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Monday, 16 October 2006


Kenneth J. Smith, MD, MSc and Mark S. Roberts, MD, MPP. University of Pittsburgh, Pittsburgh, PA

Purpose: Quality of life utilities for health states associated with pelvic inflammatory disease (PID) have not been directly measured, but could have important implications on the cost-effectiveness of interventions to prevent and manage this disease.

Methods: Using Impact 3.0, we obtained, in women with and without a history of PID, visual analogue scale (VAS) and time-tradeoff (TTO) valuations for PID associated health states: ambulatory PID treatment, hospital PID treatment, ectopic pregnancy, chronic pelvic pain, and infertility. Subjects read brief scenarios describing the medical, functional, and social activity effects typically associated with each state, then gave valuations in the order above.

Results: We obtained data from 55 women with and 150 women without a PID history. PID history subjects were older (31.6 vs. 27.2) and more frequently nonwhite (76.4% vs. 52.7%). Mean utilities were similar in women with and without a history of PID for ambulatory treatment (VAS 0.71 vs. 0.69, TTO 0.89 vs. 0.87) and hospital treatment (VAS 0.62 vs. 0.60, TTO 0.82 vs. 0.84). The PID history group had significantly lower scores (p<0.05) in VAS for ectopic pregnancy (0.56 vs. 0.63), pelvic pain (0.45 vs. 0.53), and infertility (0.52 vs. 0.66) but not for TTO, although similar magnitude of differences between groups was observed. Significant VAS differences remained when controlling for age, race, and desired fertility.

Conclusion: PID has substantial impact on utility, with some PID-related health states preferred less by women who have experienced PID, which could have some impact on societal- vs. patient-perspective analyses of PID interventions.

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