Medical Decision Making

 

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Medical Decision Making, Vol. 24, No. 4, 367-378 (2004)
DOI: 10.1177/0272989X04267692

Positive Association between Current Health and Health Values for Hypothetical Disease States

Joseph T. King, Jr., MD, MSCE

Surgical Service/112, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT 06516; telephone: (203) 937-4433; fax: (203) 937-3845; Joseph.KingJr{at}med.va.gov

Joel Tsevat, MD, MPH

Section of Outcomes Research, Division of General Internal Medicine, Department of Internal Medicine, University of Cincinnati Medical Center, Cincinnati, OH; Center for Clinical Effectiveness, Institute for Health Policy and Health Services Research, University of Cincinnati Medical Center, Cincinnati, OH; Veterans Affairs Medical Center, Cincinnati, OH

Mark S. Roberts, MD, MPP

Section of Decision Sciences and Clinical Systems Modeling, Division of General Internal Medicine, Department of Medicine, University of Pittsburgh, Pittsburgh, PA; Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA; Center for Research on Health Care, University of Pittsburgh, Pittsburgh, PA; Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA

Background: Valuations of hypothetical health state scenarios can be affected by participant characteristics. Methods: The authors interviewed 108 veterans using the visual analogue scale (VAS), standard gamble (SG), time tradeoff (TTO), and willingness to pay (WTP) tomeasure health values for 1) current health and 2) 3 hypothetical health states portrayed in written scenarios describing cervical spondylotic myelopathy (CSM), a degenerative spine condition. They used bivariate rank order and multivariate regression analyses to assess the relationship between CSM values, participants’ characteristics, and participants’ current health values. Results: Participants were predominantly male (89.8%) and Caucasian (75.9%), with a median age of 58.3 years and a median annual income of $15,000. Median values for current health were VAS, 0.75; SG, 0.80; TTO, 0.80; and WTP, $25,000. In the multivariate analysis, higher CSM values were associated with better current health as measured with the SG, TTO, and WTP (for all,P < 0.001); there was no association with VAS values (P = 0.157). Conclusions: Health values for CSM are positively associated with the current health of the study population.

Key Words: cervical vertebrae • preferences • quality of life • spinal stenosis • standard gamble • time tradeoff • utility • visual analogue scale • willingness to pay


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