Ep. Havranek et al., Patient preferences for heart failure treatment: Utilities are valid measures of health-related quality of life in heart failure, J CARD FAIL, 5(2), 1999, pp. 85-91
Background: Current standards hold that cost-effectiveness analyses should
incorporate measures of both quantity and quality of life, and that quality
of life in this context is best measured by a utility. We sought to measur
e utility scores for patients with heart failure and to assess their validi
ty as measures of health-related quality of life (HRQL).
Methods and Results: We studied 50 patients with heart failure. We measured
utilities with the time trade-off technique, exercise capacity with a 6-mi
nute walk test, and HRQL with the Minnesota Living With Heart Failure quest
ionnaire, the Medical Outcomes Study Short Form-36 (SF-36) questionnaire, a
nd a visual analogue score. Validity was assessed by establishing correlati
on between utilities and these other measures. Mean utility score was 0.77
+/- 0.28. There were significant (P < .05) curvilinear relationships betwee
n utility score and visual analogue score, the physical function summary sc
ale of the SF-36, 6-minute walk distance, and the Living With Heart Failure
score. Utility scores on retest at 1 week were unchanged in a subset of 12
patients. Utilities did not vary systematically with age, sex, or ethnicit
y.
Conclusion: Utilities are valid measures of HRQL in patients with heart fai
lure, and cost-effectiveness analyses of heart failure treatments incorpora
ting utilities in the outcome measure can be meaningful.