Utilities for major stroke: Results from a survey of preferences among persons at increased risk for stroke

G. P. Samsa*, D. B. Matchar, L. Goldstein, A. Bonito, P. W. Duncan, J. Lipscomb, C. Enarson, D. Witter, P. Venus, J. E. Paul, M. Weinberger

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

112 Citations (Scopus)

Abstract

Background: Patient beliefs, values, and preferences are crucial to decisions involving health care. In a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke. Methods and Results: Respondents were obtained from the Academic Medical Center Consortium (n = 621), the Cardiovascular Health Study (n = 321), and United Health Care (n = 319). Preferences were primarily assessed by using the time trade off (TTO). Although major stroke is generally considered an undesirable event (mean TTO = 0.30), responses were varied: although 45% of respondents considered major stroke to be a worse outcome than death, 15% were willing to trade off little or no survival to avoid a major stroke. Conclusions: Providers should speak directly with patients about beliefs, values, and preferences. Stroke-related interventions, even those with a high price or less than dramatic clinical benefits, are likely to be cost- effective if they prevent an outcome (major stroke) that is so undesirable.

Original languageEnglish
Pages (from-to)703-713
Number of pages11
JournalAmerican Heart Journal
Volume136
Issue number4 I
DOIs
Publication statusPublished - 1998
Externally publishedYes

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