Whose Utilities for Decision Analysis?
| Autor: | Bernard J. Cummings, Norman F. Boyd, Karen Z. Heasman, H. J. Sutherland, David Tritchler |
|---|---|
| Rok vydání: | 1990 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Patients Attitude of Health Personnel Colorectal cancer medicine.medical_treatment MEDLINE Rectum Disease Choice Behavior Decision Support Techniques 03 medical and health sciences Life Expectancy 0302 clinical medicine Game Theory Physicians Colostomy medicine Humans Clinical significance 030212 general & internal medicine business.industry 030503 health policy & services Health Policy General surgery Prognosis medicine.disease Surgery medicine.anatomical_structure Multivariate Analysis Patient Participation 0305 other medical science business Attitude to Health Decision analysis |
| Zdroj: | Medical Decision Making. 10:58-67 |
| ISSN: | 1552-681X 0272-989X |
| DOI: | 10.1177/0272989x9001000109 |
| Popis: | The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of treatment for that disease. After preparing and validating a description of colostomy and its effects on patients' lives, utilities for the state were obtained from five groups of individuals. These comprised two groups of patients who received treatment for rectal cancer, a group of physicians and surgeons specializing in the treatment of this disease, and two groups of healthy subjects, none of whom were health professionals. Of the patients who had been treated for rectal cancer, one group had been treated surgically with the formation of colostomies and the other had been treated with radiotherapy and none had a colostomy. Utilities for colostomy were elicited using the standard gamble, category rating, and a treatment choice question naire. The groups differed substantially in the utilities assigned to colostomy. In general, patients with colostomies and physicians assigned significantly higher utilities than did pa tients who did not themselves have a colostomy. The clinical significance of these differences was examined in a simplified clinical decision problem that compared surgery (with colostomy) and radiotherapy (without colostomy) as primary treatment. The expected clinical value of these treatment alternatives was substantially influenced by the differences observed in utilities for colostomy. These results emphasize the importance of patient utilities in clinical decision making and the need to gain greater understanding of the factors that influence the utilities that patients assign to health states. Key words: utilities; decision analysis; oncology. (Med Decis Making 1990;10:58-67) |
| Databáze: | OpenAIRE |
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