Economic Analysis of the EPRIDE

尿失禁（Ul）是女性中的常见问题，其导致痛苦并限制日常功能。Ul的成本是巨大的，在美国每年占160亿至320亿美元，超过了所有乳腺癌和妇科癌症的年直接成本总和。UI显著影响生活质量，并且与类似于阿尔茨海默病和中风的严重受损的健康状态相关。较高的体重增加了UI的风险，并且初始数据表明体重减轻改善了UI。为了进一步评估用于UI治疗的体重减轻的功效，NIDDK正在赞助通过饮食和运动减少肥胖的计划（PRIDE），这是对330名患有UI的肥胖女性的研究，这些肥胖女性被随机分配到体重减轻计划或对照条件（关于饮食和运动的信息会议和讲义）。虽然减肥计划是昂贵的，但它有可能改善UI，降低与UI和肥胖相关的成本，并改善生活质量。这项研究的目的，E-PRIDE（经济 PRIDE的分析），是比较PRIDE减肥和控制的成本和收益 干预措施，以估计失禁的体重减轻的成本效用。失禁和肥胖的高经济和生活质量成本以及减肥改善的高可能性使其成为成本效用分析的重要领域。由于效用捕捉所有潜在的健康相关的好处，包括改善UI和减轻体重，成本效用分析是一个理想的方法来测试的假设，体重减轻将有一个成本每质量调整生命年（QALY），这是目前接受的医疗干预。进行这种经济分析的必要步骤是：1）确定与减肥组和对照组相关的成本; 2）评估与健康相关的生活质量（效用） 与治疗和结果相关;以及3）估计减肥计划与对照条件的成本效用。为了评估UI变化的具体贡献，二次分析将探索成本、健康相关生活质量和QALY变化与UI和体重变化的关联。E-PRIDE汇集了一批在经济学、成本效益、UI和肥胖治疗方面具有专业知识的高级研究人员。E-PRIDE的辅助研究使我们能够有效地评估一种新的治疗方法-减轻体重-对失禁的成本效用。

Urinary incontinence (Ul) is a common problem among women that causes distress and limits daily functioning. The costs of Ul are substantial, accounting for $16 to $32 billion per year in the U.S., more than the annual direct costs for all breast and gynecological cancers combined. Ul substantially affects quality of life and is associated with severely impaired health status similar to Alzheimer's disease and stroke. Higher weight increases the risk of Ul and initial data suggest that weight reduction improves Ul. To further evaluate the efficacy of weight loss for Ul treatment, the NIDDK is sponsoring the Program to Reduce Incontinence by Diet and Exercise (PRIDE), a study of 330 obese women with Ul randomized to a weight reduction program or control condition (informational sessions & handouts on diet and exercise). While a weight loss program is costly, it has the potential to improve Ul, decrease costs associated with both Ul and obesity and improve quality of life. The aim of this proposed study, E-PRIDE (Economic analysis of the PRIDE), is to compare the costs and benefits of the PRIDE weight loss and control interventions to estimate the cost-utility of weight loss for incontinence. The high economic and quality of life costs of incontinence and obesity and the high probability of improvement with weight loss make this an important area to explore with cost-utility analysis. Since utilities capture all potential health-related benefits, including improved Ul and reduced weight, cost-utility analysis is an ideal method to test the hypothesis that weight loss will have a cost per quality adjusted life year (QALY) that is comparable with currently accepted medical interventions. The steps necessary to perform this economic analysis are to 1) determine costs associated with the weight loss and control groups; 2) assess the health-related quality of life (utilities) associated with treatments and outcomes; and 3) estimate the cost-utility of the weight reduction program vs. the control condition. To evaluate the specific contributions of changes in Ul, secondary analyses will explore the association of changes in costs, health-related quality of life and QALY's with changes in Ul and weight. E-PRIDE brings together a group of senior investigators with expertise in economics, cost-effectiveness, Ul and obesity treatment. The E- PRIDE ancillary study allows us to efficiently evaluate the cost-utility of a novel treatment approach - weight reduction -- for incontinence.