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Establishment of Health Utility Indices for Post-Infectious Functional Gastrointestinal Disorders in Active Duty US Military.

Publication Status: Published

Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)

Sponsoring Office: Uniformed Services University of Health Sciences

Congressionally Mandated: No

Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)

Release Date/Publication: July 01, 2015

Principle Investigator Status: Government

Primary DoD Data Source: Other Survey

Secondary DoD Data Source:

Abstract

INTRODUCTION:
Knowledge of disease burden attributable to functional gastrointestinal disorders (FGD) in travelers is lacking, despite the high incidence of travelers' diarrhea (TD) associated with increased FGD risk. One tool for assessing the impact of disease on health-related quality of life is the health utility index (HUI), which values health states based on preferential health outcomes. Health utilities can be used as preference weights in the estimation of quality-adjusted life-years (QALYs).

METHODS:
Six months following travel to Egypt or Turkey, 120 US military personnel completed a survey on TD during deployment, health-related quality of life (SF-36), and the onset of functional bowel disorders (Rome II). Elements from the SF-36 were used to develop SF-6D values, which were combined with health state valuations to enable calculation of HUI scores for each subject. Mean index scores were compared across functional outcomes, specific symptoms, and demographic profiles.

RESULTS:
The presence of FGD significantly reduced index scores, with irritable bowel syndrome (IBS) and dyspepsia showing the greatest impact (-0.17 and -0.19, respectively) compared with those with no FGD (p < 0.05). Importantly, however, several individuals met multiple FGD outcome definitions. Additionally, a number of symptoms associated with abnormal bowel habits and abdominal pain were associated with reduced index scores regardless of outcome.

CONCLUSION:
FGD are associated with significant morbidity as assessed by HUIs. Given the strong link between TD and FGD as well as the large number of travelers from the developed to the developing world, additional study is needed to further understand this association and efforts aimed at primary disease prevention are warranted.

Published 2015. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Citation:

Porter CK, et. al., Establishment of Health Utility Indices for Post-Infectious Functional Gastrointestinal Disorders in Active Duty US Military. J Travel Med. 2015 Jul-Aug;22(4):237-41.

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