A national internet-based survey of cerebral aneurysm preference-based quality of life.
OBJECTIVE
Preference-based quality of life (QOL) instruments integrate all factors contributing to QOL and provide a comprehensive valuation of a health state. QOL values of the general public for cerebral aneurysm health states are not well understood.


METHODS
In an internet-based survey of a nationally representative sample of the United States population, we measured standard gamble QOL values for the subjects' own health and for low-, medium-, and high-risk cerebral aneurysm health state scenarios and determined the effect of depicting aneurysm-associated stroke and death risk as annual or cumulative.


RESULTS
The 1654 subjects matched the United States population demographics. The subjects' mean (standard deviation) QOL for their current health was 0.82 (0.19), and for a cerebral aneurysm it was 0.78 (0.19) (P < 0.001). Mean low-, medium-, and high-risk aneurysm QOL values were 0.01, 0.06, and 0.13 lower than for current health, respectively (P < 0.001). The average discrepancy between aneurysm QOL and current health narrowed with age: 18 to 25 years, 0.09; 24 to 44 years, 0.06; 45 to 64 years, 0.03; and 65+ years, 0.01 (trend P < 0.001). Subjects who received only annual risk data provided the highest mean aneurysm QOL values (0.81 [0.18]); those who received both annual and 20-year cumulative risk information gave intermediate values (0.79 [0.18]), and those who received only data on cumulative 20-year risk provided the lowest values (0.76 [0.20]) (P < 0.001).


CONCLUSIONS
Preference-based QOL values for cerebral aneurysms derived from the general public vary with the subjects' age, the risk of aneurysmal stroke and death, and the mathematical terminology used to convey the risk of stroke and death.
King
Joseph T
JT
Section of Neurosurgery, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. Joseph.KingJr@va.gov
Brandt
Cynthia A
CA
Tsevat
Joel
J
Roberts
Mark S
MS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003625:Data Collection; D005260:Female; D006801:Humans; D020407:Internet; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011788:Quality of Life; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D055815:Young Adult