(Stroke. 1997;28:2395-2399.)
© 1997 American Heart Association, Inc.
Articles |
Quality of Life of Stroke in Younger Individuals
Utility Assessment in Patients With Arteriovenous Malformations
From the Division of General Internal Medicine, Department of Medicine, Toronto Hospital (A.Y.S., G.N.); Program in Clinical Epidemiology and Health Care Research, Toronto Hospital (G.N., P.J.P.) and Sunnybrook Health Science Center, North York, Ontario (A.Y.S.); Brain Vascular Malformation Study Group (P.J.P., M.C.W.); and the Department of Health Administration, University of Toronto (G.N.), Ontario, Canada.
Correspondence to Dr Anne Y. Shin, Sunnybrook Health Science Center, Clinical Epidemiology Unit and Institute for Clinical Evaluative Sciences, G Wing, 2075 Bayview Ave, North York, Ontario, Canada M4N 3M5. E-mail gary.naglie{at}utoronto.ca
Background and Purpose Patients with arteriovenous malformations are younger individuals who are at risk of a stroke or have experienced one. Our objective was to determine these patients' perceptions of quality of life with a stroke by eliciting utility values.
Methods Utility values were obtained with the standard gamble technique. Utilities are a holistic, quality of life measure between 0 and 1. We evaluated the patients' current health state and written descriptions of major and minor stroke.
Results Thirty-one consecutive outpatients participated. The mean age was 37 years (range, 18 to 57 years). Approximately 65% had suffered a stroke, of which 55% were major. Approximately 61% had a persistent deficit. The mean utilities were 0.45 for major stroke (95% confidence interval [CI], 0.33 to 0.56; range, 0.00 to 1.00), 0.81 for minor stroke (95% CI, 0.75 to 0.88; range, 0.30 to 1.00), and 0.81 for current health (95% CI, 0.73 to 0.89; range, 0.01 to 1.00). Subgroup analyses by demographic and clinical characteristics showed no significant differences. However, in both those patients who had never had a stroke and those who had survived a major stroke, values for the major stroke scenario were clustered at the two extremes. Among those with a current deficit, 79% preferred their own health state to that of the stroke scenario that was similar in severity.
Conclusions Younger people who have had a stroke or are at risk demonstrate wide variations in their perception of quality of life. Furthermore, patients tend to be more risk averse with their own lives than with theoretical scenarios. We suggest tailoring medical decision making to individual preferences.
Key Words: cerebral arteriovenous malformations • quality of life • stroke • adults
This article has been cited by other articles:
 |
|
 |
|
  E. S. Huang, S. E.S. Brown, B. G. Ewigman, E. C. Foley, and D. O. Meltzer Patient Perceptions of Quality of Life With Diabetes-Related Complications and Treatments Diabetes Care, October 1, 2007; 30(10): 2478 - 2483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Schleinitz and P. A. Heidenreich A Cost-Effectiveness Analysis of Combination Antiplatelet Therapy for High-Risk Acute Coronary Syndromes: Clopidogrel plus Aspirin versus Aspirin Alone Ann Intern Med, February 15, 2005; 142(4): 251 - 259. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The CDC Diabetes Cost-effectiveness Group Cost-effectiveness of Intensive Glycemic Control, Intensified Hypertension Control, and Serum Cholesterol Level Reduction for Type 2 Diabetes JAMA, May 15, 2002; 287(19): 2542 - 2551. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Al-Shahi and C. Warlow A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults Brain, October 1, 2001; 124(10): 1900 - 1926. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. N. Post, A. M. Stiggelbout, and P. P. Wakker The Utility of Health States After Stroke : A Systematic Review of the Literature Stroke, June 1, 2001; 32(6): 1425 - 1429. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. O. Tengs, M. Yu, E. Luistro, and H. B. Bosworth Health-Related Quality of Life After Stroke A Comprehensive Review Editorial Comment : Health-Related Quality Of Life After Stroke: A Comprehensive Review Stroke, April 1, 2001; 32(4): 964 - 972. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Buck, A. Jacoby, A. Massey, and G. Ford Evaluation of Measures Used to Assess Quality of Life After Stroke Stroke, August 1, 2000; 31(8): 2004 - 2010. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Nietert, M. R. Abboud, M. D. Silverstein, and S. M. Jackson Bone marrow transplantation versus periodic prophylactic blood transfusion in sickle cell patients at high risk of ischemic stroke: a decision analysis Blood, May 15, 2000; 95(10): 3057 - 3064. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M J E Van Zandvoort, L J Kappelle, A Algra, and E H F De Haan Decreased capacity for mental effort after single supratentorial lacunar infarct may affect performance in everyday life J. Neurol. Neurosurg. Psychiatry, November 1, 1998; 65(5): 697 - 702. [Abstract] [Full Text]
|
|