adjusted life-years (QALY) in cost-utility analyses. Currently, there is a paucity of data on association of knee symptoms with HSUs for middle-aged populations. We aimed to describe the association of knee symptoms and change in knee symptoms with SF-6D HSUs and described the distribution of HSUs against knee symptoms' severity.

Methods: Participants (36-49-years) were selected from the third follow-up (completed 2019) of Australian Childhood Determinants of Adult Health study. SF-6D HSUs were generated from the participant-reported SF-12. Association between participant-reported WOMAC knee symptoms' severity, change in knee symptoms over 6-9 years, and HSUs were evaluated using linear regression models.

Results: For the cross-sectional analysis, 1,567 participants were included; mean age 43.5 years, female 54%, BMI SD 27.18 5.31 kg/m2. Mean SD HSUs for normal, moderate, and severe WOMAC scores were 0.820 0.120, 0.800 0.120, and 0.740 0.130, respectively. A significant association was observed between worsening knee symptoms and HSUs in univariable and multivariable analyses after adjustment (age and sex). HSU decrement for normal-to-severe total-WOMAC and WOMAC-pain was - 0.080 (95% CI - 0.100 to - 0.060, p < 0.01) and - 0.067 (- 0.085 to - 0.048, p < 0.01), exceeding the mean minimal clinically important difference (0.04). Increase in knee pain over 6-9 years was associated with a significant reduction in HSU.

Conclusion: In a middle-aged population-based sample, there was an independent negative association between worse knee symptoms and SF-6D HSUs. Our findings may be used by decision-makers to define more realistic and conservative baseline and ongoing HSU values when assessing QALY changes associated with osteoarthritis interventions.

Item Details

Item Type:Refereed Article
Keywords:health state utility, osteoarthritis, population norm, QALY, SF-6D, WOMAC
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Rheumatology and arthritis
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Determinants of health
UTAS Author:Singh, A (Mr Ambrish Singh)
UTAS Author:Campbell, JA (Dr Julie Campbell)
UTAS Author:Venn, A (Professor Alison Venn)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Blizzard, L (Professor Leigh Blizzard)
UTAS Author:Palmer, AJ (Professor Andrew Palmer)
UTAS Author:Dwyer, T (Professor Terry Dwyer)
UTAS Author:Ding, C (Professor Chang-Hai Ding)
UTAS Author:Antony, B (Dr Benny Eathakkattu Antony)
ID Code:147319
Year Published:2021
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2021-10-26
Last Modified:2021-11-23

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