Utilities for major stroke: Results from a survey of preferences among persons at increased risk for stroke - 09/09/11
Abstract |
Background Patient beliefs, values, and preferences are crucial to decisions involving health care. In a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke. Methods and Results Respondents were obtained from the Academic Medical Center Consortium (n = 621), the Cardiovascular Health Study (n = 321), and United Health Care (n = 319). Preferences were primarily assessed by using the time trade off (TTO). Although major stroke is generally considered an undesirable event (mean TTO = 0.30), responses were varied: although 45% of respondents considered major stroke to be a worse outcome than death, 15% were willing to trade off little or no survival to avoid a major stroke. Conclusions Providers should speak directly with patients about beliefs, values, and preferences. Stroke-related interventions, even those with a high price or less than dramatic clinical benefits, are likely to be cost-effective if they prevent an outcome (major stroke) that is so undesirable. (Am Heart J 1998;136:703-13.)
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 | From the Center for Clinical Health Policy Research, Sanford Institute of Public Policy, the Department of Medicine, the Department of Community and Family Medicine, and the Department of Neurology, Duke University; the Department of Veterans Affairs Medical Center; Research Triangle Institute; the Center for Aging, University of Kansas Medical Center; the Department of Health Services Administration, University of Kansas; Bowman Gray School of Medicine, Wake Forest University; Academic Medical Center Consortium and the Department of Community and Preventive Medicine; the Center for Health Care Policy and Evaluation, United Health Care; Roudebush Medical Center, Department of Veterans Affairs, Regenstrief Institute for Health Care, Indiana University, and the Division of General Internal Medicine, Indiana University School of Medicine. |
| This work was performed as part of the Stroke Prevention Patient Outcomes Research Team (PORT) and was funded through contract 282-91-0028 from the US Agency for Health Care Policy and Research. |
 | Reprint requests: Gregory P. Samsa, PhD, Duke University Center for Clinical Health Policy Research, First Union Tower, Suite 230, 2200 W Main St, Durham NC 27705. |
| 4/1/90223 |
Vol 136 - N° 4
P. 703-713 - octobre 1998 Retour au numéro
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