Comparing Utility Scores in Common Spinal Radiculopathies: Results of a Prospective Valuation Study.
Study Design Prospective observational study. Objective To determine whether preference-based health utility scores for common spinal radiculopathies vary by specific spinal level. Methods We employed a standard gamble study using the general public to calculate individual preference-based quality of life for four common radiculopathies: C6, C7, L5, and S1. We compared utility scores obtained for each level of radiculopathy with analysis of variance and t test. Multivariable regression was used to test the effects of the covariates age, sex, and years of education. We also reviewed the literature for publications reporting EuroQol-5 Dimensions (EQ-5D) scores for patients with radiculopathy. Results Two hundred participants were included in the study. Average utility for the four spinal levels fell within a narrow range (0.748 to 0.796). There were no statistically significant differences between lumbar and cervical radiculopathies, nor were there significant differences among the different spinal levels (F = 0.0850, p = 0.086). Age and sex had no significant effect on utility scores. There was a significant correlation between years of education and utility values for S1 radiculopathy (p = 0.037). On review of the literature, no study separated utility values by specific spinal level. EQ-5D utilities for both cervical and lumbar radiculopathy were considerably lower than the results of our study. Conclusions Utility values associated with the most common levels of cervical and lumbar radiculopathy do not significantly differ from each other, validating the current practice of grouping utility by spinal segment rather than by specific root levels. The discrepancy in average utility values between our study and the EQ-5D highlights the need to be mindful of the underlying instruments used when assessing outcomes studies from different sources.
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Nikhil R
NR
Nayak
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States.
James H
JH
Stephen
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Kalil G
KG
Abdullah
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Sherman C
SC
Stein
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Neil R
NR
Malhotra
EQ-5D; HRQoL; quality of life; radiculopathy; standard gamble