CLinical Prediction Rule Score in Veterans

Study Overview
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Brief Summary
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We will study whether the health care costs and health utilities differ in patients with gout and those without gout and whether they differ between those with more severe versus less severe gout

Detailed Description
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The purpose of this project is to study the out-patient and inpatient utilization and costs associated with tophaceous gout (a classic form of treatment-failure gout), compare these costs to patients with non-tophaceous gout and evaluate health utilities associated with these gout states. The analyses will be conducted in a manner to support a burden of illness type of presentation / manuscript. Study Questions What are the VA health care costs (inpatient and outpatient) for patients with gout compared to those without gout? Does health utility, as calculated by SF-6D, differ in patients with gout compared to patients without gout and between tophaceous and non-tophaceous gout? What are the relationships between costs and health utility? How does the burden of illness differ by subgroups of gout patients (costs and utilities)? What are the VA health care costs for patients with tophaceous gout and are they higher than patients with non-tophaceous gout? Inclusion criteria Patients with and without gout from the Veterans database described above will be included in the analyses for Study aims 1 and 5. This is approximately 3000 gout patients and 67,000 non-gout patients Patients with SF-36 data from the above cohort will be included in the analyses for Study aims 2-4. This is approximately 1500 gout patients and 38,000 non-gout patients

Official Title
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Development of CLinical Prediction Rule Score in Veterans: A Study of Impact of Gout on Health Care Utilization and Costs

Conditions
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Gout

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: participated in the survey Have SF-36 adn utilization data Exclusion Criteria: Absence of utilization and/or cost data
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Gout<br>Patients with ICD-9 for gout | |
| No Gout<br>Patients withOUT ICD-9 for gout | |
| Tophaceous gout<br>Patients with ICD-9 for tophaceous gout | |
| non-tophaceous gout<br>those with ICD-9 for gout other than the codes specific for tophaceous gout | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health care costs | Total of outpatient, inpatient and emergent care costs | Up to 5-year post-survey | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Health utility index, SF-6D | at 18-month post-survey | 18-months | 
| Health care utilization | Health care utilization as sum of outpatient, inpatient and emergent care utilization | 1-year post-survey | 
| Activity limitation on Katz 6 ADL | Katz 6 ADL questions assess difficulty with doing 6 key activities, bathing, eating, toileting, walking, getting up and climbing stairs | 18-months | 
| Mortality | Up to 5-year post-survey | 5-years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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gout, cost, utilization