AUTOMATED UTILITY-ASSESSMENT OF GLOBAL HEALTH

The objective of this study was to characterize the performance of an automated utility assessment instrument for measuring preferences for overall health. The study population consisted of 83 subjects recruite d from the cafeteria of a large tertiary care hospital. We assessed ut ilities for current health relative to perfect health and death using the rating scale, time tradeoff and standard gamble metrics. To valida te the instrument, we compared utilities with the General Health subsc ale of the SF-36 Health Survey instrument, satisfaction with current h ealth, and degree of bother due to current health. We evaluated interv iew failure rate based on irrational orderings of two practice assessm ents (monocular and binocular blindness) or inability to complete the interview. As expected, utility for overall health was statistically s ignificantly associated with the General Health subscale score and mea sures of satisfaction with current health and degree of bother. There is substantial variation in utilities among patients with similarly se vere overall health, and substantial overlap in utilities among subjec ts with different levels of overall health. The failure rate in the st udy was acceptable (9.6%). Automated assessment of utility far overall health provides a feasible means for estimating individual preference s.