Pain Quality of Life as Measured by Utilities

• Published in: Pain medicine (Malden, Mass.) Vol. 15; no. 5; pp. 865 - 870
• Main Authors: Wetherington, Sarah, Delong, Laura, Kini, Seema, Veledar, Emir, Schaufele, Michael K., McKenzie‐Brown, Anne M., Chen, Suephy C.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.05.2014
• Subjects: Adult; Aged; Chronic Pain - diagnosis; Chronic Pain - psychology; Cross-Sectional Studies; EQ‐5D; EuroQoL; Evidence-Based Practice; Female; Health Status; Health Surveys - methods; Health Surveys - standards; Humans; Male; Measurement; Middle Aged; Pain; Pain Measurement - methods; Pain Measurement - standards; Quality of Life; Quality of Life - psychology; Reproducibility of Results; Utility; Measurement; Quality of Life; EQ-5D; Utility; Pain; EuroQoL
• ISSN: 1526-2375; 1526-4637; 1526-4637
• DOI: 10.1111/pme.12405

Objective Utilities are values of health‐related quality of life (HRQoL) based on patient preference for a health status. The purpose of this study was to compare indirect measures to a directly elicited utility. Design Cross‐sectional study. Setting and Patients Emory Spine Center and the Emory Center for Chronic Pain at Crawford Long Hospital. Patients at least 18 years of age with chronic pain, defined as pain that persists beyond the normal time of healing, usually beyond 6 months. Measures Chronic pain subjects completed a paper‐based, self‐administered time trade‐off (TTO) survey, EQ‐5D survey, and a face‐to‐face (FTF) TTO interview. Current pain severity was graded using the Numeric Rating Scale‐11, subsequently stratified into no (0), mild (1–3), moderate (4–6), and severe (7–10) pain. Results Paired t test comparing FTF TTO and proxy utility measures stratified by severity revealed FTF TTO utility values significantly higher than EQ‐5D utility values for all pain severities (overall mean difference 0.18, standard deviation [SD] 0.30, P < 0.001; Pearson's correlation 0.34, P < 0.0001); FTF TTO utility values were lower than paper TTO utility values, reaching statistical significance for mild and moderate pain (overall mean difference 0.09, SD 0.29, P = 0.0006; Pearson's correlation 0.38, P < 0.0001). Conclusions This study demonstrates that the EQ‐5D overestimates, whereas the paper version of TTO underestimates, the impact of pain on HRQoL compared with the directly elicited FTF TTO utility. Our findings provide preliminary evidence that utilities vary by method, and directly elicited utility values differ from indirectly elicited measures.