Patient preferences for heart failure treatment: utilities are valid measures of health-related quality of life in heart failure.
BACKGROUND
Current standards hold that cost-effectiveness analyses should incorporate measures of both quantity and quality of life, and that quality of life in this context is best measured by a utility. We sought to measure utility scores for patients with heart failure and to assess their validity as measures of health-related quality of life (HRQL).


RESULTS
We studied 50 patients with heart failure. We measured utilities with the time trade-off technique, exercise capacity with a 6-minute walk test, and HRQL with the Minnesota Living With Heart Failure questionnaire, the Medical Outcomes Study Short Form-36 (SF-36) questionnaire, and a visual analogue score. Validity was assessed by establishing correlation between utilities and these other measures. Mean utility score was 0.77 +/- 0.28. There were significant (P < .05) curvilinear relationships between utility score and visual analogue score, the physical function summary scale of the SF-36, 6-minute walk distance, and the Living With Heart Failure score. Utility scores on retest at 1 week were unchanged in a subset of 12 patients. Utilities did not vary systematically with age, sex, or ethnicity.


CONCLUSIONS
Utilities are valid measures of HRQL in patients with heart failure, and cost-effectiveness analyses of heart failure treatments incorporating utilities in the outcome measure can be meaningful.
Havranek
E P
EP
Denver Health Medical Center, CO 80204-4507, USA.
McGovern
K M
KM
Weinberger
J
J
Brocato
A
A
Lowes
B D
BD
Abraham
W T
WT
D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005069:Evaluation Studies as Topic; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006333:Heart Failure / Q000191:economics* / Q000628:therapy*; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011788:Quality of Life; D015203:Reproducibility of Results; D012494:Sampling Studies; D012720:Severity of Illness Index