Measuring health state preferences in women with breast hypertrophy

The purpose of this article is to introduce the measurement of utilities, o r patient preferences, to the plastic surgery community. Specifically, the study demonstrated the development and validation of a utility measure for estimating the health-related quality of life in women with breast hypertro phy Two self-administered instruments were developed, a Wheel and a Table. All subjects completed the utility assessments for their "current health" a nd again for "breast-related symptoms." The reliability of the instruments was assessed in repeat (test-retest) inter views of 47 women within 10 to 1 8 days. Utilities obtained with the new instruments were also compared with the performance of other validated utility assessment instruments, includi ng a visual analogue stale, a computer-based instrument (U-Titer), and a pr eference classification system (EuroQol). Of the 47 women in the test-retes t reliability study, 21 had experienced bl-east hypertrophy (13 had not had reduction surgery and 8 had undergone reduction mammaplasty). Mean utility values for breast-related symptoms among women with breast hypertrophy (n = 13) were: Table, 0.85; Wheel, 0.90; and U-Titer, 0.66. Current health uti lity scores were significantly lower for women with breast hypertrophy (n = 13), as measured by all instruments except the Wheel. The Table had good r eliability and distinguished women with breast hypertrophy from those witho ut. Although the Table Provided higher utility values for the same health s tate compared with the computer-based interview (U-Titer), it is much less costly to implement. The Table is recommended as a reasonable alternative f or use in multicenter studies of women with breast hypertrophy. The reporte d utility value for breast hypertrophy of 0.86 is much lower than predicted . Tt is comparable with the reported burden of living with other health con ditions, such as moderate angina (0.90) and a kidney transplant (0.84).