AN EVALUATION OF UTILITY MEASUREMENT IN CROHNS-DISEASE

We evaluated the use of utility measurements to assess the quality of life of patients with Crohn's disease. Utility scores were obtained us ing the Time Trade-Off (TTO), Standard Gamble, and Visual Analog Scale (VAS) methods in 180 consecutive patients with Crohn's disease. The m ean utility scores of patients with a spectrum of disease severity wer e compared with other measures of disease activity to assess the opera ting properties of these instruments. All methods of utility estimatio n yielded lower mean scores in patients with more severe disease. (Rem ission versus chronically active? therapy resistant disease: TTO 0.96 versus 0.88; Standard Gamble 0.88 versus 0.74; VAS 0.84 versus 0.61). TTO scores were consistently higher than those derived by the other me thods (p = 0.001). The utility scores were reliable in patients who we re stable (intraclass correlation coefficient 0.55-0.54), but were les s responsive than the Crohn's Disease Activity Index (responsiveness r atio 0.97-1.3 versus 2.10) to changes in disease severity. Patients wi th active Crohn's disease have decreased quality of life as measured b y utility scores. Although utilities are valid and reliable quality of life assessments, they are less responsive than other measures of out come used for clinical trials.