Work-in-progress toward incorporating patients' preferences in practice guidelines for imaging aneurysmal subarachnoid hemorrhage.
OBJECTIVE
Patient-centered care has become a primary focus in clinical practice. In developing practice guidelines for clinical care, the patients' perspective is an important component.


METHODS
Patients' preferences are represented in a decision analytic model as quality-of-life weights for different health states associated with the aneurysmal subarachnoid hemorrhage population. The time-tradeoff method is used to obtain the individual patients' preferences, which are directly measured in quality-adjusted life years. An individualized care model is explained as a means of implementing a patient-centered approach into practice guidelines for clinical care. A method for calculating the expected value for societal benefit from improved decision making using an individualized care model is reviewed.


RESULTS
We discuss our work-in-progress towards incorporating patients' preferences in a decision analytic model for aneurysmal subarachnoid hemorrhage patients. The main methodologic concerns for using patients' preferences in cost-effectiveness analyses for developing practice guidelines are discussed.


CONCLUSIONS
Emphasis is placed on using patients' preferences and patient-centered outcome measures in cost-effectiveness analyses.
Department of Radiology, Weill Cornell Medical College, New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10065, USA. psc9001@med.cornell.edu
Pina C
PC
Sanelli
Rachel L
RL
Gold
Edward D
ED
Greenberg
Melissa B
MB
Reichman
Igor
I
Ugorec
Alan Z
AZ
Segal
Matthew
M
Fink
D000792:Angiography / Q000592:standards*; D006801:Humans; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis*; D014481:United States