ASSESSING PATIENT PREFERENCES FOR VISUAL ACUITY LOSS

（申请人摘要）干预措施所提供的好处

DESCRIPTION:(Applicant's Abstract) The benefit offered by interventions that prevent or treat visual impairments primarily reflect gains in quality rather than length of life. The broad objective of the proposed project is to measure and characterize the impact of a variety of eye diseases on quality of life. W will measure quality of life by assessing patients' utilities. Because utilities are quantitative measures of patient preferences for health states, they offer a means to evaluate the magnitude of health benefit offered by health interventions. Specifically, formal methods such as cost-effectiveness analysis rely on utilities to quantify the effects of interventions on quality of life. The primary specific aim of the proposed project is to describe the burden of various eye diseases (and thus the potential benefit of treatment and prevention) in units of utility. To accomplish this aim, we will assess utilities, clinical parameters (e.g., visual acuity) and functioning (e.g., th National Eye Institute's 25 question Visual Functioning Questionnaire, or NEI VFQ) in 600 patients, each with one of six target eye diseases (cataract, diabetic retinopathy, age-related macular degeneration, CMV retinitis, uveitis and glaucoma), and in 100 patients with no eye disease other than refractive error. In addition, we will investigate: (1) the variation in utilities among patients with similarly severe eye disease, (2) the variation in utilities across patients with different eye diseases, adjusting for differences in visual acuity and other clinical measures, and (3) possible predictors for patients' utilities for eye disease, including disease-related factors (e.g., severity of disease), level of visual functioning (e.g., the NEI VFQ), and sociodemographic factors (e.g., employment). The data collected in the proposed study will provide an important resource fo clinicians, policy makers and researchers seeking to evaluate formally the impacts of eye disease and interventions on quality of life. Rational clinical and policy decision making requires tradeoffs: are the health benefits of the intervention under consideration worth the risks and costs? The proposed project will provide information that is essential to evaluate the full benefi of treatment of eye disease, and will therefore help patients and clinicians evaluate the risks and benefits of treatments for eye disease.