Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?

The main goal of current pain management approaches is to increase the patients' quality of life by improving pain coping skills and by reducing the levels of disability in daily life, often despite persistent pain. Direct measurement of quality of life is of crucial importance in economic eval...

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Veröffentlicht in:Pain (Amsterdam) 1999-03, Vol.80 (1), p.365-375
Hauptverfasser: Goossens, Mariëlle E.J.B, Vlaeyen, Johan W.S, Rutten- van Mölken, Maureen P.M.H, van der Linden, Sjef M.J.P
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container_end_page 375
container_issue 1
container_start_page 365
container_title Pain (Amsterdam)
container_volume 80
creator Goossens, Mariëlle E.J.B
Vlaeyen, Johan W.S
Rutten- van Mölken, Maureen P.M.H
van der Linden, Sjef M.J.P
description The main goal of current pain management approaches is to increase the patients' quality of life by improving pain coping skills and by reducing the levels of disability in daily life, often despite persistent pain. Direct measurement of quality of life is of crucial importance in economic evaluation research, in which not only is the estimation of financial costs and benefits included, but so is the evaluation of costs and benefits in terms of changes in health states. The purpose of this study is to compare the psychometric qualities of two instruments for assessing patients' utilities, the rating scale (RS) and the standard gamble (SG). Such instruments are designed for their application in economic evaluation research, but have seldomly been used in chronic pain trials. Both methods provide a single measure between 0 and 1. The relationship between these utility measures and descriptive and domain-specific quality of life measures was examined in 133 fibromyalgia patients and 148 patients with chronic non-specific low back pain. Mean utility score at baseline was 0.43 with the RS and 0.78 for the SG. The correlation between both methods was found to be poor ( r=0.21). Both measures appeared to be fairly stable in a 2-week test-retest period (intra class correlation coefficient (ICC)=0.74 and 0.77). Scores on the description of patient's own health on six domains, global assessment of change and domain specific measures correlated moderately with the RS scores and low with the SG. Multiple regression analyses demonstrated that 32% of the variance in RS values and only 13% of the variance in SG utilities could be explained by domain-specific measures. These results suggest an acceptable construct validity for the RS but insufficient construct validity for the SG. Valuations of ones own health appear only partially to be related to the assessment of the pain-specific measures and measures of distress. It can be concluded that the RS and domain-specific measures assess partly different, but nevertheless complementary aspects of health-related quality of life. It is therefore recommended to include in economic evaluation studies both domain-specific measures and valuation measures. Finally, in chronic musculoskeletal pain patients, RS scores were found to be more responsive in detecting significant changes in preferences than SG scores. For use in patients with chronic musculoskeletal pain, the RS is preferred to the SG for establishing accurate decisions a
doi_str_mv 10.1016/S0304-3959(98)00232-2
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Direct measurement of quality of life is of crucial importance in economic evaluation research, in which not only is the estimation of financial costs and benefits included, but so is the evaluation of costs and benefits in terms of changes in health states. The purpose of this study is to compare the psychometric qualities of two instruments for assessing patients' utilities, the rating scale (RS) and the standard gamble (SG). Such instruments are designed for their application in economic evaluation research, but have seldomly been used in chronic pain trials. Both methods provide a single measure between 0 and 1. The relationship between these utility measures and descriptive and domain-specific quality of life measures was examined in 133 fibromyalgia patients and 148 patients with chronic non-specific low back pain. Mean utility score at baseline was 0.43 with the RS and 0.78 for the SG. The correlation between both methods was found to be poor ( r=0.21). 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It is therefore recommended to include in economic evaluation studies both domain-specific measures and valuation measures. Finally, in chronic musculoskeletal pain patients, RS scores were found to be more responsive in detecting significant changes in preferences than SG scores. 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Both measures appeared to be fairly stable in a 2-week test-retest period (intra class correlation coefficient (ICC)=0.74 and 0.77). Scores on the description of patient's own health on six domains, global assessment of change and domain specific measures correlated moderately with the RS scores and low with the SG. Multiple regression analyses demonstrated that 32% of the variance in RS values and only 13% of the variance in SG utilities could be explained by domain-specific measures. These results suggest an acceptable construct validity for the RS but insufficient construct validity for the SG. Valuations of ones own health appear only partially to be related to the assessment of the pain-specific measures and measures of distress. It can be concluded that the RS and domain-specific measures assess partly different, but nevertheless complementary aspects of health-related quality of life. It is therefore recommended to include in economic evaluation studies both domain-specific measures and valuation measures. Finally, in chronic musculoskeletal pain patients, RS scores were found to be more responsive in detecting significant changes in preferences than SG scores. For use in patients with chronic musculoskeletal pain, the RS is preferred to the SG for establishing accurate decisions about the impact of new interventions on their health outcomes.</description><subject>Activities of Daily Living</subject><subject>Adaptation, Psychological</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Chronic Disease</subject><subject>Chronic musculoskeletal pain</subject><subject>Cross-Sectional Studies</subject><subject>Data Interpretation, Statistical</subject><subject>Depression - psychology</subject><subject>Female</subject><subject>Fibromyalgia - psychology</subject><subject>Fibromyalgia - rehabilitation</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Health-related quality of life</subject><subject>Humans</subject><subject>Illness and personality</subject><subject>Illness, stress and coping</subject><subject>Longitudinal Studies</subject><subject>Low Back Pain - psychology</subject><subject>Low Back Pain - rehabilitation</subject><subject>Male</subject><subject>Musculoskeletal Diseases - psychology</subject><subject>Musculoskeletal Diseases - rehabilitation</subject><subject>Pain - psychology</subject><subject>Pain - rehabilitation</subject><subject>Psychology and medicine</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychology. Psychophysiology</subject><subject>Quality of Life</subject><subject>Reproducibility of Results</subject><subject>ROC Curve</subject><subject>Surveys and Questionnaires</subject><subject>Utility measurement</subject><issn>0304-3959</issn><issn>1872-6623</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0F2LFSEYwHGJoj1tfYTCi4i6mE2d0dFullh6WVgoqO4CcfSxYzkzJx9no2_fnD2H6m6vFPk9Kn9CHnN2xhlXLz-xlnVNa6R5bvQLxkQrGnGHbLjuRaOUaO-SzV9yQh4gfmerEsLcJyecCdb1km3I14-uJpgqXWrKad0iTRP12zJPydNxQb_kGX9Ahuoy3bk0vaLb-RddEOKSaUJat0Cxuim4Eug3Nw4Z6Ah1O4fzh-RedBnh0XE9JV_evvl88b65-vDu8uL1VeM7LWsT-tAPMRghhQwm8qHjA6hOBa60HHQEGV30WkAnlWPrmWAx8gAh9pFxEdtT8uxw767MPxfAaseEHnJ2E8wLWmWU1q1hK5QH6MuMWCDaXUmjK78tZ3af1d5ktftm1mh7k9WKde7J8YFlGCH8N3XouIKnR-DQuxyLm3zCf67XnLd7dn5gsNa4TlAs-rW-h5AK-GrDnG75yR8ZKpVd</recordid><startdate>19990301</startdate><enddate>19990301</enddate><creator>Goossens, Mariëlle E.J.B</creator><creator>Vlaeyen, Johan W.S</creator><creator>Rutten- van Mölken, Maureen P.M.H</creator><creator>van der Linden, Sjef M.J.P</creator><general>Elsevier B.V</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19990301</creationdate><title>Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?</title><author>Goossens, Mariëlle E.J.B ; Vlaeyen, Johan W.S ; Rutten- van Mölken, Maureen P.M.H ; van der Linden, Sjef M.J.P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-d7d7bfd92525d9f1b41be646d1685b8fe5fafc82e456a068520ff1dedf7f012f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Activities of Daily Living</topic><topic>Adaptation, Psychological</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Chronic Disease</topic><topic>Chronic musculoskeletal pain</topic><topic>Cross-Sectional Studies</topic><topic>Data Interpretation, Statistical</topic><topic>Depression - psychology</topic><topic>Female</topic><topic>Fibromyalgia - psychology</topic><topic>Fibromyalgia - rehabilitation</topic><topic>Fundamental and applied biological sciences. 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Psychophysiology</topic><topic>Quality of Life</topic><topic>Reproducibility of Results</topic><topic>ROC Curve</topic><topic>Surveys and Questionnaires</topic><topic>Utility measurement</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goossens, Mariëlle E.J.B</creatorcontrib><creatorcontrib>Vlaeyen, Johan W.S</creatorcontrib><creatorcontrib>Rutten- van Mölken, Maureen P.M.H</creatorcontrib><creatorcontrib>van der Linden, Sjef M.J.P</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pain (Amsterdam)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goossens, Mariëlle E.J.B</au><au>Vlaeyen, Johan W.S</au><au>Rutten- van Mölken, Maureen P.M.H</au><au>van der Linden, Sjef M.J.P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?</atitle><jtitle>Pain (Amsterdam)</jtitle><addtitle>Pain</addtitle><date>1999-03-01</date><risdate>1999</risdate><volume>80</volume><issue>1</issue><spage>365</spage><epage>375</epage><pages>365-375</pages><issn>0304-3959</issn><eissn>1872-6623</eissn><coden>PAINDB</coden><abstract>The main goal of current pain management approaches is to increase the patients' quality of life by improving pain coping skills and by reducing the levels of disability in daily life, often despite persistent pain. Direct measurement of quality of life is of crucial importance in economic evaluation research, in which not only is the estimation of financial costs and benefits included, but so is the evaluation of costs and benefits in terms of changes in health states. The purpose of this study is to compare the psychometric qualities of two instruments for assessing patients' utilities, the rating scale (RS) and the standard gamble (SG). Such instruments are designed for their application in economic evaluation research, but have seldomly been used in chronic pain trials. Both methods provide a single measure between 0 and 1. The relationship between these utility measures and descriptive and domain-specific quality of life measures was examined in 133 fibromyalgia patients and 148 patients with chronic non-specific low back pain. Mean utility score at baseline was 0.43 with the RS and 0.78 for the SG. The correlation between both methods was found to be poor ( r=0.21). Both measures appeared to be fairly stable in a 2-week test-retest period (intra class correlation coefficient (ICC)=0.74 and 0.77). Scores on the description of patient's own health on six domains, global assessment of change and domain specific measures correlated moderately with the RS scores and low with the SG. Multiple regression analyses demonstrated that 32% of the variance in RS values and only 13% of the variance in SG utilities could be explained by domain-specific measures. These results suggest an acceptable construct validity for the RS but insufficient construct validity for the SG. Valuations of ones own health appear only partially to be related to the assessment of the pain-specific measures and measures of distress. It can be concluded that the RS and domain-specific measures assess partly different, but nevertheless complementary aspects of health-related quality of life. It is therefore recommended to include in economic evaluation studies both domain-specific measures and valuation measures. Finally, in chronic musculoskeletal pain patients, RS scores were found to be more responsive in detecting significant changes in preferences than SG scores. For use in patients with chronic musculoskeletal pain, the RS is preferred to the SG for establishing accurate decisions about the impact of new interventions on their health outcomes.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>10204750</pmid><doi>10.1016/S0304-3959(98)00232-2</doi><tpages>11</tpages></addata></record>
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subjects Activities of Daily Living
Adaptation, Psychological
Adult
Biological and medical sciences
Chronic Disease
Chronic musculoskeletal pain
Cross-Sectional Studies
Data Interpretation, Statistical
Depression - psychology
Female
Fibromyalgia - psychology
Fibromyalgia - rehabilitation
Fundamental and applied biological sciences. Psychology
Health-related quality of life
Humans
Illness and personality
Illness, stress and coping
Longitudinal Studies
Low Back Pain - psychology
Low Back Pain - rehabilitation
Male
Musculoskeletal Diseases - psychology
Musculoskeletal Diseases - rehabilitation
Pain - psychology
Pain - rehabilitation
Psychology and medicine
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Quality of Life
Reproducibility of Results
ROC Curve
Surveys and Questionnaires
Utility measurement
title Patient utilities in chronic musculoskeletal pain: how useful is the standard gamble method?
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