Stability of time trade-off utilities for health states associated with the treatment of prostate cancer.
BACKGROUND
Patients diagnosed with localized prostate cancer face several treatment options. Patient preferences for treatment side effects often dominate the decision making process. We proposed to learn more about the nature of patient preferences, or utilities, for these side effects.


METHODS
Two hundred and fifteen men were consecutively enrolled from three institutions for assessment after prostate needle biopsy. Baseline and 6 month follow-up assessments were done using the University of California, Los Angeles Prostate Cancer Index (UCLA PCI), and a laptop utility assessment application, U-Titer II. Patient utility was assessed for current pelvic functions as well as hypothetical pelvic dysfunctions. We calculated stability of utility scores and correlations between utility scores and UCLA PCI scores.


RESULTS
Utility scores for current pelvic functions exhibited a significant 'ceiling effect.' Utility scores for current pelvic functions and hypothetical impaired states were stable after 6 months in patients with negative biopsies. In patients who underwent treatment, utility for current sexual function decreased by 0.13 units (p < 0.00) and utility for current urinary function decreased by 0.09 units (p < 0.01). Utility for hypothetical stress urinary incontinence rose in men with a >25-point drop in UCLA PCI score.


CONCLUSIONS
Utilities for some 'current' pelvic functions decreased in tandem with UCLA PCI scores in men who experienced >25-point changes in these scores. Utilities for some 'hypothetical' pelvic dysfunctions rose as men began to actually experience functional changes in those areas.
Department of Urology, School of Medicine, University of California, Los Angeles 90095-1738, USA.
Christopher S
CS
Saigal
Jeffrey
J
Gornbein
Kristen
K
Reid
Mark S
MS
Litwin
D000328:Adult; D000368:Aged; D002140:California; D003657:Decision Making; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D018434:Sickness Impact Profile