Quantifying health utilities of young adult orthodontic patients using the time trade-off method: a cross-sectional study

ABSTRACT Objective: To study the feasibility of time trade-off (TTO) method in quantifying health utility ratings in different types of malocclusion. Material and Methods: In this cross-sectional study, 70 orthodontic patients aged 18 years or above, reporting for treatment/consultation, were included and interviewed. Malocclusion-related health utilities were assessed through the TTO method, and oral health-related quality of life was measured with the help of Orthognathic Quality of Life Questionnaire (OQLQ). Angle's classification of malocclusion was recorded. Bivariate analyses and multivariate Poisson's regression were done to find out an association between the oral health utility values, OQLQ and demographic and clinical characteristics. Results: Patients with skeletal Class III malocclusion had lower health utility values than those with Class I and Class II malocclusions (p=0.013). Poisson's regression showed that Angle's Class II division 1 (0.90, CI 0.84 to 0.97), Class III (0.68, CI 0.59 to 0.95) and Skeletal malocclusion (0.79, CI 0.71 to 0.87) and OQLQ scores (1.0, CI 1 to 1.003) were found to be significant predictors of TTO utility scores. Conclusions: TTO utilities were found to be valid and well correlated with clinical findings. Health utilities could serve as useful and reliable markers of health-related quality of life (HRQL) among individuals or communities and help cost-effective preventive or intervention programs planning.

RESUMO Objetivo: Estudar a viabilidade do método Time trade-off (TTO) para quantificar escores de valoração da saúde em diferentes tipos de má oclusão. Material e Métodos: Neste estudo transversal, foram incluídos e entrevistados 70 pacientes ortodônticos com idade igual ou superior a 18 anos, que compareceram para tratamento/consulta. A valoração da saúde em relação à má oclusão foi avaliada por meio do método TTO e a qualidade de vida relacionada à saúde bucal foi medida com a ajuda do Questionário de Qualidade de Vida Ortognática (Orthognathic Quality of Life Questionnaire, OQLQ). A classificação da má oclusão segundo Angle foi registrada, e análises bivariadas e regressão multivariada de Poisson foram feitas para verificar qualquer associação entre os escores de valoração da saúde bucal, OQLQ e características demográficas e clínicas. Resultados: Os pacientes com má oclusão esquelética de Classe III apresentaram escores de valoração da saúde mais baixos do que aqueles com má oclusão de Classe I e Classe II (p=0,013). A regressão de Poisson mostrou que a Classe II de Angle divisão 1 (0,90, IC 0,84 a 0,97), Classe III (0,68, IC 0,59 a 0,95), má oclusão esquelética (0,79, IC 0,71 a 0,87) e os escores do OQLQ (1,0, IC 1 a 1,003) foram considerados preditores significativos dos escores de valoração pelo método TTO. Conclusões: Os escores do TTO foram considerados válidos e bem correlacionados com os achados clínicos, e podem servir como marcadores úteis e confiáveis da qualidade de vida relacionada à saúde (health-related quality of life, HRQL) entre indivíduos ou comunidades, e ajudar no planejamento de programas de prevenção ou de intervenção, com uma boa relação custo-benefício.

Quality of life after first- and second- eye cataract surgery on community project in Lombok Island, West Nusa Tenggara, Indonesia.

Background: This study aims to assess the quality of life and the time trade off-utility value of the first eye cataract surgery and the second eye cataract surgery in Lombok Island-Indonesia. Methods: This was an epidemiologic survey study on community of cataract surgery. Evaluations of quality of life (QoL) and time trade-off (TTO) were performed using questionnaire prior and three weeks after cataract surgeries who had either first (group A) or second eye cataract surgery (group B). Personal data was noted especially on self-care, mobility, socially, and mentally status. Data was analyzed by chi-square test for categorical data and unpaired t-test or Mann-Whitney test for numeric data. Results: A total of 77 subjects was included in this study, there were 50 subjects in group A and 27 subjects in group B. Elements of QoL were improved after surgeries including self care, mobility, social, and mental status in both groups (p < 0.001). The modified TTO was accepted in 35 subjects in group A and 22 subjects in group B. Quality of life was improved in 46 patients in group A, there was further improvement in 22 patients in group B. The degree of patient’s expectation was good in 87% of all subjects. Conclusion: Second- eye cataract surgery showed further improvement in QoL despite better outcome of the first- eye cataract surgery. The outcome of cataract surgery conducted was relevant to the patient’s expectation.

Assessment of vision-related quality of life in Chinese glaucoma patients by utility analysis / 中华实验眼科杂志

BackgroundThe influence of glaucoma on the quality of life in patients is of increasing concern for ophthalmologists in recent years. However,some studies demonstrated that different types of questionnaires about quality of life have various disadvantages. Therefore, to accurately and fully assess the influencing factors of quality of life in glaucoma patients is very important. ObjectiveThe present study was to survey the self-reported visionrelated quality of life(QOL) in glaucoma patients by means of utility analysis and to tentatively analyze its influencing factors. Methods Patients with glaucoma were recruited from a single tertiary ophthalmic department. Standard face-to-face interviews were conducted. Utility values of linear rating scale ( RS ) and time trade-off ( TTO ) were calculated to evaluate the self-reported vision-related QOL of the patients. The correlations of the utility values with the patients' general and ophthalmologic characteristics were also analyzed. This survey was approved by the Ethic Committee of Beijing Tongren Hospital. Oral informed consent was obtained from the subjects before the study.ResultsA cross-sectional study was designed. A total of 86 glaucoma patients were enrolled in this study with 62 male and 24 female, with a mean age of 44. 67 years old. The mean utility values measured by RS and TTO were 0. 62± 0. 19 and 0. 77 ± 0. 12, respectively, and no evidential correlation was found between these two values ( r =0. 074, P=0. 499 ). The RS value was associated with daily visual acuity,mean deviation(MD) of visual field and the history of trabeculectomy. Neither daily visual acuity nor MD showed a significant correlation with the TTO value. Age, work status and educational background contributed to higher utility value for the TTO method. After adjusting for age, work status and educational level,patients with visual acuity in the worse-seeing eye better than 0. 3 showed a higher TTO value than those with less than 0. 3. Conclusions Utility analysis possesses the advantages of convenience and sensitivity. RS utility value is easily affected by the Objective visual status and surgery history in glaucomatous patients,which reflects the subjective assessment of patients'visual quality. However, TTO value is primarily associated with age,work status and education level rather than visual function in glaucoma patients,which is therefore subjective assessment of the disease-related quality of life. These Results indicate that visual function impairment is not a determining factor for the QOL of glaucoma patients.