Original Articles Health values of adolescents with cystic fibrosis

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The Journal of Pediatrics, February 2003 • Volume 142

• Number 2

Original Articles

Health values of adolescents with cystic fibrosis

S. Yi, MD, MSc [MEDLINE LOOKUP]

T. Britto, MD, MPH [MEDLINE LOOKUP]

W. Wilmott, MD [MEDLINE LOOKUP]

Uma R. Kotagal, MBBS, MSc [MEDLINE LOOKUP]

Mark H. Eckman, MD, MSc [MEDLINE LOOKUP]

Dennis W. Nielson, MD, PhD [MEDLINE LOOKUP]

Vikki L. Kociela, RN [MEDLINE LOOKUP]

Tsevat, MD, MPH [MEDLINE LOOKUP]

   Abstract      TOP

Objectives To assess health values (utilities) in

adolescents with cystic fibrosis (CF) and to evaluate

how health status and clinical factors affect their

health values.

Methods Adolescents 12 to 18 years of age completed

the Child Health Questionnaire (CHQ), Health Utilities

Index Mark 2 (HUI2), and 3 health value measures: the

visual analog scale (VAS), time tradeoff (TTO), and

standard gamble (SG). Severity of illness was measured

by percent of predicted forced expiratory volume in 1

second (FEV1) and frequency of pulmonary

exacerbations.

Results The mean age (± SD) of the 65 adolescents was

15.1 (± 2.1) years; 53.8% were male; their mean FEV1

was 72.8% (± 27.0%) predicted. The mean TTO utility

was 0.96 (± 0.07) and the mean SG utility was 0.92 (±

0.15). In multivariable analysis, the General Health

Perceptions domain from the CHQ was the only health

status scale significantly associated with the VAS,

TTO, and SG. No clinical or demographic measures were

significantly related to both TTO and SG scores.

Conclusions Direct utility assessment in adolescents

with CF is feasible. Their TTO and SG utilities are

generally high, indicating that they are willing to

trade very little of their life expectancy or take

more than a small risk of death to obtain perfect

health. Their self-rated health perceptions are

related to their health values, but, as in adult

populations, only moderately so, indicating that

health values are highly individualistic. Therefore,

health values should be ascertained directly from

adolescents. (J Pediatr 2003;142:133-40)

   Publishing and Reprint Information    TOP

•       From the Department of Internal Medicine, University

of Cincinnati Medical Center; the Department of

Pediatrics, Cincinnati Children's Hospital Medical

Center and Institute for Health Policy and Health

Services Research, Cincinnati; and the Department of

Pediatrics, The Children's Medical Center, Dayton,

Ohio.

•       Submitted for publication June 4, 2002;

•       revision received Sept 19, 2002;

•       accepted Nov 4, 2002.

•       Reprint requests: S. Yi, MD, MSc, University

of Cincinnati Medical Center, Division of General

Internal Medicine, Section of Outcomes Research, PO

Box 670535, Cincinnati, OH 45267-0535.

•       Copyright © 2003, Mosby, Inc. All rights reserved.

•       0022-3476/2003/$30.00 + 0

•       doi:10.1067/mpd.2003.51

Becki

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