[Estimation of benefits and risks of the treatment of rheumatoid polyarthritis with glucocorticoids using the health-related quality of life measurements].
The purpose of this study was to use the utility approach to evaluate the risks and benefits of corticosteroid therapy in rheumatoid arthritis patients. The utility approach provides us with a quantitative measure of the value or preference a patient attaches to his overall health status defined on a scale from perfect health (1) to death (0). Benefits and toxicity are combined into a number reflecting the patients combined assessment of the benefits of treatment and the side-effects associated with it. Utility of 3 scenarios (rheumatoid arthritis patients treated respectively with no, 5 mg/day and 15 mg/day of prednisone) were determined through the time trade-off (TTO) and thermometer scale (TS) techniques. Twenty-five rheumatoid arthritis patients selected at random among subjects attending an outpatient clinic and 25 rheumatologists were interviewed using visual aids. Treatment with 15 mg/d prednisone was assigned the highest utilities by both patients and physicians. Coefficients of correlation between thermometer scale and time trade-off utilities were 0.675 (p < 0.01) for physician-assigned utilities and 0.518 (p < 0.05) for patient-assigned utilities. Medical decisions concerning rheumatoid arthritis patients should take into account the preferences of patients and physicians.
Ferraz
M B
MB
CEU Escola Paulista de Medicina, Sao Paolo, Brézil.
Quaresma
M R
MR
Goldsmith
C H
CH
Bennett
K
K
Atra
E
E
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use*; D011788:Quality of Life; D012219:Rheumatology
D011241:Prednisone
Estimation des bénéfices et des risques du traitement de la polyarthrite rhumatoïde par les glucocorticoïdes à l'aide de mesures des préférences.