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Preferences for Fractures and Other Glucocorticoid-Associated Adverse Effects among Rheumatoid Arthritis Patients

Author

Listed:
  • Linda A. Merlino

    (Department of Internal Medicine, University of Iowa, Iowa City)

  • Indranil Bagchi

    (Smith Kline Beecham & Co., Collegeville, Pennsylvania)

  • Thomas N. Taylor

    (Parke-Davis & Co., Ann Arbor, Michigan)

  • Paul Utrie

    (Department of Internal Medicine, University of Iowa, Iowa City)

  • Elizabeth Chrischilles

    (Department of Epidemiology, University of Iowa, Iowa City)

  • Walton Sumner II

    (Division of General Medical Sciences, Washington University, St. Louis, Missouri)

  • Amy Mudano

    (Department of Medicine and Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, University of Alabama at Birmingham)

  • Kenneth G. Saag

    (Department of Medicine and Center for Education and Research on Therapeutics (CERTs) of Musculoskeletal Disorders, University of Alabama at Birmingham)

Abstract

Objective . The objective of this study was to determine rheumatoid arthritis (RA) patients’ preferences for validated health state scenarios depicting glucocorticoid adverse events, predictors of these preferences, and psychometric properties of different preference techniques in this population. Methods . Preferences were elicited by rating scale and time trade-off methods. Time trade-offs included trading current health for either time spent alive in an adverse health state for chronic conditions (time trade-off) or time spent in a sleeplike state for acute conditions (sleep trade-off). Results . A total of 107 subjects with long-standing RA participated in the preference interviews. Mean preference values (rating scale/trade-off) were lowest for serious fracture adverse events, including hip fracture requiring a nursing home stay (0.55 ± 0.22/0.76 ± 0.36) and vertebral fracture with chronic pain (0.59 ± 0.23/0.67 ± 0.35), and highest for cataracts (0.84 ± 0.17/0.96 ± 0.09) and wrist fracture (0.82 ± 0.18/0.81 ± 0.29). Rating scales had a stronger correlation (r= 0.88) with physician ranking of scenarios than trade-off methods (r = 0.31). All methods were feasible and demonstrated good reliability, while rating scale method showed better construct validity than trade-off techniques. Conclusion . Relative to their current health, RA patients assigned low preference values to many glucocorticoid adverse events, particularly those associated with chronic fracture outcomes. Results varied with the preference measure used, indicating that methodological attributes of preference determinations must be considered in clinical decision making.

Suggested Citation

  • Linda A. Merlino & Indranil Bagchi & Thomas N. Taylor & Paul Utrie & Elizabeth Chrischilles & Walton Sumner II & Amy Mudano & Kenneth G. Saag, 2001. "Preferences for Fractures and Other Glucocorticoid-Associated Adverse Effects among Rheumatoid Arthritis Patients," Medical Decision Making, , vol. 21(2), pages 122-132, April.
    • Handle: RePEc:sae:medema:v:21:y:2001:i:2:p:122-132
    DOI: 10.1177/0272989X0102100205
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    References listed on IDEAS

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    1. Torrance, George W., 1976. "Social preferences for health states: An empirical evaluation of three measurement techniques," Socio-Economic Planning Sciences, Elsevier, vol. 10(3), pages 129-136.
    2. Krabbe, Paul F. M. & Essink-Bot, Marie-Louise & Bonsel, Gouke J., 1997. "The comparability and reliability of five health-state valuation methods," Social Science & Medicine, Elsevier, vol. 45(11), pages 1641-1652, December.
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    Cited by:

    1. Oscar Andrés Espinosa Acuna, 2020. "Clasificación de estados de salud y metodologías de valoración de preferencias para el cálculo de AVAC: una revisión de literatura," Ensayos de Economía 19137, Universidad Nacional de Colombia Sede Medellín.

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