Worst-case future scenarios of patients with rheumatoid arthritis: a cross-sectional study


Buitinga, Laurien and Taal, Erik and Braakman-Jansen, Louise M.A. and Laar, Mart A.F.J. van de (2012) Worst-case future scenarios of patients with rheumatoid arthritis: a cross-sectional study. Rheumatology, 51 (11). 2027 - 2033. ISSN 1462-0324

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Abstract:Objective. The time trade-off is a health-related quality of life instrument that measures valuations for health states (utilities) by asking patients to value their health state anchored on a scale between death (0) and perfect health (1). Dying earlier is not perceived as a realistic worst-case consequence of the disease by RA patients. Of the previous focus groups study on RA patients, five worst-case future scenarios emerged. The aim of this study was to examine which potential worst-case scenario was the most appropriate for RA patients to use in utility calculation.

Methods. In a cross-sectional study of 74 consecutive RA patients visiting the rheumatology outpatient clinic, participants were presented with descriptions of the five worst-case future scenarios. In pairwise comparisons, patients had to choose the scenario that would be the worst to experience. The worst-case future scenario was defined by the scenario that was chosen by a significantly greater proportion of participants than could be expected based on chance (20%). Therefore, analysis based on a single fraction () was used and 95% CI was calculated.

Results. The scenario being dependent on others was chosen most often as the worst to experience [by 35% of participants (95% CI 24%, 46%)] and significantly more often than could be expected based on chance ( = 0.35, z = 6.45, P = 0.00).

Conclusion. The scenario being dependent on others is likely to be the most appropriate worst-case future scenario for RA patients. Using an alternative anchor could improve the validity and responsiveness of the time trade-off in RA patients.
Item Type:Article
Copyright:© 2012 Oxford University Press
Faculty of Behavioural, Management and Social sciences (BMS)
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Link to this item:http://purl.utwente.nl/publications/82278
Official URL:https://doi.org/10.1093/rheumatology/kes196
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