Determining patient utility following coronary revascularization.
The observation of the primary endpoints of a clinical trial is only one part of what goes into determining the flow of benefits an individual receives from the treatments under consideration.  An optimal comparison of CABG and PTCA requires a consideration of the varying time paths of patient "utility" associated with each procedure because these procedures differ in that CABG will have a higher initial morbidity and mortality while PTCA involves more frequent recurrent angina pectoris resulting in more repeat procedures or crossovers.  This paper introduces a survey which can be used to estimate the patient's utility associated with two alternative forms of therapy, CABG and PTCA, for the treatment of multivessel coronary artery disease.  Once these estimates of utility are determined, they can be combined with expected years of survival to create Quality Adjusted Life Years (QALYs).
Division of Health Policy and Management, Emory University, Atlanta, Georgia 30329.
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Mauldin
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Weintraub
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011788:Quality of Life; D011795:Surveys and Questionnaires