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Purpose To investigate the influence of ethnic origin on the incidence of keratoconus and the association of atopic diseases in patients with keratoconus.Methods Retrospective study of new patients referred to Dewsbury District General Hospital and diagnosed with keratoconus in a 6-year period between 1994 and 2000. The ethnic origin of the patient was defined as white, Asian, or other. Incidence was calculated from the catchment population of 176?774 (82% white people, 17% Asians, 1% others). t-Test, confidence intervals and ?2 tests were used to show statistical significance.Results A total of 74 cases of keratoconus were diagnosed over this period. Of these patients 29 (39%) were white and 45 (61%) were Asian. This equated to an incidence of keratoconus of 25 per 100?000 (1 in 4000) per year for Asians, compared with 3.3 per 100?000 (1 in 30?000) per year for white people (P<0.001). Asians presented significantly younger than white patients. The incidence of atopic disease was found to be significantly higher in white compared to Asian keratoconic patients.Conclusions Asians were significantly more likely to present with keratoconus. The Asian patients were mostly of Northern Pakistani origin. This community has a tradition of consanguineous, especially first-cousin marriages. The higher incidence in this population was highly suggestive of a genetic factor being significant in the aetiology. The incidence was higher than revealed by previous studies. Atopic disease was significantly less common in Asians compared to white people, supporting the theory of a different aetiology in these patients.Eye (2004) 18, 379-383. doi:10.1038/sj.eye.6700652 [ABSTRACT FROM AUTHOR]

Objective: Previous studies have demonstrated the effect of incontinence, and urge incontinence in particular, on patients' quality of life. This study assessed the effects of urge incontinence on quality of life and measured the value of a reduction in symptoms.Design: A self-administered questionnaire was mailed to 591 patients with urge or mixed incontinence. 495 (83.8%) surveys were returned with complete quality of life and symptom data. Of the total sample, 411 patients received the willingness-to-pay (WTP) survey, from which 257 (62.53%) returns were judged complete and reliable. Information was collected about the number of micturitions and urinary leakages. Health-related quality of life (HR-QOL) was measured using the Short Form 36 (SF-36) Health Survey. Socioeconomic characteristics were also recorded. Value was assessed with a binary WTP question.Main Outcome Measures and Results: Quality of life among the sample population was significantly lower in 5 of 8 dimensions compared with the general US population, and was significantly related to the severity of the symptoms in 6 of 8 dimensions. The median (mean) willingness to pay was $US27.24 ($US87.74) per month for a 25% reduction in micturitions and leakages, and $US75.92 ($US244.54) per month for a 50% reduction in micturitions and leakages. As expected, the willingness to pay was significantly related to the size of the reduction in micturitions and leakages, and household income.Conclusions: Patients with incontinence perceive substantial benefits from a reduction in the number of micturitions and leakages. [ABSTRACT FROM AUTHOR]

Presents a letter to the editor in response to an article about incidence of keratoconus in Asian populations.

We compare different contingent valuation question formats with eachother and with observed behaviour for a non-monetary estimation task, the expected number of kilometers traveled by automobile. Open-ended questions, open-ended follow-up questions, dichotomous choice (DC) questions, and double-bound DC questions are included. The single anddouble-bound DC questions result in an estimated mean about twice ashigh as the actual value and the open-ended mean. The DC question overestimation seems to be due to an anchoring effect leading to 'yea-saying' behaviour. Our results about the difference between DC questions and open-ended questions is consistent with the pattern observed in contingent valuations studies of the willingness to pay. Our results indicates that DC questions seem to be associated with a general overestimation problem that is present even for simple non-monetary estimation tasks. [ABSTRACT FROM AUTHOR]