Stability of time-tradeoff utilities in survivors of myocardial infarction.
To investigate whether time-tradeoff utilities of survivors of myocardial infarction change over time and whether changes in utilities correlate with changes in functional status, the authors conducted serial interviews using a time tradeoff and three measures of functional status in a cohort of 67 patients who had recently had myocardial infarction. The patients were also asked to rate their overall health on a rating scale and were asked about chest pain, exercise status, and employment status. Each patient was interviewed two to five times over one and a half years. The mean (95% CI) time-tradeoff score for all patients was 0.88 (0.84, 0.93). Over a mean interval of 8.4 months, 28 (42%) patients changed Karnofsky scores, 28 (42%) changed Specific Activity Scale classes, and 11 (16%) changed New York Heart Association classes, with most changes representing improvements in functional status. Scores on the rating scale improved by a mean (95% CI) of 0.06 [(0.03, 0.10); p < 0.002], but scores on the time tradeoff remained stable, with a mean (95% CI) change of 0.03 [(-0.02, 0.08); p = NS]. Changes in time-tradeoff scores did not correlate with changes in Specific Activity Scale classes (Kendall's tau = 0.21), New York Heart Association classes (tau = -0.02), or Karnofsky scores (tau = 0.14); with changes on the verbal rating scale (R = 0.20); with changes in chest pain status (tau = -0.05), exercise status (tau = 0.11), or employment status (tau = 0.11); or with interim hospitalizations (tau = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Tsevat
J
J
Department of Medicine, Beth Israel Hospital, Boston, Massachusetts.
Goldman
L
L
Soukup
J R
JR
Lamas
G A
GA
Connors
K F
KF
Chapin
C C
CC
Lee
T H
TH
D000328:Adult; D000368:Aged; D002755:Choice Behavior; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000523:psychology*; D011788:Quality of Life