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Monday, 16 October 2006
17

HEALTH VALUES IN ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE

Michael S. Yi, MD, MSc1, Maria T. Britto, MD, MPH2, M. Susan Moyer, MD2, Susan N. Sherman, DPA1, Uma R. Kotagal, MBBS, MSc2, Frank W. Putnam, MD2, Steven L. Carlton-Ford, Phd1, and Joel Tsevat, MD, MPH1. (1) University of Cincinnati, Cincinnati, OH, (2) Cincinnati Children's Hospital Medical Center, Cincinnati, OH

PURPOSE: Health values or utilities have never been directly assessed from adolescents with inflammatory bowel disease (IBD). We examined differences in health value scores between teens with IBD and controls and evaluated how subjects' health status, health perceptions, and other psychosocial factors may be associated with their utilities.

METHODS: Patients 12-18 years of age were individually interviewed as part of an ongoing study at a large Midwestern medical center. We collected socio-demographic data and we used the PedsQL to measure physical, emotional, social, and school functioning; the General Health Perceptions (GHP) subscale from the Child Health Questionnaire; the Children's Health Locus of Control Scale; the Rosenberg Global Self-esteem Scale; the Kidcope to measure positive and negative coping; the General Self Efficacy Scale; the Perceived Stress Scale; the Satisfaction with Life Scale; the Existential Spiritual Well Being Scale; and the Family Awareness Scale to measure family competence. The rating scale (RS), time tradeoff (TTO) and standard gamble (SG) techniques were administered with the aid of a computer software package. We performed linear regression for multivariable analyses.

RESULTS: We analyzed data collected thus far from 30 subjects with IBD and 50 controls. Mean (SD) health value scores are in the table.

 

       Age

    Male, %

        RS

        TTO

        SG

IBD (N=30)

15.4 (2.0)*

43.3

79.0 (15.7)*

0.90 (0.21)*

0.98 (0.03)

Controls (N=50)

14.6 (1.9)

58.0

85.9 (11.9)

0.97 (0.12)

0.97 (0.14)

*p<0.05

In stepwise multivariable analyses, higher RS scores were associated with better GHP and physical functioning, less use of positive coping, and greater life satisfaction (R2=0.54); higher TTO scores were associated with religious affiliation, greater paternal education, and greater life satisfaction (R2=0.18); and higher SG scores were associated with religious affiliation and greater life satisfaction (R2=0.24).

CONCLUSION: Direct utility assessment in adolescents with and without IBD is feasible. Life satisfaction was related to all three methods of health valuation. Utility scores obtained from adolescents with and without IBD were generally high. Adolescents with IBD reported significantly lower RS and TTO scores than controls in univariate analyses, but when controlling for other significant factors, having IBD was not significantly associated with any difference in health value scores.


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See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)