INTERMITTENT CLAUDICATION - SYMPTOM SEVERITY VERSUS HEALTH VALUES

Objective: The objective of this study was to obtain health values fro m patients with intermittent claudication with five different instrume nts and to study the construct validity of these measures of health-re lated quality of life by examining their relation with symptom severit y. Methods: We included all patients with intermittent claudication wh o participated in an exercise program of the Department of Internal Me dicine at our university hospital (n = 92). Health value instruments i ncluded the verbal rating scale, time trade-off, standard gamble, Euro Qol, and the Health Utilities Index (Mark III). Symptom-free walking d istance was used as a measure of symptom severity. Results: For all in struments the average health values in groups of patients with a sympt om-free walking distance less than or equal to 150 m were lower than t he average values in patients with a greater walk distance, but the di fferences for the time trade-off and the standard gamble were small, a nd only the differences for the verbal rating scale and the EuroQol we re statistically significant. At the individual patient level consider able heterogeneity was seen, and the statistical association of the sy mptom-free walking distance with health values varied from poor to mod erate (Spearman rank correlations, 0.03 to 0.48; p values, 0.003 to 0. 78). Conclusion: At least for the verbal rating scale and the EuroQol, the results of our study provide evidence of the validity of the vari ous health value instruments in a population of patients with peripher al arterial occlusive disease.