title: Examining the Value of Menopausal Symptom Relief Among US Women.
abstract: BACKGROUND
  Menopausal symptoms can cause significant distress to women, yet little is known about the value women place on these symptoms.
  
  
  METHODS
  In April 2013, 3397 US women, aged 40 to 69 years, completed an online survey that included 30 paired comparisons. Specifically, respondents were shown two menopausal symptoms described using the Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events and asked, "Which do you prefer?" From their choices, we estimated a generalized linear model to assess the values women place on symptom relief in terms of quality-adjusted life-years (QALYs).
  
  
  RESULTS
  Approximately half the respondents (1753 of 3397 [52%]) always preferred a reduced lifespan (up to 90 days) instead of experiencing menopausal symptoms at their worst for 30 days. For most of the symptoms (248 of 263 [94%]), including low-grade events, QALYs were significantly reduced (P < 0.05). The value women placed on relief ranged widely by symptom domain: the relief from depression, problems with memory, headache, pain in abdomen, problems with anger, and vomiting were the most valuable.
  
  
  CONCLUSIONS
  Overall, the value women place on menopausal symptom relief is surprisingly high. As the first national study to directly ask women about their preferences and to estimate the value of menopausal symptom relief on a QALY scale, this work provides critical evidence for health outcomes research in midlife women and can be applied in the evaluation of treatments that reduce or eliminate menopausal symptoms. This work also provides proof-of-concept for an approach to value Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events responses on a QALY scale.
authors.affiliation: Health Outcomes and Behavior, Moffitt Cancer Center and University of South Florida, Tampa, Florida, USA. Electronic address: benjamin.craig@moffitt.org.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Craig
authors.affiliation: Outcomes Research Branch, Healthcare Delivery Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Rockville, Maryland, USA.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D000368:Aged; D057189:Checklist; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D016014:Linear Models; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D017059:Models, Econometric; D057240:Patient Preference / Q000523:psychology*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D011795:Surveys and Questionnaires; D014481:United States; D016387:Women's Health / Q000191:economics
keywords: Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE); QALY; menopause; preference; quality-adjusted life-year; symptoms; women’s health