The Influence of Time and Adaptation on Health State Valuations in Patients With Spinal Cord Injury

Edelaar-Peeters, Yvette; Putter, Hein; Snoek, Govert J.; Sluis, Tebbe; Smit, Christof A; Post, Marcel W M; Stiggelbout, Anne M.

doi:10.1177/0272989x12447238

Cited by 5 publications

(4 citation statements)

References 27 publications

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“…We take this to be the most significant difference between the two approaches. It is argued that the general public also tends to be considerably misled by focusing effects (effects of focusing on some aspects of ill health while not considering unaffected life domains) [3,42] and to have difficulties understanding the degree to which the individual can adapt to a new health state, even if the change from a healthy state to ill health is dramatic, shocking, and deeply saddening when it occurs [31,45,46]. However, there are also convincing arguments that patients in various ways may misrepresent their new situation to themselves.…”

Section: No Flawless Positionmentioning

confidence: 99%

Whom should we ask? A systematic literature review of the arguments regarding the most accurate source of information for valuation of health states

et al. 2020

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Purpose To determine and critically evaluate the arguments in the published literature regarding the most accurate source of information for valuation of health states: values based on experienced health states (patient values) or values based on described health states (general public values). Methods A search strategy was applied to three electronic databases: Scopus, Ovid Medline, and Econlit. The first search was conducted in October 2015 and a complementary search in November 2017. Articles containing arguments in favor of either using patient values or using general public values were included in the analysis. The arguments were analyzed qualitatively and grouped into first-, second-, and third-level themes. Results After initial identification, screening and assessment for eligibility, 163 articles were thoroughly assessed for arguments; 82 articles were finally included in the analysis. Our analysis indicates that none of the debated positions is flawless: although patients in many cases have superior knowledge about the health state they experience, their view of what their life is like may be distorted, e.g., due to reference point effects. Some popular arguments are irrelevant to the issue at stake: they seem to fail to recognize the difference between what is the most accurate source of information for valuation of health states and who should get a say regarding policy decisions. Conclusions Our review provides a structured overview of the arguments found in the published literature. It suggests that the overall most accurate source of information for valuation of health states is that based on experience. This suggestion is not conclusive, but what is required of new empirical input to change the balance is to show that those with experience of the state are as a matter of fact not better informed about their own health state than those getting the state described to them. Keywords Described health state • Experienced health state • General public values • Health state valuation • Hypothetical health state • Patient values Olivia Ernstsson and Mimmi Åström have made equal contributions to the paper.

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Section: No Flawless Positionmentioning

confidence: 99%

Whom should we ask? A systematic literature review of the arguments regarding the most accurate source of information for valuation of health states

et al. 2020

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“…Patients were able to estimate correctly their increase in QoL in the first part of their rehabilitation trajectory and the lack of increase in the second part of their rehabilitation trajectory. Previously it was found that during rehabilitation patients with SCI do adapt to their situation both physically as psychologically [34]. In this study we find that at the group level patients accurately estimate the effect of physical and psychological adaptation on their future QoL, where the concept 'adaptation’ refers to aspects such as learning how to handle a wheelchair, finding new hobbies and learn how to live with the new situation, reflecting reprioritization and reconceptualization in terms of quality of life measurement.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to a population without any experience of a disability [35], only even limited experience with a disability seems to be sufficient for accurate predictions on a TTO. Even shortly after injury, patients adapt to their disability [34,36]. The insight into their ability to adapt may have enabled them to anticipate accurately.…”

Section: Discussionmentioning

confidence: 99%

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Anticipated adaptation or scale recalibration?

Edelaar-Peeters

Stiggelbout

2013

Health and Quality of Life Outcomes

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BackgroundThe aim of our study was to investigate anticipated adaptation among patients in the subacute phase of Spinal Cord Injury (SCI).MethodsWe used an observational longitudinal design. Patients with SCI (N = 44) rated their actual, previous and expected future Quality of Life (QoL) at three time points: within two weeks of admission to the rehabilitation center (RC), a few weeks before discharge from the RC, and at least three months after discharge. We compared the expected future rating at the second time point with the actual ratings at the third time point, using student’s t-tests. To gain insight into scale recalibration we also compared actual and previous ratings.ResultsAt the group level, patients overpredicted their improvement on the VAS. Actual health at T3(M = 0.65, sd =0.20)) was significantly lower than the predicted health at T1 of T3 (M = 0.76, sd = 0.1; t(43) = 3.24, p < 0.01), and at T2 of T3(M = 0.75,sd = 0.13; t(43) = 3.44, p < 0.001). Similarly the recalled health at T3 of T2 (M = 0.59, sd = 0.18) was significantly lower than the actual health at T2 (M = 0.67, sd = 0.15; t(43) = 3.26, p <0.01). Patients rated their future and past health inaccurately compared to their actual ratings on the VAS. In contrast, on the TTO patients gave accurate estimates of their future and previous health, and they also accurately valued their previous health. Looking at individual ratings, the number of respondents with accurate estimates of their future and previous health were similar between the VAS and TTO. However, the Bland-Altman plots show that the deviation of the accuracy is larger for the TTO then the VAS. That is the accuracy of 95% of the respondents was lower in the TTO then in the VAS.ConclusionsPatients at the onset of a disability were able to anticipate adaptation. Valuations given on the VAS seem to be biased by scale recalibration.

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Quality-Adjusted Life-Years, Quality-Adjusted Life-Year-Like Measures, or Neither? The Debate Continues

Devlin,

Drummond,

Mullins

2024

Value in Health

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The Influence of Time and Adaptation on Health State Valuations in Patients With Spinal Cord Injury

Abstract: Patients' health state valuations change over time, over and above the change expected by the rehabilitation process, and this change is partly explained by adaptation. Experience with a chronic illness did not lead to change in valuations of hypothetical health states.

Cited by 5 publications

References 27 publications

Whom should we ask? A systematic literature review of the arguments regarding the most accurate source of information for valuation of health states

Whom should we ask? A systematic literature review of the arguments regarding the most accurate source of information for valuation of health states

Anticipated adaptation or scale recalibration?

Quality-Adjusted Life-Years, Quality-Adjusted Life-Year-Like Measures, or Neither? The Debate Continues

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