The quality-of-life burden of knee osteoarthritis in New Zealand adults: A model-based evaluation

<div><p>Background</p><p>Knee osteoarthritis is a leading global cause of health-related quality of life loss. The aim of this project was to quantify health losses arising from knee osteoarthritis in New Zealand (NZ) in terms of quality-adjusted life years (QALYs) lost.</p><p>Methods</p><p>The Osteoarthritis Policy Model (OAPol), a validated Monte Carlo computer simulation model, was used to estimate QALYs lost due to knee osteoarthritis in the NZ adult population aged 40–84 over their lifetimes from the base year of 2006 until death. Data were from the NZ Health Survey, NZ Burden of Diseases, NZ Census, and relevant literature. QALYs were derived from NZ EQ-5D value set 2. Sensitivity to health state valuation, disease and pain prevalence were assessed in secondary analyses.</p><p>Results</p><p>Based on NZ EQ-5D health state valuations, mean health losses due to knee osteoarthritis over people’s lifetimes in NZ are 3.44 QALYs per person, corresponding to 467,240 QALYs across the adult population. Average estimated per person QALY losses are higher for non-Māori females (3.55) than Māori females (3.38), and higher for non-Māori males (3.34) than Māori males (2.60). The proportion of QALYs lost out of the total quality-adjusted life expectancy for those without knee osteoarthritis is similar across all subgroups, ranging from 20 to 23 percent.</p><p>Conclusions</p><p>At both the individual and population levels, knee osteoarthritis is responsible for large lifetime QALY losses. QALY losses are higher for females than males due to greater prevalence of knee osteoarthritis and higher life expectancy, and lower for Māori than non-Māori due to lower life expectancy. Large health gains are potentially realisable from public health and policy measures aimed at decreasing incidence, progression, pain, and disability of osteoarthritis.</p></div

Ethnicity, sex, and age-specific per-person and population-based QALY losses due to OA, assuming 90% moderate pain for subjects in pain not due to OA.

<p>Ethnicity, sex, and age-specific per-person and population-based QALY losses due to OA, assuming 90% moderate pain for subjects in pain not due to OA.</p

Summary of per-person and population-based QALY losses due to knee OA in New Zealand.

<p>Summary of per-person and population-based QALY losses due to knee OA in New Zealand.</p

Quality of life utilities, by age and pain level.

<p>Quality of life utilities, by age and pain level.</p

Estimates of prevalence of knee osteoarthritis in New Zealand.

<p>Estimates of prevalence of knee osteoarthritis in New Zealand.</p

Additional file 2: Table S1. of A hypofractionated radiation regimen avoids the lymphopenia associated with neoadjuvant chemoradiation therapy of borderline resectable and locally advanced pancreatic adenocarcinoma

Phenotyping of peripheral blood immune cells. (DOCX 16 kb