Relationship of meeting physical activity guidelines with quality-adjusted life-years

Kai Sun, Jing Song, Larry M. Manheim, Rowland W. Chang, Kent C. Kwoh, Pamela A. Semanik, Charles B. Eaton, Dorothy D. Dunlop

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Objective: The quality-adjusted life-year (QALY) is a standard outcome measure used in cost-effectiveness analyses. This study investigates whether attainment of federal physical activity guidelines is associated with higher QALY estimates among adults with or at an increased risk for knee osteoarthritis. Methods: This is a prospective study of 1794 Osteoarthritis Initiative participants. Physical activity was measured using accelerometers at baseline. Participants were classified as (1) Meeting Guidelines [≥150. min of moderate-to-vigorous (MV) activity per week acquired in sessions ≥10. min], (2) Insufficiently Active (≥1 MV session[s]/week but below the guideline), or (3) Inactive (zero MV sessions/week). A health-related utility score was derived from participant responses to the 12-item Short-Form Health Survey at baseline and 2 years later. The QALY was calculated as the area under utility curve over 2 years. The relationship of physical activity level to median QALY adjusted for socioeconomic and health factors was estimated using quantile regression. Results: Relative to the Inactive group, median QALYs over 2 years were significantly higher for the Meeting Guidelines (0.112, 95% CI: 0.067-0.157) and Insufficiently Active (0.058, 95% CI: 0.028-0.088) groups, controlling for socioeconomic and health factors. Conclusion: We found a significant graded relationship between greater physical activity level and higher QALYs. Using the more conservative estimate of 0.058, if an intervention could move someone out of the Inactive group and costs <$2900 over 2 years, it would be considered cost effective. Our analysis supports interventions to promote physical activity even if recommended levels are not fully attained.

Original languageEnglish (US)
Pages (from-to)264-270
Number of pages7
JournalSeminars in Arthritis and Rheumatism
Issue number3
StatePublished - Dec 1 2014


  • Cost effectiveness analysis
  • Knee osteoarthritis
  • Physical activity guidelines
  • Quality adjusted life years

ASJC Scopus subject areas

  • Rheumatology
  • Anesthesiology and Pain Medicine


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