Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study

• Published in: Health and quality of life outcomes Vol. 17; no. 1; p. 166
• Main Authors: van Dongen, J M, van Hooff, M L, Finch, A P, van Tulder, M W, Bosmans, J E, Ostelo, R W J G, de Kleuver, M
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06-11-2019; BioMed Central; BMC
• Subjects: Adult; Back pain; Case studies; Catastrophization - psychology; Chronic low back pain; Cohort Studies; Comorbidity; Female; General public values; Health Status; Humans; Low Back Pain - psychology; Male; Medical research; Middle Aged; Pain management; Patient values; Physical Functional Performance; Proxy; Public utilities; Quality of Life; Self Report; Social aspects; Social Support; Tariffs; Utility values; Netherlands; Patient values; Chronic low back pain; General public values; Utility values
• ISSN: 1477-7525; 1477-7525
• DOI: 10.1186/s12955-019-1240-8

Utility values can be obtained from different respondent groups, including patients and members of the general public. Evidence suggests that patient values are typically higher than general public values. This study explores whether the magnitude of disagreement between both values can be explained by socio-demographic characteristics and/or health status.
Data of 5037 chronic low back pain patients were used. Self-reported EQ-VAS was employed as a proxy of patients' preference for their own health state. General public values for the patients' EQ-5D-3L health states were obtained using the Dutch VAS-based tariff. The difference between patient and general public values was assessed using a paired t-test. Subsequently, this difference was used as a dependent variable and regressed upon dummy variables of socio-demographic and health status characteristics. Coefficients represented age, gender, education level, social support, back pain intensity, leg pain intensity, functional status, comorbidities, catastrophizing, and treatment expectations.
Patient values were higher than general public values (0.069; 95%CI:0.063-0.076). The magnitude of disagreement between both values was associated with age, gender, education level, social support, functional status, and comorbidities, but not with back pain intensity, leg pain intensity, catastrophizing, and treatment expectations.
Patients were found to value their own health status higher than members of the general public. The magnitude of disagreement between both values was found to differ by various socio-demographic and/or health status characteristics. This suggest that patient characteristics account for a relevant fraction of the identified disagreements between patient and general public values, and that mechanisms thought to be responsible for these disagreements, such as adaptation and response shift, have a differential impact across patient sub-groups.