Validity of standard gamble utilities in patients referred for aortic valve replacement
- 24 November 2015
- journal article
- Published by Springer Science and Business Media LLC in Quality of Life Research
- Vol. 25 (7), 1703-1712
- https://doi.org/10.1007/s11136-015-1186-1
Abstract
Purpose Standard gamble (SG) is the preferred method of assessing preferences in situations with uncertainty and risk, which makes it relevant to patients considered for aortic valve replacement (AVR). The present study assesses SG preferences in patients with severe aortic stenosis (AS). Methods All patients >18 years old with severe AS referred for AVR to our institution were invited to enroll in the study. The SG was administered by a clinical research nurse. The SF-36, EQ-5D 3L, Hospital Anxiety and Depression Scale (HADS), and AS symptoms were administered by self-completed questionnaire. We hypothesized that SG utilities would have low-to-moderate correlations with physical and mental aspects of health based on our pathophysiological understanding of severe AS. No correlations were expected with echocardiographic measures of the aortic valve. Results The response rate for SG was 98 %. SG moderately correlated with physical aspects of SF-36 (PCS, role-physical, vitality), health transition, AS symptoms, and EQ-VAS (ρ S = 0.31–0.39, p < 0.001) and had low correlation with mental aspects of SF-36 and EQ-5D (ρ S = 0.17–0.28, p < 0.001). No correlation was found between SG and HADS, echocardiographic measures, age, gender, or education level (ρ S = 0.01–0.06). Conclusions SG is an acceptable and feasible method of assessing preferences in patients with severe AS that has evidence for validity. The inclusion of uncertainty lends the SG face validity in this population as a direct approach to assessing preferences and basis for QALY calculations.Keywords
Funding Information
- The Norwegian Health Association
This publication has 55 references indexed in Scilit:
- Validity of the SF-36 in Patients with Morbid ObesityObesity Facts, 2011
- Health Utility Bias: A Systematic Review and Meta-Analytic EvaluationMedical Decision Making, 2008
- What difference does it make? The calculation of QALY gains from health profiles using patient and general population valuesHealth Policy, 2007
- EQ-SD: a measure of health status from the EuroQol GroupAnnals of Medicine, 2001
- Valuing Health-Related Quality of LifePharmacoEconomics, 2000
- Validation of a combined comorbidity indexJournal of Clinical Epidemiology, 1994
- The MOS 36-Item Short-Form Health Survey (SF-36)Medical Care, 1993
- EuroQol - a new facility for the measurement of health-related quality of lifeHealth Policy, 1990
- Utility approach to measuring health-related quality of lifeJournal of Chronic Diseases, 1987
- A new method of classifying prognostic comorbidity in longitudinal studies: Development and validationJournal of Chronic Diseases, 1987