Variation in patient utilities for outcomes of the management of chronic stable angina. Implications for clinical practice guidelines. Ischemic Heart Disease Patient Outcomes Research Team - PubMed (original) (raw)
. 1995 Apr 19;273(15):1185-90.
Affiliations
- PMID: 7707625
Variation in patient utilities for outcomes of the management of chronic stable angina. Implications for clinical practice guidelines. Ischemic Heart Disease Patient Outcomes Research Team
R F Nease Jr et al. JAMA. 1995.
Erratum in
- JAMA 1995 Aug 23-30;274(8):612
Abstract
Objective: Although practice guidelines sometimes make recommendations based on symptom severity, they rarely account for how patients feel about their symptoms. To investigate the possible importance of patient preferences in treatment of ischemic heart disease, we assessed attitudes toward symptoms in patients with angina pectoris.
Design: Case series.
Setting: Ambulatory cardiology clinics at two tertiary care medical centers.
Patients: A total of 220 subjects were selected from 589 patients with chronic stable angina referred from cardiologists to achieve patients samples balanced for sex, race, and angina severity.
Main outcome measures: We measured patients' attitudes toward their angina using the rating scale, time trade-off, and standard gamble utility metrics. Reliability of measurements was evaluated by repeating the assessments 2 weeks later on 50 willing patients.
Results: While the mean responses followed the expected patterns (those with more severe Canadian Cardiovascular Society scores chose lower utilities), attitudes toward symptoms varied substantially among patients with similarly severe angina. For example, there was a 33% chance that a patient with class II angina had a time trade-off utility that was lower (ie, more bothered by symptoms) than a patient with more severe angina (class III/IV). This variation in utilities was not due to random error in the assessments.
Conclusions: Angina patients with similar functional limitation vary considerably in their tolerance for their symptoms, as measured by utilities. Our findings suggest that guidelines for the management of ischemic heart disease should be based on the preferences of the individual patient rather than on symptom severity alone.
Comment in
- Patient preferences and clinical guidelines.
Hlatky MA. Hlatky MA. JAMA. 1995 Apr 19;273(15):1219-20. JAMA. 1995. PMID: 7707631 No abstract available.
Similar articles
- Assessing the preferences of patients with psoriasis. A quantitative, utility approach.
Zug KA, Littenberg B, Baughman RD, Kneeland T, Nease RF, Sumner W, O'Connor GT, Jones R, Morrison E, Cimis R. Zug KA, et al. Arch Dermatol. 1995 May;131(5):561-8. Arch Dermatol. 1995. PMID: 7741543 - Utility assessment among patients with dry eye disease.
Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W. Schiffman RM, et al. Ophthalmology. 2003 Jul;110(7):1412-9. doi: 10.1016/S0161-6420(03)00462-7. Ophthalmology. 2003. PMID: 12867401 - Angina patients' ratings of current health and health without angina: associations with severity of angina and comorbidity.
Chen AY, Daley J, Thibault GE. Chen AY, et al. Med Decis Making. 1996 Apr-Jun;16(2):169-77. doi: 10.1177/0272989X9601600209. Med Decis Making. 1996. PMID: 8778535 - Utility assessment to measure the impact of dry eye disease.
Buchholz P, Steeds CS, Stern LS, Wiederkehr DP, Doyle JJ, Katz LM, Figueiredo FC. Buchholz P, et al. Ocul Surf. 2006 Jul;4(3):155-61. doi: 10.1016/s1542-0124(12)70043-5. Ocul Surf. 2006. PMID: 16900272 Review. - API expert consensus document on management of ischemic heart disease.
Association of Physicians of India. Association of Physicians of India. J Assoc Physicians India. 2006 Jun;54:469-80. J Assoc Physicians India. 2006. PMID: 16909697 Review.
Cited by
- The Hidden Toll of Psychological Distress in Australian Adults and Its Impact on Health-Related Quality of Life Measured as Health State Utilities.
Ul Husnain MI, Hajizadeh M, Ahmad H, Khanam R. Ul Husnain MI, et al. Appl Health Econ Health Policy. 2024 Jul;22(4):583-598. doi: 10.1007/s40258-024-00879-z. Epub 2024 Mar 26. Appl Health Econ Health Policy. 2024. PMID: 38530626 Free PMC article. - Applicability Area: A novel utility-based approach for evaluating predictive models, beyond discrimination.
Liu S, Wei S, Lehmann HP. Liu S, et al. AMIA Annu Symp Proc. 2024 Jan 11;2023:494-503. eCollection 2023. AMIA Annu Symp Proc. 2024. PMID: 38222359 Free PMC article. - Health burden and economic costs of smoking in Chile: The potential impact of increasing cigarettes prices.
Castillo-Riquelme M, Bardach A, Palacios A, Pichón-Riviere A. Castillo-Riquelme M, et al. PLoS One. 2020 Aug 28;15(8):e0237967. doi: 10.1371/journal.pone.0237967. eCollection 2020. PLoS One. 2020. PMID: 32857819 Free PMC article. - Age, knowledge, preferences, and risk tolerance for invasive cardiac care.
Nanna MG, Peterson ED, Wu A, Harding T, Galanos AN, Wruck L, Alexander KP. Nanna MG, et al. Am Heart J. 2020 Jan;219:99-108. doi: 10.1016/j.ahj.2019.09.008. Epub 2019 Oct 23. Am Heart J. 2020. PMID: 31733450 Free PMC article. - The cost-effectiveness of using chronic kidney disease risk scores to screen for early-stage chronic kidney disease.
Yarnoff BO, Hoerger TJ, Simpson SK, Leib A, Burrows NR, Shrestha SS, Pavkov ME; Centers for Disease Control and Prevention CKD Initiative. Yarnoff BO, et al. BMC Nephrol. 2017 Mar 13;18(1):85. doi: 10.1186/s12882-017-0497-6. BMC Nephrol. 2017. PMID: 28288579 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical