Medical Devices: Evidence and Research (Oct 2018)

Gains in health utility associated with urinary catheter innovations

  • Krassioukov A,
  • Igawa Y,
  • Averbeck MA,
  • Madersbacher H,
  • Lloyd AJ,
  • Bøgelund M,
  • Thiruchelvam N

Journal volume & issue
Vol. Volume 11
pp. 345 – 351

Abstract

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Andrei Krassioukov,1,2 Yasuhiko Igawa,3 Márcio Augusto Averbeck,4 Helmut Madersbacher,5 Andrew J Lloyd,6 Mette Bøgelund,7 Nikesh Thiruchelvam8 1University of British Columbia, International Collaboration On Repair Discoveries (ICORD), Vancouver, British Columbia, Canada; 2Division of Physical Medicine and Rehabilitation, Department of Medicine, G.F. Strong Rehabilitation Centre, Vancouver, British Columbia, Canada; 3Department of Continence Medicine, The University of Tokyo, Graduate School of Medicine, Tokyo, Japan; 4Head of Neuro-Urology Unit, Moinhos de Vento Hospital, Porto Alegre, Brazil; 5Department of Neurology, Medical University Innsbruck, Innsbruck, Austria; 6Bladon Associates Ltd., Oxford, UK; 7Incentive Partners ApS, Holte, Denmark; 8Department of Urology, Cambridge University Hospitals NHS Trust, Cambridge, UK Purpose: To estimate gains in health utility for two different catheter features and a support service related to urinary catheters used for intermittent catheterization. Patients and methods: Two internet-based time trade-off (TTO) surveys were undertaken to value vignettes describing two innovative catheter features and a support service. The first TTO survey “Size and Service” included catheters with compact design and the availability of a support service for users; the second TTO survey “Phthalates” included avoidance of potentially harmful phthalates in the material of the catheters. All participants were from the UK; they traded health states against a time horizon that matched their total life expectancy. Sensitivity analyses were done to estimate the impact of extreme values on disutilities. Results: The participants (n=890) estimated the incremental value of 0.031 (95% CI: 0.024–0.039), 0.009 (95% CI: 0.003–0.015), and 0.037 (95% CI: 0.027–0.046), respectively, for catheters with compact design, availability of support service, and catheters not containing phthalates. Conclusions: Participants valued all three improvements in catheter design. To capture the impact of such design improvements on quality of life and utilities, vignette-based approaches can be a useful supplement to the conventional, generic tools. Keywords: intermittent catheterization, time trade-off, vignette-based approach, health-related quality of life, QALY

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