The relationship between health perception and utility in heart failure patients in a clinical trial: results from an OVERTURE substudy.
BACKGROUND
Cost-effectiveness analyses should be based on incremental years of life gained adjusted with a health status measure known as a utility. Measuring utilities for all subjects in a large-scale randomized trial, however, would be prohibitively cumbersome. We therefore sought to estimate utilities for all subjects from results obtained in a subset of patients.


RESULTS
We studied a subset of patients enrolled in a randomized trial of omapatrilat for the treatment of heart failure. Survey instruments (a time trade-off questionnaire, a visual analog scale [VAS] score of overall health perception, and the Duke Activity Status Index [DASI]) were administered to patients by mail and by telephone interviews. There was a significant (P <.0001) relationship between VAS score and utility described by the power function u=1-(1-v)q, where q=2.17 (95% CI 1.76 to 2.58). There was a significant positive correlation (r=.17, P <.04) between the DASI and utility, and a significant negative correlation (r=-.26, P <.001) between utility and New York Heart Association functional class.


CONCLUSIONS
There is a significant relationship between the relatively easily obtainable health perception score by VAS with the more complex utility by time tradeoff for a subset of patients in a multicenter randomized clinical trial. This relationship may be helpful in examining the cost-effectiveness of new treatments for heart failure.
Havranek
Edward P
EP
Division of Cardiology, Denver Health Medical Center, University of Colorado Health Sciences Center, Denver, Colorado 80204-4507, USA.
Simon
Teresa A
TA
L'Italien
Gilbert
G
Smitten
Allison
A
Hauber
A Brett
AB
Chen
Roland
R
Lapuerta
Pablo
P
D000368:Aged; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009656:North America / Q000453:epidemiology; D010147:Pain Measurement; D010465:Perception; D013223:Statistics as Topic