The relationship between health perception and utility in heart failure patients in a clinical trial: results from an OVERTURE substudy.

Abstract

BACKGROUND:

Cost-effectiveness analyses should be based on incremental years of life gained adjusted with a health status measure known as a utility. Measuring utilities for all subjects in a large-scale randomized trial, however, would be prohibitively cumbersome. We therefore sought to estimate utilities for all subjects from results obtained in a subset of patients.

METHODS AND RESULTS:

We studied a subset of patients enrolled in a randomized trial of omapatrilat for the treatment of heart failure. Survey instruments (a time trade-off questionnaire, a visual analog scale [VAS] score of overall health perception, and the Duke Activity Status Index [DASI]) were administered to patients by mail and by telephone interviews. There was a significant (P <.0001) relationship between VAS score and utility described by the power function u=1-(1-v)q, where q=2.17 (95% CI 1.76 to 2.58). There was a significant positive correlation (r=.17, P <.04) between the DASI and utility, and a significant negative correlation (r=-.26, P <.001) between utility and New York Heart Association functional class.

CONCLUSION:

There is a significant relationship between the relatively easily obtainable health perception score by VAS with the more complex utility by time tradeoff for a subset of patients in a multicenter randomized clinical trial. This relationship may be helpful in examining the cost-effectiveness of new treatments for heart failure.

• Authors: Edward P Havranek, Teresa A Simon, Gilbert L'Italien, Allison Smitten, A Brett Hauber, Roland Chen, Pablo Lapuerta
• Journal: Journal of cardiac failure (J Card Fail) Vol. 10 Issue 4 Pg. 339-43 (Aug 2004) ISSN: 1071-9164 [Print] United States
• PMID: 15309702 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Female
• Health Status
• Heart Failure (epidemiology, psychology)
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• North America (epidemiology)
• Pain Measurement
• Perception
• Statistics as Topic