Medical decision making : an international journal of the Society for Medical Decision Making · 2003
Validity of standard gamble utilities as measured by transplant readiness in lung transplant candidates.
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Singer Lianne G, Theodore James, Gould Michael K
Аннотация
PURPOSE: To evaluate the validity of standard gamble (SG) utilities, by comparing utilities with decision-making behavior in a group of lung transplant candidates facing a risky health decision.
METHODS: The authors elicited SG utilities for current health from 57 transplant candidates. They assessed the concordance between utility scores and patients' self-reported readiness to be placed on the transplant waiting list ("listed"). Because transplantation represents a real-life gamble with a short-term survival probability of 85%, the authors defined their minimum validity criterion as utility for current health < or = 0.85 in transplant-ready patients.
RESULTS: Utilities were significantly higher in patients who were not ready for listing (n = 22, median utility = 0.79, range 0.06-1) than in those who were ready or listed (n = 35, median utility = 0.50, range 0-0.85, P < 0.00005). All transplant-ready patients had utilities < or = 0.85 for current health.
CONCLUSIONS: Low SG utilities were associated with transplant readiness in this population of lung transplant candidates. These results provide one line of evidence supporting the validity of SG utilities as a measure of health-related quality of life, using the criterion of decision-making behavior.
METHODS: The authors elicited SG utilities for current health from 57 transplant candidates. They assessed the concordance between utility scores and patients' self-reported readiness to be placed on the transplant waiting list ("listed"). Because transplantation represents a real-life gamble with a short-term survival probability of 85%, the authors defined their minimum validity criterion as utility for current health < or = 0.85 in transplant-ready patients.
RESULTS: Utilities were significantly higher in patients who were not ready for listing (n = 22, median utility = 0.79, range 0.06-1) than in those who were ready or listed (n = 35, median utility = 0.50, range 0-0.85, P < 0.00005). All transplant-ready patients had utilities < or = 0.85 for current health.
CONCLUSIONS: Low SG utilities were associated with transplant readiness in this population of lung transplant candidates. These results provide one line of evidence supporting the validity of SG utilities as a measure of health-related quality of life, using the criterion of decision-making behavior.