Table 2.

Calculation of Quality-Adjusted Life-Days Lost in Event Pathways for Decision Model of Treatment Strategies for Acute Otitis Media

PathwayA 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 observation2.7 × 0.79 = 2.133027.3 × 0.96 = 26.20800001.6590 (0.7686–2.3583)
Clinical failure2.7 × 0.79 = 2.133020.062 × 0.96 = 19.25957 × 0.72 = 5.04000.198 × 0.7 = 0.13860.04 × 0.77 = 0.03083.3981 (2.2898–4.5063)
Resolution with amoxicillin2.7 × 0.79 = 2.133027.062 × 0.96 = 25.979500.198 × 0.7 = 0.13860.04 × 0.77 = 0.03081.7181 (1.0018–2.4344)
Clinical failure with amoxicillin2.7 × 0.79 = 2.133019.824 × 0.96 = 19.03107 × 0.72 = 5.04000.396 × 0.7 = 0.27720.08 × 0.77 = 0.06163.4572 (2.3319–4.5824)