A community-based study of acne-related health preferences in adolescents.
OBJECTIVE
To examine preferences for acne-related outcomes in adolescents.


METHODS
Community-based, cross-sectional survey study.


METHODS
Four public high schools in San Francisco, California.


METHODS
Volunteer sample of 266 adolescents with acne.


METHODS
Health utilities for current acne state and 3 hypothetical acne-related states (100% clearance, 50% clearance, and 100% clearance but with residual scarring) using time trade-off (TTO) and willingness to pay metrics. A self-administered written survey was used.


RESULTS
The mean (median) utilities for current acne state using the TTO metric was 0.961 (0.985). One hundred percent acne clearance received a higher utility score (mean [median] score, 0.978 [0.994]) than 50% clearance (0.967 [0.992]; P < .001 by Wilcoxon signed rank test) and 100% clearance with scarring (0.965 [0.992]; P < .001). Although current acne state utility was not correlated with physician-rated severity (P = .23), a significant association with subject-rated severity was observed in both univariate analysis (P = .01) and after adjustment for duration of acne, having seen a physician for acne, and income (P = .05). Adolescents were willing to pay a median of $275 to have never had acne in their lifetime and were willing to pay significantly more for 100% clearance than for 50% clearance or 100% clearance but with scarring (P < .001 for both comparisons).


CONCLUSIONS
We describe adolescents' acne-related health state utilities. Compared with current acne state utility, both partial and total clearance with scarring are substantially less preferable than total clearance. Subjects' self-rated disease severity correlates with current acne state utility, whereas physician-rated severity does not. A self-administered paper instrument can effectively assess adolescents' acne-related preferences in community-based samples.
Chen
Cynthia L
CL
School of Medicine, University of California, San Francisco, CA, USA.
Kuppermann
Miriam
M
Caughey
Aaron B
AB
Zane
Lee T
LT
D000152:Acne Vulgaris / Q000150:complications / Q000191:economics / Q000523:psychology*; D000293:Adolescent; D002921:Cicatrix / Q000191:economics / Q000209:etiology / Q000523:psychology*; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D010290:Parents / Q000523:psychology; D017060:Patient Satisfaction; D010820:Physicians / Q000706:statistics & numerical data; D000297:Psychology, Adolescent; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires