Center for Value-Based Medicine, Hilton Head, South Carolina; Wills Eye Hospital, Jefferson Medical University, Philadelphia, Pennsylvania; The Eye Research Institute, Philadelphia, Pennsylvania; Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
Center for Value-Based Medicine, Hilton Head, South Carolina; Wills Eye Hospital, Jefferson Medical University, Philadelphia, Pennsylvania; The Eye Research Institute, Philadelphia, Pennsylvania; Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia.
Ophthalmology. 2018 Jul;125(7):965-971. doi: 10.1016/j.ophtha.2017.12.033. Epub 2018 Feb 21.
To present ophthalmic patient time-tradeoff vision utilities for quantifying vision-related quality-of-life when the fellow eye still has good vision. These utilities are important for performing reliable cost-utility analyses.
Consecutive time-tradeoff vision utilities were obtained from ophthalmic patients with good vision (20/20-20/25) in one eye and vision ranging from 20/20 to no light perception in the fellow eye over a 15-year period from 2000 through 2014.
Five hundred eighty-six ophthalmic participant interviews from Wills Eye Hospital, New York Eye and Ear Hospital, and ophthalmology office practices in Pennsylvania and New Jersey.
Participants underwent a full ophthalmic examination, after which time-tradeoff vision utilities were obtained by personal interview by the authors using a standardized, validated instrument.
Time-tradeoff vision utilities.
Mean time-tradeoff vision utilities were as follows in participants with good vision (20/20-20/25) in at least one eye and the following visions in the fellow eyes: no light perception, 0.79; counting fingers to light perception, 0.87; 20/200 to 20/400, 0.88; 20/60 to 20/100, 0.88; 20/30 to 20/50, 0.87; and 20/20 to 20/25, 0.94.
In people with good vision (20/20-20/25) in one eye, the associated mean time-tradeoff vision utility is a remarkably consistent 0.87 to 0.88 when vision in the fellow eye ranges from 20/30 to light perception. Vision of 20/20 to 20/25 in the fellow eye results in a significantly higher associated utility of 0.94 (P < 0.01), whereas vision of no light perception in the fellow eye results in a significantly lower utility of 0.079 (P < 0.01). These utilities are important for calculating reliable patient value (quality-adjusted life-year) gains in ophthalmic cost-utility analysis populations in which there is unilateral and bilateral disease involvement.
当对侧眼仍有良好视力时,提出眼科患者时间权衡视力效用,以量化与视力相关的生活质量。这些效用对于进行可靠的成本效用分析很重要。
从 2000 年至 2014 年的 15 年期间,连续从纽约眼耳医院和宾夕法尼亚州及新泽西州的眼科诊所中具有良好视力(20/20-20/25)的单眼和对侧眼视力从 20/20 至无光感的眼科患者中获得时间权衡视力效用。
来自威尔斯眼科医院,纽约眼耳医院和宾夕法尼亚州及新泽西州眼科诊所的 586 名眼科患者。
参与者接受了全面的眼科检查,之后作者通过个人访谈使用标准化,经过验证的工具获得时间权衡视力效用。
时间权衡视力效用。
在至少一眼视力良好(20/20-20/25)且对侧眼视力如下的患者中,平均时间权衡视力效用如下:无光感,0.79;手动至光感,0.87;20/200 至 20/400,0.88;20/60 至 20/100,0.88;20/30 至 20/50,0.87;20/20 至 20/25,0.94。
在一眼视力良好(20/20-20/25)的人群中,当对侧眼视力从 20/30 至光感时,相关的平均时间权衡视力效用非常一致,在 0.87 至 0.88 之间。对侧眼视力为 20/20 至 20/25 时,相关的效用明显较高,为 0.94(P <0.01),而对侧眼无光感时,效用明显较低,为 0.079(P <0.01)。这些效用对于计算单侧和双侧疾病人群中可靠的患者价值(质量调整生命年)收益很重要。