Preference-Based Health Outcome Measures in Low Back Pain

Anna N. A. Tosteson
2000 Spine  
The motivation for measurement of preference-based health outcomes in clinical practice settings and in determining health policy is reviewed. In clinical practice, where preferences for various health outcomes should guide treatment decisions, utility assessment using the visual analogue scale, time trade-off and standard gamble is described. In determining health policy, where economic evaluations motivate the need for preferencebased measures, preference classification systems for valuing
more » ... lth are considered. The desirability of health outcomes can be compared using preference-based health outcome measures. Such measures are distinct from health status instruments, because they characterize how health outcomes are valued rather than functional performance or capacity. It is important to recognize that two individuals with identical self-assessed health status as measured by a generic instrument, such as SF-36, 47 may value their health quite differently. Preference-based health outcome measures are important in several contexts. 45 In this article, approaches to preference-based outcome measurement are considered in both the clinical and health policy settings. In the clinical context, it is recognized that patients' preferences should be considered in guiding clinical care. 5,37 Therefore, an understanding of how health outcomes are valued can provide important information for both the clinician and patient. 38 In the health policy context, efforts to assess the economic value of health interventions require an outcome measure that facilitates comparisons across diverse diseases. Quality-adjusted life years (QALYs), which account for morbidity by applying an explicit value to the desirability of various health outcomes, have been recommended for this purpose. 25
doi:10.1097/00007632-200012150-00011 pmid:11124732 fatcat:44iozd7kwfhrjni2wiz6crsfuq