Can we assess utility using the patient's own words?

Current methods of utility assessment enable systematic elicitation of patient values in support of medical treatment decision making where interventions involve tradeoffs. Until now, utility assessment protocols have generally employed health care providers' rather than patients' terminology. This study evaluates the feasibility of a protocol that extends traditional methods by using the patient's own words. Fifteen dialysis patients were interviewed with the protocol to elicit individualized multidimensional quality of life (IMQOL) models representing their values. The IMQOL models were then used to assess two modes of dialysis, each with and without complications, as well as the patient's current health. Interview completion rate was 88.2%. Of those completing the interviews, 80% said that they would want the results used to guide decision making in the event of mental incapacity. 53% said the IMQOL model represented their values as well as or better than did traditional utility assessment results.