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Paul B, Urala AS, Acharya S. Quantifying health utilities of young adult orthodontic patients using the time trade-off method: a cross-sectional study. Dental Press J Orthod 2023; 28:e2321238. [PMID: 37283425 DOI: 10.1590/2177-6709.28.2.e2321238.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 03/16/2022] [Indexed: 06/08/2023] Open
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.
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Affiliation(s)
- Budhaditya Paul
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Public Health Dentistry (Manipal, Karnataka, India)
| | - Arun Srinivasa Urala
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Orthodontics and Dentofacial Orthopedics (Manipal, Karnataka, India)
| | - Shashidhar Acharya
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Public Health Dentistry (Manipal, Karnataka, India)
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Kataoka A, Fukui K, Sato T, Kikuchi H, Inoue S, Kondo N, Nakaya T, Ito Y. Geographical socioeconomic inequalities in healthy life expectancy in Japan, 2010-2014: An ecological study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 14:100204. [PMID: 34527999 PMCID: PMC8355904 DOI: 10.1016/j.lanwpc.2021.100204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 11/26/2022]
Abstract
Background Area differences in life expectancy (LE) and healthy life expectancy (HLE) in large geographical units have been monitored around the world. Area characteristics may be based on culture, history, socioeconomic status and discrimination in smaller geographical units, so it is important to consider these when looking at health inequality. We aimed to evaluate LE, HLE, and non-healthy life expectancy (NHLE) in 1707 municipalities using Areal Deprivation Index (ADI) in Japan for the first time. Methods We calculated the observed LE, HLE, and NHLE using death, population, and Long-term care insurance data for 2010-2014 and applied the variance weighted least squares model to estimate LE, HLE, and NHLE by 100 percentiles using the standardized ADI. Findings The estimated LE, HLE, and NHLE became lower as the deprivation index worsened: the differences between the most and least deprived areas for HLE were 2·49 years for LE and 2·32 years for HLE in males; 1·22 years for LE and 0·93 years for HLE in females. The observed LE and HLE in the most deprived areas were much lower than other areas. Interpretation Using ADI has enabled us to see the disparity within municipalities precisely. LE and HLE outlier for the 100th percentile might be linked to historical areal deprivation and marginalization. Precise monitoring of socioeconomic status-based health inequalities could help manage these inequalities by identifying the groups most in need of intervention. Funding The Ministry of Education, Science and Culture of Japan (a Grant-in-Aid for Scientific Research [A] No. 20H00040 and 18H04071).
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Affiliation(s)
- Aoi Kataoka
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University.,Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Keisuke Fukui
- Department of Mathematics Program, Graduate School of Advanced Science and Engineering, Hiroshima University
| | - Tomoharu Sato
- Department of Biostatistics and Data Science, Graduate School of Medicine, Osaka University
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine, Kyoto University
| | - Tomoki Nakaya
- Department of Frontier Science for Advanced Environment, Graduate School of Environmental Studies, Tohoku University
| | - Yuri Ito
- Department of Medical Statistics, Research & Development Center Osaka Medical and Pharmaceutical University
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Abalos JB, Booth H. Factors associated with regional variation in disability-free life expectancy based on functional difficulty among older persons in the Philippines. ASIAN POPULATION STUDIES 2020. [DOI: 10.1080/17441730.2020.1795997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Jeofrey B. Abalos
- Demographic Research and Development Foundation, Inc., University of the Philippines Diliman, 2/F Palma Hall, Roxas Avenue, corner Roces St, Quezon City, Philippines, 1101
| | - Heather Booth
- School of Demography, ANU College of Arts and Social Sciences, The Australian National University, 9 Fellows Road, Acton ACT 2601, Australia
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Bong Y, Song W. The effects of elastic band exercises and nutritional education on frailty, strength, and nutritional intake in elderly women. Phys Act Nutr 2020; 24:37-45. [PMID: 32408413 PMCID: PMC7451834 DOI: 10.20463/pan.2020.0007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/28/2020] [Accepted: 03/29/2020] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The purpose of this study was to examine the effects of elastic band exercises and nutritional education, as well as to identify the factors influencing frailty, strength, and nutritional intake of elderly women. METHODS The subjects in this study were 30 elderly women who were divided into four groups. All groups agreed to participate in four programs: health education only (HE), elastic band exercises only (EX), nutritional education only (NU), and elastic band exercises plus nutritional education (EX+NU). Frailty was evaluated by measuring the frailty factors according to Fried et al. Leg strength was measured using a leg-extension machine. Nutritional intake was assessed by the 24-hour recall method and food records. Nutritional intake was analyzed by CAN Pro 5.0 program. RESULTS After three months, the prevalence of frailty significantly decreased in the EX+NU group (P=0.013) compared with that of the HE group (P=0.088). There was significant improvement in leg strength in both the EX (P=0.012) and EX+NU groups (P=0.003) compared with that of the HE group (EX, P=0.005; EX+NU, P=0.002). The nutritional intake significantly decreased in the EX group compared with that of the HE group (P<0.05, P<0.05). CONCLUSION The combination of elastic exercises and nutrition education had positive effects on frailty and leg strength, while having negative effects on total calories, carbohydrate, sodium, and iron intake in elderly women. Elastic exercises only had positive effects on leg strength while having negative effects on nutritional intake in elderly women.
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Affiliation(s)
- Yena Bong
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, SeoulRepublic of Korea
| | - Wook Song
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, SeoulRepublic of Korea
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Tsuji T, Kondo K, Kondo N, Aida J, Takagi D. Development of a risk assessment scale predicting incident functional disability among older people: Japan Gerontological Evaluation Study. Geriatr Gerontol Int 2018; 18:1433-1438. [PMID: 30105800 PMCID: PMC6220974 DOI: 10.1111/ggi.13503] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 06/27/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
Aim The aim of the present study was to develop a risk assessment scale for predicting incident functional disability among older adults. Methods We used prospective cohort data from the Japan Gerontological Evaluation Study, a nationwide survey of 90 889 functionally independent older people collected from 23 municipalities. The incidence of functional disability was determined from long‐term care information obtained from municipal insurance databases. We constructed a Cox proportional hazards model with forward stepwise selection that used sex, age, and 12 of the essential items of the Public Survey of Long‐Term Care Prevention and Needs in Spheres of Daily Life (the Needs Survey). We assigned a score based on the obtained non‐standardized regression coefficients for each item and summed the scores to establish the risk assessment scale. The predictive validity was examined. Results The cumulative incidence of functional disability during the 3‐year follow‐up period was 9.7%. A risk assessment scale of 0–48 that used sex, age and the Needs Survey's 10 essential items was established. The area under the receiver operating characteristic curve was 0.804, and the sensitivity and specificity were both 0.733 (cut‐off 16/17). There was no significant intermunicipality difference in the associations between the total scores calculated by using the scale and the risk of new incidence (P = 0.135). Conclusions We developed a risk assessment scale predicting incident functional disability composed of 10 essential items of the Needs Survey, sex and age. The scale had superior predictive validity, regardless of the level of urbanness. Geriatr Gerontol Int 2018; 18: 1433–1438.
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Affiliation(s)
- Taishi Tsuji
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan.,Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu City, Aichi, Japan
| | - Naoki Kondo
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo Ward, Tokyo, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai City, Miyagi, Japan
| | - Daisuke Takagi
- Department of Health and Social Behavior, School of Public Health, The University of Tokyo, Bunkyo Ward, Tokyo, Japan
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Hikichi H, Kondo N, Kondo K, Aida J, Takeda T, Kawachi I. Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults: propensity score matching and instrumental variable analyses, JAGES Taketoyo study. J Epidemiol Community Health 2015; 69:905-10. [PMID: 25888596 PMCID: PMC4552922 DOI: 10.1136/jech-2014-205345] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Revised: 03/05/2015] [Accepted: 03/26/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND The efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias. METHODS The government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called 'community salons', providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument. RESULTS In the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74). CONCLUSIONS A community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability.
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Affiliation(s)
- Hiroyuki Hikichi
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Naoki Kondo
- School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
- Centor for Well-being and Society, Nihon Fukushi University, Nagoya, Japan
| | - Jun Aida
- Department of International and Community Oral Health, Tohoku University Graduate School of Density, Sendai, Japan
| | - Tokunori Takeda
- Faculty of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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Azuma MK, Ikeda S. Investigation of Evidence Sources for Health-Related Quality of Life in Cost-Utility Analysis of Pharmaceuticals in Japan. Value Health Reg Issues 2014; 3:190-196. [DOI: 10.1016/j.vhri.2014.04.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Yang S, Hoshi T, Wang S, Nakayama N, Kong F. Socioeconomic status, comorbidity, activity limitation, and healthy life expectancy in older men and women: a 6-year follow-up study in Japan. J Appl Gerontol 2014; 33:831-47. [PMID: 24652922 DOI: 10.1177/0733464813503041] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to explore the structural contributions of socioeconomic status (SES), comorbidity, and activity limitation to the healthy life expectancy (HALE) of Japanese suburban elderly. A questionnaire survey was distributed to all residents aged 65 years and older in Tama City, Tokyo, in 2001; a follow-up study was conducted in 2004; and individual vital status data from the municipal residents' registry were tracked until 2007. In all, 7,905 respondents were included for analysis. Data analysis was performed by structural equation modeling (SEM). The data were well fit by the models, and HALE was found to be well explained by SES, comorbidity, and activity limitation (R (2) = .59 for men and R (2) = .71 for women). In conclusion, elderly people with higher SES were more likely to live longer with good self-rated health, via living with less chronic diseases and better performance in daily living activities, especially for elderly women.
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Affiliation(s)
| | | | - Shuo Wang
- Tokyo Metropolitan University, Japan
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Gotoh M, Matsukawa Y, Yoshikawa Y, Funahashi Y, Kato M, Hattori R. Impact of urinary incontinence on the psychological burden of family caregivers. Neurourol Urodyn 2009; 28:492-6. [PMID: 19090589 DOI: 10.1002/nau.20675] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AIMS The present study was conducted to assess the impact of urinary incontinence on the psychological burden of family caregivers providing care to disabled family members with urinary incontinence. MATERIALS AND METHODS This survey was conducted using an Internet panel for family caregivers in Japan, consisting of 7,316 members. We requested the members to respond to an online questionnaire to assess the impact of urinary incontinence on the burden of caregivers. The questionnaire included basic characteristics, and the Japanese version of the Zarit Caregiver Burden Interview (ZBI) comprising 22 questions related to the impact of the patient's disabilities on the burden of their caregivers. Additionally, the participants were asked to include the level of care need, ranging from 0 to 5 according to the grade of disability of the cared individuals. RESULTS Relevant data obtained from 757 caregivers were analyzed. Of these caregivers, 452 provided care to family members with urinary incontinence (group 1), and 305 provided care to those without urinary incontinence (group 2). The mean total ZBI score was significantly higher in group 1 than in group 2 (mean, 40.7 vs. 34.7, P < 0.001). The difference in the scores for each item was also significant in 20 of the 22 items. With regard to the level of care need, irrespective of the level, the ZBI scores in group 1 tended to be higher than those in group 2. CONCLUSIONS The present survey demonstrated a negative impact of urinary incontinence on the psychological burden of family caregivers.
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Affiliation(s)
- Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
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Saito I, Kobayashi M, Matsushita Y, Mori A, Kawasugi K, Saruta T. Cost-utility analysis of antihypertensive combination therapy in Japan by a Monte Carlo simulation model. Hypertens Res 2008; 31:1373-83. [PMID: 18957808 DOI: 10.1291/hypres.31.1373] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of the present study was to analyze the cost-effectiveness of lifetime antihypertensive therapy with angiotensin II receptor blocker (ARB) monotherapy, calcium channel blocker (CCB) monotherapy, or ARB plus CCB (ARB+CCB) combination therapy in Japan. Based on the results of large-scale clinical trials and epidemiological data, we constructed a Markov model for patients with essential hypertension. Our Markov model comprised coronary heart disease (CHD), stroke, and progression of diabetic nephropathy submodels. Based on this model, analysis of the prognosis of each patient was repeatedly conducted by Monte Carlo simulation. The three treatment strategies were compared in hypothetical 55-year-old patients with systolic blood pressure (SBP) of 160 mmHg in the absence and presence of comorbid diabetes. Olmesartan medoxomil 20 mg/d was the ARB and azelnidipine 16 mg/d the CCB in our model. On-treatment SBP was assumed to be 125, 140, and 140 mmHg in the ARB+CCB, ARB alone, and CCB alone groups, respectively. Costs and quality-adjusted life years (QALYs) were discounted by 3%/year. The ARB+CCB group was the most cost-effective both in male and female patients with or without diabetes. In conclusion, ARB plus CCB combination therapy may be a more cost-effective lifetime antihypertensive strategy than monotherapy with either agent alone.
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Affiliation(s)
- Ikuo Saito
- Health Center, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan.
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Fukuda Y, Nakao H, Yahata Y, Imai H. In-depth descriptive analysis of trends in prevalence of long-term care in Japan. Geriatr Gerontol Int 2008; 8:166-71. [DOI: 10.1111/j.1447-0594.2008.00466.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Health-related quality of life and beneficiaries of long-term care insurance in Japan. Health Policy 2008; 85:349-55. [DOI: 10.1016/j.healthpol.2007.08.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 08/14/2007] [Accepted: 08/31/2007] [Indexed: 11/19/2022]
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Ding H, Koinuma N, Stevenson M, Ito M, Monma Y. The cost-effectiveness of risedronate treatment in Japanese women with osteoporosis. J Bone Miner Metab 2008; 26:34-41. [PMID: 18095061 DOI: 10.1007/s00774-007-0794-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2006] [Accepted: 06/19/2007] [Indexed: 10/22/2022]
Abstract
We constructed a mathematical model for assessing the cost-effectiveness of providing BMD (bone mineral density) scans to Japanese women aged 55 years and over and treating, with risedronate, those that are shown to be osteoporotic. Fracture rates, cost data, utility values, and the increased risks of fractures associated with T-score and vertebral fracture history were taken from published literature. We estimated the cost of fractures avoided due to risedronate treatment, allowing the net changes in cost, incorporating both intervention and fracture costs to be calculated. The QALYs (quality adjusted life years) gained through treatment were calculated enabling cost per QALY ratios to be presented. Further analyses were undertaken assuming treatment was reserved for older women and/or those who had sustained a vertebral fracture in the previous 2 years. Cost per QALY values were inversely related to absolute risk of fracture. Assuming a cost per QALY value threshold of US dollars 100,000, we concluded that providing BMD scans to women aged 70 years and over who had sustained a vertebral fracture in the previous 2 years and treating those that were osteoporotic was cost-effective. However, providing BMD scans for women without a vertebral fracture in the previous 2 years was not cost-effective, even in women aged 85 years and older.
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Affiliation(s)
- Hansheng Ding
- Department of Health Administration and Policy, Graduate School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
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