COMBINED DISCRETE CHOICE AND TIME TRADE-OFF METHODS TO ESTIMATE UTILITIES FOR THE SINO-NASAL OUTCOME TEST (SNOT-22) IN CHRONIC RHINOSINUSITIS WITH NASAL POLYPS
Author(s)
Claire Lawrence, MSc, PhD1, Elin Gruffydd, MSc1, Bhovina Buguth, MSc2, Michael Watt, PhD2, Paul Macleod, BSc, MSc2, Millie Gaydon, BSc1, Sonia Shpendi, PhD1, Andrew Lloyd, DPhil1.
1Acaster Lloyd, London, United Kingdom, 2AstraZeneca UK Ltd, London, United Kingdom.
1Acaster Lloyd, London, United Kingdom, 2AstraZeneca UK Ltd, London, United Kingdom.
OBJECTIVES: The Sino-Nasal Outcome Test (SNOT-22) is a disease-specific patient-reported outcome measure used to assess symptoms and impacts of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). This research aimed to derive utility weights for a simplified SNOT-22-based descriptive system to enable estimation of preference-based utilities in CRSwNP.
METHODS: A subset of SNOT-22 items representing key symptoms and impact domains were selected based on a targeted literature review, analysis of patient data, and interviews with clinicians (N=5) and patients (N=10). A discrete choice experiment (DCE) with members of the general public (N=341) estimated relative preferences for selected item levels. A separate valuation study using time trade off (TTO) and EQ-5D-5L was conducted with CRSwNP patients (N=36) and members of the general public (N=100) to anchor DCE estimates onto a 0 (dead) to 1 (full health) utility scale and derive item-level disutilities.
RESULTS: Six SNOT-22 items were selected, representing all SNOT-22 domains. DCE coefficients were directionally consistent, with worsening response levels associated with lower preference across all items. The largest negative coefficients for the most severe level were observed for facial pain/pressure (-4.11), followed by lack of a good night’s sleep (-3.30), nasal blockage (-2.43), reduced concentration (-2.11) and frustrated/restless/irritable (-1.97). The smallest negative coefficients were observed for lack of smell/taste (-1.93). Using general public TTO-anchoring, the estimated utility range were 0.980 for the best health state and 0.289 for the worst health state. Disutilities for the most severe level of each item were -0.179 (facial pain/ pressure), -0.144 (lack of a good night’s sleep), -0.106 (nasal blockage), -0.092 (reduced concentration), -0.086 (frustrated/restless/irritable), and -0.084 (decreased smell/taste).
CONCLUSIONS: This study derived disutility weights for six representative SNOT-22 items relevant to CRSwNP. These weights enable estimation of patient-level preference-based utilities from SNOT-22 data to support economic evaluations of treatments for CRSwNP.
METHODS: A subset of SNOT-22 items representing key symptoms and impact domains were selected based on a targeted literature review, analysis of patient data, and interviews with clinicians (N=5) and patients (N=10). A discrete choice experiment (DCE) with members of the general public (N=341) estimated relative preferences for selected item levels. A separate valuation study using time trade off (TTO) and EQ-5D-5L was conducted with CRSwNP patients (N=36) and members of the general public (N=100) to anchor DCE estimates onto a 0 (dead) to 1 (full health) utility scale and derive item-level disutilities.
RESULTS: Six SNOT-22 items were selected, representing all SNOT-22 domains. DCE coefficients were directionally consistent, with worsening response levels associated with lower preference across all items. The largest negative coefficients for the most severe level were observed for facial pain/pressure (-4.11), followed by lack of a good night’s sleep (-3.30), nasal blockage (-2.43), reduced concentration (-2.11) and frustrated/restless/irritable (-1.97). The smallest negative coefficients were observed for lack of smell/taste (-1.93). Using general public TTO-anchoring, the estimated utility range were 0.980 for the best health state and 0.289 for the worst health state. Disutilities for the most severe level of each item were -0.179 (facial pain/ pressure), -0.144 (lack of a good night’s sleep), -0.106 (nasal blockage), -0.092 (reduced concentration), -0.086 (frustrated/restless/irritable), and -0.084 (decreased smell/taste).
CONCLUSIONS: This study derived disutility weights for six representative SNOT-22 items relevant to CRSwNP. These weights enable estimation of patient-level preference-based utilities from SNOT-22 data to support economic evaluations of treatments for CRSwNP.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR34
Topic
Economic Evaluation, Patient-Centered Research
Topic Subcategory
Health State Utilities
Disease
Biologics & Biosimilars, Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)