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Abstract #19354 Published in IGR 9-3
Preference-based quality of life measures in people with visual impairment
Kymes SM; Lee BSOptometry and Vision Science 2007; 84: 809-816
The use of preference-based measures of quality of life represents the application of principles of decision theory and welfare economics to the measurement of health-related concepts. In this Perspective, we present the theoretical basis of preference-based measures in the assessment of the impact of vision-related disease on quality of life and their role in cost-effectiveness analysis. We discuss the use of the standard gamble and time trade-off in eliciting utilities and the limitations of both methods. Scaling issues related to utility are discussed, in particular the reasons for use of the 'policy scale' (i.e., a scale where utilities are anchored at 1.0 for perfect health and 0 as death). This is contrasted with the use of the 'vision-truncated scale' (i.e., a scale with 1.0 representing perfect vision and 0 being death), which is commonly used in assessment of vision-related utilities. We discuss problematic aspects of using the truncated scale in conducting cost-effectiveness research for vision-related disease, and provide a theoretical and empirical discussion of these limitations. In particular, we point out how these results raise questions concerning the conceptual relationship between vision- and health-related quality of life. Finally, we present the results of previous cross-cultural and trans-national studies of vision-related quality of life to demonstrate how utility studies might provide insight into the meaning of disease across cultures.
Dr. S.M. Kymes, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, Campus Box 8096, 660 South Euclid, St. Louis, MO 63110-1093, USA. kymes@vrcc.wustl.edu
Classification:
1.4 Quality of life (Part of: 1 General aspects)
