Health utility decreases with increasing clinical stage in amyotrophic lateral sclerosis

Jones, Ashley R, Jivraj, Naheed, Balendra, Rubika, Murphy, Caroline, Kelly, Joanna, Thornhill, Marie, Young, Carolyn, Shaw, Pamela J, Leigh, Nigel, Turner, Martin R, Steen, I Nick, McCrone, Paul and Al-Chalabi, Ammar (2014) Health utility decreases with increasing clinical stage in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 15 (3-4). pp. 285-291. ISSN 2167-9223

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Abstract

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease typically causing death within three years. Understanding the impact of disease on patients using health utility at different stages of ALS would allow meaningful cost-benefit analysis of new potential therapies. A common health-related quality of life measurement, developed and validated for the UK, is the EQ-5D. Using clinical trial data from the LiCALS study, we calculated health utility using the EQ-5D for each King's ALS clinical stage from 214 patients. We analysed whether health utility, and other health-related measures, significantly changed between each of the clinical stages. Results showed that mean health utility decreased by 0.487 (the scale runs from 1 to - 0.594) between clinical stages 2A and 4. Emotional states, measured using the Hospital Anxiety and Depression Scale (HADS), showed worsening depression and anxiety scores as ALS progressed. Age of onset, disease onset, gender and treatment group were not predictors of EQ-5D, depression or anxiety. In conclusion, increasing severity of King's ALS Clinical Stage is associated with a progressive decrease in EQ-5D health utility. This is useful for cost-benefit analysis of new therapies and validates this ALS clinical staging system.

Item Type: Article
Keywords: Clinical staging; EQ-5D; amyotrophic lateral sclerosis; health utility; quality of life
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
Subjects: R Medicine > RC Internal medicine > RC0321 Neurosciences. Biological psychiatry. Neuropsychiatry > RC0346 Neurology. Diseases of the nervous system Including speech disorders
Depositing User: Patricia Butler
Date Deposited: 26 Nov 2015 14:37
Last Modified: 25 Jul 2017 14:30
URI: http://sro.sussex.ac.uk/id/eprint/54189
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