Abstract 13381: Changes in Quality of Life and Utility in Patients with Cardiovascular Disease: A Comparison of Trajectories
Background: Patients' perceptions of health-related quality of life (HRQOL) and utility have become important data to collect in clinical trials and patient registries. We examined the longitudinal relationship between HRQOL and utility in heart failure (HF) patients and chronic coronary artery disease (CAD) patients.
Methods: In the Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (EVEREST) trial, HRQOL was assessed with The Kansas City Cardiomyopathy Questionnaire (KCCQ) administered to patients at baseline, 1, 8, 24, and 48 weeks post-treatment, and utility with the EuroQol EQ-5D. In the Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial, HRQOL was assessed with the Seattle Angina Questionnaire (SAQ) at baseline, 1, 3, 6, 12 months and annually thereafter, and utility by standard gamble methods. The relationship between HRQOL and utility was analyzed by cross-correlation methods. Results are shown for the Physical Limitation (PL) domains of the KCCQ and SAQ.
Results: KCCQ PL and utility trajectories were virtually parallel for HF patients with zero-order correlation of 0.92. SAQ PL and utility trajectories for CAD patients were not parallel with zero-order correlation of 0.50 and a ceiling effect of utility (Figure). Results for other domains were similar.
Conclusion: The strong zero-order correlation associated with HF patients indicates HRQOL and utility are synonymous from their perspective. The weaker zero-order correlation associated with CAD patients indicates more differentiation between HRQOL and utility. Although the mode of utility assessment (questionnaire in EVEREST and standard gamble in COURAGE) may influence these findings, these results suggest that mapping specific disease states to a single utility index may or may not be successful, depending upon the patient population.
- © 2010 by American Heart Association, Inc.