Health utilities lost and risk factors associated with HPV-induced diseases in men and women: The HPV Italian collaborative study group. Marcellusi, A; Mennini, F.; Capone, A; Favato, G; Baio, G; Haeussler, K; Bononi, M; Crocetti, A; Cesare, A D.; Miccini, M; Sapienza, P; Mosto, M. D.; Boscolo-Rizzo, P; Stellin, M; Fuson, R; Palamara, G; Giuliani, M; Picardo, M; Panatto, D; Sasso, T; Gasparini, R; Cristoforoni, P; Capua, E D.; Vincenzo, R D.; Ricci, C; Conte, C; Scambia, G; and Ferrandina, G Clinical Therapeutics, 37:156--167, Jan, 2015.
Health utilities lost and risk factors associated with HPV-induced diseases in men and women: The HPV Italian collaborative study group [link]Paper  doi  abstract   bibtex   
Purpose: A complete economic evaluation requires accurate data concerning the resources used, outcomes, and utilities (patient's preferences) to properly value the cost utility of human papillomavirus (HPV) vaccination strategies. This study was designed to measure the utility loss in health states affected by a broad range of HPV-induced pathologies in both sexes in Italy. As a secondary objective, risk factors influencing the viral transmission and development of HPV infections were also investigated. Methods: Patients with a diagnosis of several HPV-induced pathologies including atypical squamous cells of undetermined significance (ASC-US), cervical intraepithelial neoplasia (CIN), cervical and anal-colorectal cancer, head and neck squamous cell carcinoma (HNSCC) and anogenital warts (AWs) were evaluated. Utilities, quality of life, and risk factors were elicited using a standardized and computer-guided administration of time trade-off, European Quality of Life 5 Dimensions (EQ-5D), 3 levels, and risk factor questionnaires. Utilities were measured at 6 clinical research centers across Italy. A group of healthy subjects was used as a control. A mean number of 20 healthy subjects was used as a control for each pathology group. Findings: Overall, 600 respondents were eligible for analysis: 465 patients (mean [SD] age, 44.0 [16.3] years) and 135 controls (mean [SD] age, 44.0 [13.2] years). With the exception of anal and HNSCC cancer, no statistically significant differences were observed between case and control groups, in terms of either age or quality of life at the time of interview. The patients' perception of their health condition at baseline was equal to an EQ-5D score of 0.87 (0.22). The mean (SD) value of utilities associated with the HPV-induced pathologies corresponded to 0.83 (0.24), 0.78 (0.27), 0.83 (0.22), 0.81 (0.27), 0.58 (0.31), 0.51 (0.26), and 0.69 (0.30) for ASC-US, AWs, CIN 1 (mild), CIN 2-3 (moderate to severe), cervical cancer, anal cancer and HNSCC, respectively. Utility lost due to AWs was significantly higher in females compared with males (0.71 [0.29] vs 0.83 [0.25]; P = 0.018). Having >5 sexual partners increased the risk of acquiring HPV-induced infections as much as 2.52-fold (P = 0.004), whereas for smoking or the age at start of sexual activity younger than 18 years, the risk increased by $∼$ 1.62-fold (P = 0.034). High levels of education were associated with a statistically significant protective effect (P < 0.001). Implications: Risk factors and utilities elicited in this study can be used as part of future economic assessments of other HPV vaccination strategies, including an immunization program for preadolescents of both sexes in Italy.
@article{ Marcellusietal:2015,
  author = {Marcellusi, A and Mennini, FS and Capone, A and Favato, G and Baio,
	G and Haeussler, K and Bononi, M and Crocetti, A and De Cesare, A
	and Miccini, M and Sapienza, P and Da Mosto, MC and Boscolo-Rizzo,
	P and Stellin, M and Fuson, R and Palamara, G and Giuliani, M and
	Picardo, M and Panatto, D and Sasso, T and Gasparini, R and Cristoforoni,
	P and Di Capua, E and De Vincenzo, R and Ricci, C and Conte, C and
	Scambia, G and Ferrandina, G},
  title = {Health utilities lost and risk factors associated with HPV-induced
	diseases in men and women: The HPV Italian collaborative study group},
  journal = {Clinical Therapeutics},
  year = {2015},
  volume = {37},
  pages = {156--167},
  month = {Jan},
  abstract = {Purpose: A complete economic evaluation requires accurate data concerning
	the resources used, outcomes, and utilities (patient's preferences)
	to properly value the cost utility of human papillomavirus (HPV)
	vaccination strategies. This study was designed to measure the utility
	loss in health states affected by a broad range of HPV-induced pathologies
	in both sexes in Italy. As a secondary objective, risk factors influencing
	the viral transmission and development of HPV infections were also
	investigated. Methods: Patients with a diagnosis of several HPV-induced
	pathologies including atypical squamous cells of undetermined significance
	(ASC-US), cervical intraepithelial neoplasia (CIN), cervical and
	anal-colorectal cancer, head and neck squamous cell carcinoma (HNSCC)
	and anogenital warts (AWs) were evaluated. Utilities, quality of
	life, and risk factors were elicited using a standardized and computer-guided
	administration of time trade-off, European Quality of Life 5 Dimensions
	(EQ-5D), 3 levels, and risk factor questionnaires. Utilities were
	measured at 6 clinical research centers across Italy. A group of
	healthy subjects was used as a control. A mean number of 20 healthy
	subjects was used as a control for each pathology group. Findings:
	Overall, 600 respondents were eligible for analysis: 465 patients
	(mean [SD] age, 44.0 [16.3] years) and 135 controls (mean [SD] age,
	44.0 [13.2] years). With the exception of anal and HNSCC cancer,
	no statistically significant differences were observed between case
	and control groups, in terms of either age or quality of life at
	the time of interview. The patients' perception of their health condition
	at baseline was equal to an EQ-5D score of 0.87 (0.22). The mean
	(SD) value of utilities associated with the HPV-induced pathologies
	corresponded to 0.83 (0.24), 0.78 (0.27), 0.83 (0.22), 0.81 (0.27),
	0.58 (0.31), 0.51 (0.26), and 0.69 (0.30) for ASC-US, AWs, CIN 1
	(mild), CIN 2-3 (moderate to severe), cervical cancer, anal cancer
	and HNSCC, respectively. Utility lost due to AWs was significantly
	higher in females compared with males (0.71 [0.29] vs 0.83 [0.25];
	P = 0.018). Having >5 sexual partners increased the risk of acquiring
	HPV-induced infections as much as 2.52-fold (P = 0.004), whereas
	for smoking or the age at start of sexual activity younger than 18
	years, the risk increased by $∼$ 1.62-fold (P = 0.034). High levels
	of education were associated with a statistically significant protective
	effect (P < 0.001). Implications: Risk factors and utilities elicited
	in this study can be used as part of future economic assessments
	of other HPV vaccination strategies, including an immunization program
	for preadolescents of both sexes in Italy.},
  day = {1},
  doi = {10.1016/j.clinthera.2014.11.002},
  eissn = {1879-114X},
  issn = {0149-2918},
  issue = {1},
  url = {http://www.ncbi.nlm.nih.gov/pubmed/25487083}
}
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