Patients’ Perceptions of the Value of Current Vision: Assessment of Preference Values Among Patients With Subfoveal ChoroidalNeovascularization—The Submacular Surgery Trials Vision Preference ValueScale: SST Report No. 6 | Ophthalmology | JAMA Ophthalmology | JAMA Network
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Leibowitz  HMKrueger  DEMaunder  LR  et al.  The Framingham Eye Study Monograph: an ophthalmological and epidemiologicalstudy of cataract, glaucoma, diabetic retinopathy, macular degeneration, andvisual acuity in a general population of 2631 adults, 1973-1975.  Surv Ophthalmol 1980;24 ((suppl)) 335- 610PubMedGoogle ScholarCrossref
Sommer  ATielsch  JMKatz  J  et al.  Racial differences in the cause-specific prevalence of blindness inEast Baltimore.  N Engl J Med 1991;3251412- 1417PubMedGoogle ScholarCrossref
Klein  RWang  QKlein  BEKMoss  SEMeuer  SM The relationship of age-related maculopathy, cataract, and glaucomato visual acuity.  Invest Ophthalmol Vis Sci 1995;36182- 191PubMedGoogle Scholar
Rahmani  BTielsch  JMGottsch  JQuigley  HJavitt  JSommer  A The cause-specific prevalence of visual impairment in an urban population:the Baltimore Eye Survey.  Ophthalmology 1996;1031721- 1726PubMedGoogle ScholarCrossref
Macular Photocoagulation Study Group, Argon laser photocoagulation for ocular histoplasmosis: results ofa randomized clinical trial.  Arch Ophthalmol 1983;1011347- 1357PubMedGoogle ScholarCrossref
Macular Photocoagulation Study Group, Krypton laser photocoagulation for neovascular lesions of ocular histoplasmosis:results of a randomized clinical trial.  Arch Ophthalmol 1987;1051499- 1507PubMedGoogle ScholarCrossref
Saaddine  JBNarayan  KMVVinicor  F Vision loss: a public health problem?  Ophthalmology 2003;110253- 254PubMedGoogle ScholarCrossref
Torrance  GW Measurement of health state utilities for economic appraisal: a review.  J Health Econ 1986;51- 30PubMedGoogle ScholarCrossref
Fryback  DGDasbach  EJKlein  R  et al.  The Beaver Dam Health Outcomes Study: initial catalog of health-statequality factors.  Med Decis Making 1993;1389- 102PubMedGoogle ScholarCrossref
Bass  EBWills  SScott  IU  et al.  Preference values for visual states in patients planning to undergocataract surgery.  Med Decis Making 1997;17324- 330PubMedGoogle ScholarCrossref
Brown  GCSharma  SBrown  MMGarrett  S Quality in Medicine Study Research Group: evidenced-based medicineand cost-effectiveness.  J Health Care Finance 1999;2614- 23PubMedGoogle Scholar
Submacular Surgery Trials Pilot Study Investigators, Submacular Surgery Trials randomized pilot trial of laser photocoagulationversus surgery for recurrent choroidal neovascularization secondary to age-relatedmacular degeneration, II: quality of life outcomes—SST Pilot Study reportNo. 2.  Am J Ophthalmol 2000;130408- 418PubMedGoogle ScholarCrossref
Morimoto  TFukui  T Utilities measured by rating scale, time trade-off, and standard gamble:review and reference for health care professionals.  J Epidemiol 2002;12160- 178PubMedGoogle ScholarCrossref
Brown  GCSharma  SBrown  MMKistler  J Utility values and age-related macular degeneration.  Arch Ophthalmol 2000;11847- 51PubMedGoogle ScholarCrossref
Froberg  DGKane  RL Methodology for measuring health-state preferences, II: Scaling methods.  J Clin Epidemiol 1989;42459- 471PubMedGoogle ScholarCrossref
Ryan  MScott  DAReeves  C  et al.  Eliciting public preferences for healthcare: a systematic review oftechniques.  Health Technol Assess 2001;5 (5) 1- 186PubMedGoogle Scholar
Ware  JESherbourne  CD The MOS 36-Item Short Form Health Survey (SF-36), I: conceptual frameworkand item selection.  Med Care 1992;30473- 483PubMedGoogle ScholarCrossref
Mangione  CMLee  PPPitts  JGutierrez  PBerry  SHays  RDNEI-VFQ Field Test Investigators, Psychometric properties of the National Eye Institute Visual FunctionQuestionnaire (NEI-VFQ).  Arch Ophthalmol 1998;1161496- 1504PubMedGoogle ScholarCrossref
Zigmond  ASSnaith  RP The Hospital Anxiety and Depression Scale.  Acta Psychiatr Scand 1983;67361- 370PubMedGoogle ScholarCrossref
Torrance  GW Utility approach to measuring health-related quality of life.  J Chronic Dis 1987;40593- 600PubMedGoogle ScholarCrossref
Havranek  EPMcGovern  KMWeinberger  J  et al.  Patient preferences for heart failure treatment: utilities are validmeasures of health-related quality of life in heart failure.  J Card Fail 1999;585- 91PubMedGoogle ScholarCrossref
Torrance  GWFeeny  D Utilities and quality-adjusted life years.  Int J Technol Assess Health Care 1989;5559- 575PubMedGoogle ScholarCrossref
Post  PNStiffelbout  AMWakker  PP The utility of health states after stroke: a systematic review of theliterature.  Stroke 2001;321425- 1429PubMedGoogle ScholarCrossref
Ghafour  IMAllan  DFoulds  WS Common causes of blindness and visual handicap in the west of Scotland.  Br J Ophthalmol 1983;67209- 213PubMedGoogle ScholarCrossref
Gibson  JMLavery  JRRosenthal  AR Blindness and partial sight in an elderly population.  Br J Ophthalmol 1986;70700- 705PubMedGoogle ScholarCrossref
Jonasson  FThordarson  K Prevalence of ocular disease and blindness in a rural area in the easternregion of Iceland during 1980 through 1984.  Acta Ophthalmol Suppl 1987;18240- 43PubMedGoogle Scholar
Attebo  KMitchell  PSmith  W Visual acuity and the causes of visual loss in Australia: the BlueMountains Eye Study.  Ophthalmology 1996;103357- 364PubMedGoogle ScholarCrossref
Rosenberg  TKlie  F Current trends in newly registered blindness in Denmark.  Acta Ophthalmol Scand 1996;74395- 398PubMedGoogle ScholarCrossref
Brown  MMBrown  GCSharma  SBusbee  BBrown  H Quality of life associated with unilateral and bilateral good vision.  Ophthalmology 2001;108643- 647PubMedGoogle ScholarCrossref
Pieramici  DJBressler  NMBressler  SBSchachat  AP Choroidal neovascularization in black patients.  Arch Ophthalmol 1994;1121043- 1046PubMedGoogle ScholarCrossref
 Cost-effectiveness in Health and Medicine. ProjectSummary. From the Report of the Panel on Cost-Effectiveness in Health andMedicine.  Washington, DC Office of Public Health and Science, US Public HealthService1996;
December 2004

Patients’ Perceptions of the Value of Current Vision: Assessment of Preference Values Among Patients With Subfoveal ChoroidalNeovascularization—The Submacular Surgery Trials Vision Preference ValueScale: SST Report No. 6

Submacular Surgery Trials Research Group*
Author Affiliations

*Authors: The Submacular Surgery Trials PatientCentered Outcomes Subcommittee and Writing Committee served as authors. Group Information: A list of the investigatorsand other personnel who contributed data for this report was published in Arch Ophthalmol. 2004;122:857-863.

Arch Ophthalmol. 2004;122(12):1856-1867. doi:10.1001/archopht.122.12.1856

Objective  To improve understanding and awareness of the impact of subfoveal choroidalneovascularization (CNV) on health-related quality of life, we sought to measurethe preference value that patients with subfoveal CNV assigned to their healthand vision status.

Patients and Methods  Patients with subfoveal CNV completed telephone interviews about theirquality of life prior to enrollment and random treatment assignment in theSubmacular Surgery Trials, a set of multicenter randomized controlled trialsevaluating outcomes of submacular surgery compared with observation. The interviewersasked patients to rate their current vision on a scale from 0 (completelyblind) to 100 (perfect vision). The interviewers also asked them to rate completeblindness and then perfect vision, assuming their health otherwise was thesame as it was at the time of the interview, on a scale from 0 (dead) to 100(perfect health with perfect vision). Scores were converted to a 0 to 1 preferencevalue scale for health and vision status, where 0 represents death and 1 representsperfect health and vision.

Results  Of 1015 participants enrolled in the Submacular Surgery Trials, 996completed interviews that included the rating questions, and 792 (80%) answeredall 3 rating questions in a manner permitting calculation of a single overallpreference value for their current health and vision status on a scale from0 (dead) to 1 (perfect). The mean preference value was 0.64 (median, 0.68;interquartile range, 0.51-0.80). The preference values correlated with age(Pearson correlation coefficient, –0.11; P = .002),patients’ self-rated perception of overall health (Spearman correlationcoefficient, 0.36; P<.001), and self-reportedperception of vision (Spearman correlation coefficient, 0.47; P<.001). The preference values were significantly lower with poorervisual acuity in the better eye and greater evidence of dysfunction on eitherthe Hospital Anxiety and Depression Scale or the Physical or Mental ComponentSummary scales of the Short Form-36 Health Survey but did not differ significantlyby gender or other baseline characteristics such as race, treatment assignment,or size of the CNV lesion.

Conclusions  Vision loss from subfoveal CNV is associated with patient preferencevalues that are as low as or lower than values previously reported for otherserious medical conditions such as dialysis-dependent renal failure and AIDS,indicating that both unilateral and bilateral CNV have a profound impact onhow patients feel about their overall health-related quality of life.