OBJECTIVES: To determine how well universal health outcome priorities represent individuals' preferences in specific clinical situations. DESIGN: Observational cohort study. SETTING: Community. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 357). MEASUREMENTS: Participants used three tools assessing universal health outcome priorities related to two common trade-offs: quality versus quantity of life and future health versus present inconveniences and burdens of treatment. The tools' ability to identify participants who were unwilling to take a medication that reduced the risk of myocardial infarction but caused dizziness and fatigue was analyzed. RESULTS: There were consistent and significant associations between unwillingness to take the medication and prioritizing quality of life or future health for all three tools in the expected direction (P < .05). Despite these associations, the positive (PPV) and negative predictive values for the tools were generally modest (0.49-0.83). The tool with the most specific statements resembling the medication scenario had the best specificity (0.97) and PPV (0.83). CONCLUSION: Universal health outcome priorities only modestly identified older persons who would be unwilling to take a medication for primary prevention of myocardial infarction that causes adverse effects. Although tools that are the most general in their assessment of priorities have the benefit of being applicable across the widest range of scenarios, tools with greater specificity may be necessary to inform individual treatment decisions.
OBJECTIVES: To determine how well universal health outcome priorities represent individuals' preferences in specific clinical situations. DESIGN: Observational cohort study. SETTING: Community. PARTICIPANTS: Community-dwelling adults aged 65 and older (N = 357). MEASUREMENTS: Participants used three tools assessing universal health outcome priorities related to two common trade-offs: quality versus quantity of life and future health versus present inconveniences and burdens of treatment. The tools' ability to identify participants who were unwilling to take a medication that reduced the risk of myocardial infarction but caused dizziness and fatigue was analyzed. RESULTS: There were consistent and significant associations between unwillingness to take the medication and prioritizing quality of life or future health for all three tools in the expected direction (P < .05). Despite these associations, the positive (PPV) and negative predictive values for the tools were generally modest (0.49-0.83). The tool with the most specific statements resembling the medication scenario had the best specificity (0.97) and PPV (0.83). CONCLUSION: Universal health outcome priorities only modestly identified older persons who would be unwilling to take a medication for primary prevention of myocardial infarction that causes adverse effects. Although tools that are the most general in their assessment of priorities have the benefit of being applicable across the widest range of scenarios, tools with greater specificity may be necessary to inform individual treatment decisions.
Authors: Hilary A Llewellyn-Thomas; J Michael Paterson; Judy A Carter; Antoni Basinsk; Martin G Myers; Gordon D Hardacre; Earl V Dunn; Ralph B D'Agostino; Philip A Wolf; C David Naylor Journal: Med Decis Making Date: 2002 Jul-Aug Impact factor: 2.583
Authors: Lee A Jennings; Alina Palimaru; Maria G Corona; Xavier E Cagigas; Karina D Ramirez; Tracy Zhao; Ron D Hays; Neil S Wenger; David B Reuben Journal: Qual Life Res Date: 2016-12-20 Impact factor: 4.147
Authors: Shelli L Feder; Eliza Kiwak; Darcé Costello; Lilian Dindo; Kizzy Hernandez-Bigos; Lauren Vo; Mary Geda; Caroline Blaum; Mary E Tinetti; Aanand D Naik Journal: J Am Geriatr Soc Date: 2019-03-07 Impact factor: 5.562
Authors: Annette Eidam; Anja Roth; André Lacroix; Sabine Goisser; Hanna M Seidling; Walter E Haefeli; Jürgen M Bauer Journal: Patient Prefer Adherence Date: 2020-03-04 Impact factor: 2.711