Stolk Elly A, Busschbach Jan J V
Institute for Medical Technology Assessment, Erasmus University Rotterdam, Rotterdam, The Netherlands.
Urology. 2003 Apr;61(4):810-5. doi: 10.1016/s0090-4295(02)02516-5.
To substantiate claims for treatment, patients may overestimate treatment effects. Consequently, in funding debates, the question becomes whether the general public agrees on the value of a treatment. Unfortunately, little is known about the social values for treatments of erectile dysfunction (ED). To solve this problem, we compared the values of patients and the general population for ED.
One hundred six ED patients and a representative sample of 169 individuals of the general population valued 28 health states of ED using time tradeoff. A hesitation to reveal preferences for this taboo subject or unawareness of the quality-of-life effects of ED may bias the social values. To explore the validity, we compared the factor structure of the valuation space of patients' and social values using a multivariate analysis of variance repeated measure analysis. Furthermore, we analyzed whether social values were related to demographic or sexual variables.
Patients valued ED lower than the general public, but the factor structure was the same. This evidence suggests that patients and the general public valued the health states of ED in the same way, although the overall level of appreciation differed slightly. Values were not systematically related to any other background variable.
Both patients and the general population consider erectile function an important aspect of quality of life. Therefore, funding for ED treatment might be considered. Moreover, because the value for erectile function was equivalent in different age groups, there is no convincing argument to limit funding to young patients.
为证实治疗效果，患者可能会高估治疗效果。因此，在资金辩论中，问题就变成了公众是否认同某种治疗的价值。遗憾的是，对于勃起功能障碍（ED）治疗的社会价值知之甚少。为解决这一问题，我们比较了患者和普通人群对ED的价值判断。
106名ED患者和169名具有代表性的普通人群样本，采用时间权衡法对28种ED健康状态进行了价值评估。对于这个禁忌话题不愿透露偏好或不了解ED对生活质量的影响，可能会使社会价值产生偏差。为探究有效性，我们使用重复测量方差分析的多变量分析方法，比较了患者评估空间和社会价值评估空间的因子结构。此外，我们分析了社会价值是否与人口统计学或性变量相关。
患者对ED的价值评估低于普通公众，但因子结构相同。这一证据表明，患者和普通公众对ED健康状态的评估方式相同，尽管总体评价水平略有差异。价值与任何其他背景变量均无系统性关联。
患者和普通人群都认为勃起功能是生活质量的一个重要方面。因此，或许可以考虑为ED治疗提供资金。此外，由于不同年龄组对勃起功能的价值判断相当，因此没有令人信服的理由将资金限制在年轻患者身上。
