Relationship Between Health Utility and Psychometric Health Status Measures

This study examined the relationship between health utility and psychometric health status measures. Utility scores derived by standard gamble and categorical rating methods were also compared to determine if they produce equivalent preference scales. Health status and utility was assessed in 73 chronic renal disease patients with anemia (hematocrit less than or equal to 30) participating in a 48-week clinical study. Patient preferences for current health and three hypothetical states were assessed using standard gamble and categorical rating procedures. Standard gamble utility was related to home management (P less than .05); categorical rating utility was related to home management (P less than .05), energy (P less than .05), alertness behavior (P less than .05), social interaction (P less than .05), and life satisfaction scale scores (P less than .05). Only 25-27% of the variance in utility scores was explained by the health status measures. Standard gamble utilities were consistently higher than categorical rating values for end-stage renal disease with hemodialysis (P less than .0001) and severe anemia requiring blood transfusions (P less than .0001). Patient preferences for current health may be influenced in part by their functional status and well-being, risk aversion or risk-taking attitudes, and the cognitive evaluation processes involved in making judgments necessary for the measurement task, as well as their actual preferences.