title: Health utility ratings for a spectrum of alcohol-related health states.
abstract: BACKGROUND
  Preference-based utility ratings for health conditions are important components of cost-utility analyses and population burden of disease estimates. However, utility ratings for alcohol problems have not been determined.
  
  
  OBJECTIVE
  The objectives of this study were to directly measure utility ratings for a spectrum of alcohol-related health states and to compare different methods of utility measurement.
  
  
  METHODS
  The authors conducted a cross-sectional interview of 200 adults from a clinic and community sample.
  
  
  METHODS
  Subjects completed computerized visual analog scale (VAS), time tradeoff (TTO), and standard gamble (SG) utility measurement exercises for their current health, a blindness scenario, and for 6 alcohol-related health state scenarios presented in random order. The main outcome measures were the utility ratings, scaled from 0 to 1, and anchored by death (0) and perfect health (1).
  
  
  RESULTS
  The 200 subjects were middle-aged (mean, 41 +/- 14 years), 61% women, and racially diverse (48% black, 43% white). Utility ratings decreased as the severity of the alcohol-related health state increased, but differed significantly among the VAS, TTO, and SG methods within each health state. Adjusted mean (95% confidence interval) utility ratings for alcohol dependence (VAS, 0.38 [0.34-0.41]; TTO, 0.54 [0.48-0.60]; SG, 0.68 [0.63-0.73]) and alcohol abuse (VAS, 0.53 [0.49-0.56]; TTO, 0.71 [0.65-77]; SG, 0.76 [0.71-0.81]) were significantly lower than utility ratings for nondrinking, moderate drinking, at-risk drinking, current health, and blindness.
  
  
  CONCLUSIONS
  Utility ratings for alcohol-related health states decrease as the severity of alcohol use increases. The low utility ratings for alcohol abuse and alcohol dependence are similar to those reported for other severe chronic medical conditions.
authors.affiliation: Center for Research on Health Care, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. kraemerkl@upmc.edu
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kraemer
authors.forename: Mark S
authors.initials: MS
authors.lastname: Roberts
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Horton
authors.forename: Tibor
authors.initials: T
authors.lastname: Palfai
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
authors.forename: Naomi
authors.initials: N
authors.lastname: Freedner
authors.forename: Nicole
authors.initials: N
authors.lastname: Tibbetts
authors.forename: Richard
authors.initials: R
authors.lastname: Saitz
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000503:physiopathology* / Q000523:psychology; D019973:Alcohol-Related Disorders / Q000503:physiopathology* / Q000523:psychology; D001294:Attitude to Health; D001766:Blindness / Q000523:psychology; D001900:Boston; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010414:Pennsylvania; D011320:Primary Health Care; D011569:Psychiatric Status Rating Scales; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires