Reprint requests to: Suephy C. Chen, MD, MS, Department of Dermatology, Emory University, 1525 Clifton Road, Atlanta, Georgia 30329, USA. Tel: (404)-778-3084; Fax: (404)-778-5395; E-mail: [email protected].Search for more papers by this author

Sarah Wetherington BS,

Sarah Wetherington BS

Medical College of Georgia, Georgia Regents University, Augusta, Georgia, USA

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Laura Delong MD, MPH,

Laura Delong MD, MPH

Department of Dermatology, Emory University, Atlanta, Georgia, USA

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Seema Kini MD, MSCR,

Seema Kini MD, MSCR

Department of Dermatology, Emory University, Atlanta, Georgia, USA

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Emir Veledar PhD,

Emir Veledar PhD

Department of Dermatology, Emory University, Atlanta, Georgia, USA

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Michael K. Schaufele MD,

Michael K. Schaufele MD

Department of Orthopaedics, Emory University, Atlanta, Georgia, USA

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Anne M. McKenzie-Brown MD,

Anne M. McKenzie-Brown MD

Department of Anesthesia, Emory University, Atlanta, Georgia, USA

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Suephy C. Chen MD, MS,

Corresponding Author

Suephy C. Chen MD, MS

Department of Dermatology, Emory University, Atlanta, Georgia, USA

Department of HSR&D & Division of Dermatology, Atlanta VA Medical Center, Emory University, Atlanta, Georgia, USA

First published: 09 April 2014

https://doi.org/10.1111/pme.12405

This study was conducted at Emory University.

Disclosure: The authors have no conflicts of interest to report.

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Abstract

Objective

Utilities are values of health-related quality of life (HRQoL) based on patient preference for a health status. The purpose of this study was to compare indirect measures to a directly elicited utility.

Design

Cross-sectional study.

Setting and Patients

Emory Spine Center and the Emory Center for Chronic Pain at Crawford Long Hospital. Patients at least 18 years of age with chronic pain, defined as pain that persists beyond the normal time of healing, usually beyond 6 months.

Measures

Chronic pain subjects completed a paper-based, self-administered time trade-off (TTO) survey, EQ-5D survey, and a face-to-face (FTF) TTO interview. Current pain severity was graded using the Numeric Rating Scale-11, subsequently stratified into no (0), mild (1–3), moderate (4–6), and severe (7–10) pain.

Results

Paired t test comparing FTF TTO and proxy utility measures stratified by severity revealed FTF TTO utility values significantly higher than EQ-5D utility values for all pain severities (overall mean difference 0.18, standard deviation [SD] 0.30, P < 0.001; Pearson's correlation 0.34, P < 0.0001); FTF TTO utility values were lower than paper TTO utility values, reaching statistical significance for mild and moderate pain (overall mean difference 0.09, SD 0.29, P = 0.0006; Pearson's correlation 0.38, P < 0.0001).

Conclusions

This study demonstrates that the EQ-5D overestimates, whereas the paper version of TTO underestimates, the impact of pain on HRQoL compared with the directly elicited FTF TTO utility. Our findings provide preliminary evidence that utilities vary by method, and directly elicited utility values differ from indirectly elicited measures.

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Volume15, Issue5

May 2014

Pages 865-870

Pain Quality of Life as Measured by Utilities

Abstract

Objective

Design

Setting and Patients

Measures

Results

Conclusions

References

References

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Pain Quality of Life as Measured by Utilities

Abstract

Objective

Design

Setting and Patients

Measures

Results

Conclusions

References

References

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