Self-report measures of patient utility: should we trust them?

As self-reports, measures of patient utility are susceptible to the effects of cognitive biases in patients. This article presents often overlooked pr oblems in these measures by outlining cognitive processes involved in patie nt self-report. It is argued that these measures: 1) require overly complex mental operations: 2) fail to elicit thoughtful response by default; 3) ma y be biased by patients' mood; 4) are affected by both researchers' choice of measurement instruments and patients' choice of judgment strategies: 5) tend to reflect the disproportionate influence of patients' values that hap pen to be recallable at the time of measurement: and 6) are affected by pat ients' fear of regret. It is suggested that solutions for these problems sh ould involve: a) improving the methods of administration; b) developing mea sures that are less taxing to patients; and c) redefining the concept of pa tient utility as judged. as opposed to retrieved. evaluation. Published by 2000 Elsevier Science Inc. All rights reserved.