UTILITY-ASSESSMENT IN CANCER-PATIENTS - ADJUSTMENT OR TIME TRADEOFF SCORES FAR THE UTILITY OF LIFE YEARS AND COMPARISON WITH STANDARD GAMBLE SCORES
UTILITY-ASSESSMENT IN CANCER-PATIENTS - ADJUSTMENT OR TIME TRADEOFF SCORES FAR THE UTILITY OF LIFE YEARS AND COMPARISON WITH STANDARD GAMBLE SCORES
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DOI：
10.1177/0272989x9401400110
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发表时间：
1994-01-01
影响因子：
3.6
通讯作者：
DEHAES, JCJM
中科院分区：
文献类型：
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作者：
STIGGELBOUT, AM;KIEBERT, GM;DEHAES, JCJM
标准赌博（SG）和时间权衡（TTO），两种常用的效用评估方法，经常被发现会导致不同的效用相同的健康状态。作者调查了是否调整TTO评分的效用寿命年（风险态度）消除了这种差异。此外，风险态度和社会人口和医疗变量之间的关联进行了研究。在30例无病睾丸癌患者中，使用SG和TTO评估与睾丸癌相关的四种健康状况的效用。寿命年的效用是从确定性当量（CE）估计的。所有特征的SG评分均显著高于未校正的TTO评分。由于大多数患者（85%）为风险厌恶型，因此CE校正的TTO评分高于未校正评分，并且与SG获得的4个特征中的3个特征无显著差异。然而，调整后的评分仍略低于SG评分，但始终低于SG评分。这种差异的可能解释进行了讨论。风险厌恶和药物治疗之间存在关联：接受过化疗的癌症患者比仅接受过监测方案的患者更厌恶风险。由于风险规避可能对治疗决策产生影响，因此评估决策相关患者的风险状况非常重要。
The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated this difference. In addition, the association between risk attitude and sociodemographic and medical variables was studied. In 30 disease-free testicular cancer patients, SG and TTO were used to assess the utilities of four health profiles relevant to testicular cancer. Utility of life years was estimated from certainty equivalents (CEs). SG scores were significantly higher than unadjusted TTO scores for all profiles. As the majority of patients (85%) were risk-averse, CE-adjusted TTO scores were higher than unadjusted scores, and were not significantly different from those obtained from the SG for three of the four profiles. However, adjusted scores were still slightly but consistently lower than SG scores. Possible explanations for this discrepancy are discussed. An association was found between risk aversion and medical treatment: patients who had received chemotherapy for their cancers were more risk-averse than were patients who had been in a surveillance protocol only. As risk aversion can have an impact on treatment decisions, it is important to assess the risk posture of the patient to whom the decision pertains.