Comparison of health-related quality of life preferences between physicians and cirrhotic patients: implications for cost-utility analyses in chronic liver disease

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Dig Dis Sci. 2004 Mar;49(3):453-8. Related Articles, Links

Comparison of health-related quality of life preferences between physicians

and cirrhotic patients: implications for cost-utility analyses in chronic

liver disease.

Wells CD, Murrill WB, Arguedas MR.

Department of Medicine, University of Alabama at Birmingham, Birmingham,

Alabama, USA.

Accurate assessment of utilities to calculate quality-adjusted life

expectancy for medical interventions is needed in cirrhosis. To date,

limited data exist in cirrhotics and are generally physician-assigned.

Therefore, our aim was to determine utilities for six clinical scenarios in

cirrhosis and to define if differences exist in utilities assigned by

physicians versus patients. We administered a questionnaire to 83 physicians

and 114 cirrhotics to obtain utilities using the time trade-off method for

(1) compensated cirrhosis, (2) decompensated cirrhosis, (3) encephalopathy,

(4) spontaneous bacterial peritonitis, (5) variceal bleeding, and (5)

hepatocellular carcinoma. On a scale from 0 (death) to 1 (perfect health),

mean utilities of physicians and patients were compared using the Student t

test. One-way analysis of variance was used to compare the utilities between

patients according to Child-Pugh class. Statistical significance was defined

as a P value <0.05. The mean age of the physicians was 42 +/- 11, with 52%

being male. The mean age of the patients was 52 +/- 9; with 59% male. The

mean Child-Pugh score was 8 +/- 2 and HCV was the most common etiology

(54%). The mean utilities for physicians and patients were as follows: CC,

0.78 vs. 0.88; DC, 0.55 vs. 0.74; E, 0.38 vs. 0.55; SBP, 0.33 vs. 0.45; VB,

0.27 vs. 0.40; and HCC, 0.19 vs. 0.30. All comparisons were statistically

significant. Although physicians and patients assigned similar relative

rankings to each health state, physicians assigned utilities were

significantly different from those assigned by patients. These results

suggest that studies that have used physician-assigned utilities do not

accurately reflect patient preferences.

PMID: 15139497 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 Mar;49(3):453-8. Related Articles, Links

Comparison of health-related quality of life preferences between physicians

and cirrhotic patients: implications for cost-utility analyses in chronic

liver disease.

Wells CD, Murrill WB, Arguedas MR.

Department of Medicine, University of Alabama at Birmingham, Birmingham,

Alabama, USA.

Accurate assessment of utilities to calculate quality-adjusted life

expectancy for medical interventions is needed in cirrhosis. To date,

limited data exist in cirrhotics and are generally physician-assigned.

Therefore, our aim was to determine utilities for six clinical scenarios in

cirrhosis and to define if differences exist in utilities assigned by

physicians versus patients. We administered a questionnaire to 83 physicians

and 114 cirrhotics to obtain utilities using the time trade-off method for

(1) compensated cirrhosis, (2) decompensated cirrhosis, (3) encephalopathy,

(4) spontaneous bacterial peritonitis, (5) variceal bleeding, and (5)

hepatocellular carcinoma. On a scale from 0 (death) to 1 (perfect health),

mean utilities of physicians and patients were compared using the Student t

test. One-way analysis of variance was used to compare the utilities between

patients according to Child-Pugh class. Statistical significance was defined

as a P value <0.05. The mean age of the physicians was 42 +/- 11, with 52%

being male. The mean age of the patients was 52 +/- 9; with 59% male. The

mean Child-Pugh score was 8 +/- 2 and HCV was the most common etiology

(54%). The mean utilities for physicians and patients were as follows: CC,

0.78 vs. 0.88; DC, 0.55 vs. 0.74; E, 0.38 vs. 0.55; SBP, 0.33 vs. 0.45; VB,

0.27 vs. 0.40; and HCC, 0.19 vs. 0.30. All comparisons were statistically

significant. Although physicians and patients assigned similar relative

rankings to each health state, physicians assigned utilities were

significantly different from those assigned by patients. These results

suggest that studies that have used physician-assigned utilities do not

accurately reflect patient preferences.

PMID: 15139497 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 Mar;49(3):453-8. Related Articles, Links

Comparison of health-related quality of life preferences between physicians

and cirrhotic patients: implications for cost-utility analyses in chronic

liver disease.

Wells CD, Murrill WB, Arguedas MR.

Department of Medicine, University of Alabama at Birmingham, Birmingham,

Alabama, USA.

Accurate assessment of utilities to calculate quality-adjusted life

expectancy for medical interventions is needed in cirrhosis. To date,

limited data exist in cirrhotics and are generally physician-assigned.

Therefore, our aim was to determine utilities for six clinical scenarios in

cirrhosis and to define if differences exist in utilities assigned by

physicians versus patients. We administered a questionnaire to 83 physicians

and 114 cirrhotics to obtain utilities using the time trade-off method for

(1) compensated cirrhosis, (2) decompensated cirrhosis, (3) encephalopathy,

(4) spontaneous bacterial peritonitis, (5) variceal bleeding, and (5)

hepatocellular carcinoma. On a scale from 0 (death) to 1 (perfect health),

mean utilities of physicians and patients were compared using the Student t

test. One-way analysis of variance was used to compare the utilities between

patients according to Child-Pugh class. Statistical significance was defined

as a P value <0.05. The mean age of the physicians was 42 +/- 11, with 52%

being male. The mean age of the patients was 52 +/- 9; with 59% male. The

mean Child-Pugh score was 8 +/- 2 and HCV was the most common etiology

(54%). The mean utilities for physicians and patients were as follows: CC,

0.78 vs. 0.88; DC, 0.55 vs. 0.74; E, 0.38 vs. 0.55; SBP, 0.33 vs. 0.45; VB,

0.27 vs. 0.40; and HCC, 0.19 vs. 0.30. All comparisons were statistically

significant. Although physicians and patients assigned similar relative

rankings to each health state, physicians assigned utilities were

significantly different from those assigned by patients. These results

suggest that studies that have used physician-assigned utilities do not

accurately reflect patient preferences.

PMID: 15139497 [PubMed - in process]

[Guest guest]

Dig Dis Sci. 2004 Mar;49(3):453-8. Related Articles, Links

Comparison of health-related quality of life preferences between physicians

and cirrhotic patients: implications for cost-utility analyses in chronic

liver disease.

Wells CD, Murrill WB, Arguedas MR.

Department of Medicine, University of Alabama at Birmingham, Birmingham,

Alabama, USA.

Accurate assessment of utilities to calculate quality-adjusted life

expectancy for medical interventions is needed in cirrhosis. To date,

limited data exist in cirrhotics and are generally physician-assigned.

Therefore, our aim was to determine utilities for six clinical scenarios in

cirrhosis and to define if differences exist in utilities assigned by

physicians versus patients. We administered a questionnaire to 83 physicians

and 114 cirrhotics to obtain utilities using the time trade-off method for

(1) compensated cirrhosis, (2) decompensated cirrhosis, (3) encephalopathy,

(4) spontaneous bacterial peritonitis, (5) variceal bleeding, and (5)

hepatocellular carcinoma. On a scale from 0 (death) to 1 (perfect health),

mean utilities of physicians and patients were compared using the Student t

test. One-way analysis of variance was used to compare the utilities between

patients according to Child-Pugh class. Statistical significance was defined

as a P value <0.05. The mean age of the physicians was 42 +/- 11, with 52%

being male. The mean age of the patients was 52 +/- 9; with 59% male. The

mean Child-Pugh score was 8 +/- 2 and HCV was the most common etiology

(54%). The mean utilities for physicians and patients were as follows: CC,

0.78 vs. 0.88; DC, 0.55 vs. 0.74; E, 0.38 vs. 0.55; SBP, 0.33 vs. 0.45; VB,

0.27 vs. 0.40; and HCC, 0.19 vs. 0.30. All comparisons were statistically

significant. Although physicians and patients assigned similar relative

rankings to each health state, physicians assigned utilities were

significantly different from those assigned by patients. These results

suggest that studies that have used physician-assigned utilities do not

accurately reflect patient preferences.

PMID: 15139497 [PubMed - in process]