Patients’ values for health states associated with hepatitis C and physicians’ estimates of those values

Scott J. Cotler*, Raj Patil, Robert A. McNutt, Theodore Speroff, Geraldine Banaad-Omiotek, Daniel R. Ganger, Howard Rosenblate, Suman Kaur, Sheldon Cotler, Donald M. Jensen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

42 Scopus citations

Abstract

OBJECTIVES: Hepatitis C is the leading cause of chronic hepatitis in the United States. Little information is available regarding how persons with hepatitis C view health with their disease. We studied patients’ perceptions about the value of hepatitis C health states and evaluated whether physicians understand their patients’ perspectives about this disease. METHODS: A total of 50 consecutive persons with hepatitis C were surveyed when they presented as new patients to a hepatology practice. Subjects provided utility assessments (preference values) for five hepatitis C health states and for treatment side effects. They also stated their threshold for accepting antiviral therapy. Five hepatologists used the same scales to estimate their patients’ responses. RESULTS: On average, patients believed that hepatitis C without symptoms was associated with an 11% reduction in preference value from that of life without infection, and the most serious condition (severe symptoms, cirrhosis) was believed to carry a 73% decrement. Patients judged the side effects of antiviral therapy quite unfavorably, and their median stated threshold for accepting treatment was a cure rate of 80%. Physicians’ estimates were not significantly associated with patients’ preference values for hepatitis C health states, treatment side effects, or with patients’ thresholds for accepting treatrnent. In multivariate analysis, patients’ stated thresholds for taking treatment were significantly associated with their decisions regarding therapy (β = −2.72 ± 1.21, p = 0.025). CONCLUSIONS: There was little agreement between patients’ preference values about hepatitis C and their physicians’ estimates of those values. Utility analysis could facilitate shared decision making about hepatitis C.

Original languageEnglish (US)
Pages (from-to)2730-2736
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume96
Issue number9
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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