Calculation of Quality-Adjusted Life-Days Lost in Event Pathways for Decision Model of Treatment Strategies for Acute Otitis Media
Pathway | A Days of AOM* | B Days of Treatment Success* | C Days of Treatment Failure* | D Days of GI Adverse Effects*† | E Days of Rash*‡ | Total QALDs Lost§ (95% CI) |
---|---|---|---|---|---|---|
AOM = acute otitis media; GI = gastrointestinal; QALDs = quality-adjusted life-days; CI = confidence interval. | ||||||
Notes: Clinical failure = continuation of symptoms after 2.7 days of observation and subsequent resolution with 7 to 10 days of amoxicillin. Clinical failure with amoxicillin = continuation of symptoms after 2.7 days of amoxicillin and subsequent resolution with 10 days of amoxicillin-clavulanate. | ||||||
* Baseline utilities were used: 0.79 utility per day for days of AOM; 0.96 for days of treatment success, 0.72 for days of treatment failure, 0.70 for days of GI adverse effects, and 0.77 for days of rash. | ||||||
† Children receiving amoxicillin had a 9.9% chance of having 2 days of GI adverse effects. Children receiving amoxicillin and then amoxicillin-clavulanate had a 9.9% chance of having 4 days of GI adverse effects. | ||||||
‡ Children receiving amoxicillin had a 2% chance of having 2 days of rash. Children receiving amoxicillin and then amoxicillin-clavulanate had a 2% chance of having 4 days of rash. | ||||||
§ QALDs lost were calculated by subtracting the sum of columns A through E from the study time frame of 30 days. | ||||||
Resolution with observation | 2.7 × 0.79 = 2.1330 | 27.3 × 0.96 = 26.2080 | 0 | 0 | 0 | 1.6590 (0.7686–2.3583) |
Clinical failure | 2.7 × 0.79 = 2.1330 | 20.062 × 0.96 = 19.2595 | 7 × 0.72 = 5.0400 | 0.198 × 0.7 = 0.1386 | 0.04 × 0.77 = 0.0308 | 3.3981 (2.2898–4.5063) |
Resolution with amoxicillin | 2.7 × 0.79 = 2.1330 | 27.062 × 0.96 = 25.9795 | 0 | 0.198 × 0.7 = 0.1386 | 0.04 × 0.77 = 0.0308 | 1.7181 (1.0018–2.4344) |
Clinical failure with amoxicillin | 2.7 × 0.79 = 2.1330 | 19.824 × 0.96 = 19.0310 | 7 × 0.72 = 5.0400 | 0.396 × 0.7 = 0.2772 | 0.08 × 0.77 = 0.0616 | 3.4572 (2.3319–4.5824) |