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).