Meeting Brochure and registration form      SMDM Homepage

Monday, October 22, 2007
P2-5

NECK PAIN PATIENTS' EVALUATIVE SCORES FOR THEIR CURRENT HEALTH

Gabrielle van der Velde, PhD, (candidate)1, Hilary A. Llewellyn-Thomas, PhD2, Sheilah Hogg-Johnson, PhD3, Eric Hurwitz, DC, PhD4, J.David Cassidy, DC, PhD1, Pierre Cote, DC, PhD1, and M. Krahn, MD, MSc5. (1) Toronto Western Hospital, Toronto, ON, Canada, (2) Dartmouth Medical School, Hanover, NH, (3) Institute for Work & Health, Toronto, ON, Canada, (4) University of Hawaii, Honolulu, HI, (5) University Health Network, Toronto, ON, Canada

Objective: To elicit neck pain patients' evaluative scores for their current health, in order to assess the burden of neck pain on quality-of-life and to use in economic analyses of neck pain treatments. Methods: 220 neck pain patients were classified into grades, using the Von Korff Pain Grade: Grade I (low-intensity pain, few activity limitations); Grade II (high-intensity pain, few activity limitations); Grade III (pain with high disability levels, moderate activity limitations); and Grade IV (pain with high disability levels, several activity limitations). Each patient rank-ordered a set of standardized scenarios that described neck pain treatment outcomes. The outcomes that the patient considered the worst and the best were used as Standard Gamble losses/gains and Rating Scale endpoints in subsequent elicitations of patients' evaluative scores for the relative desirability of their current health. Two time frames (temporary, permanent) were used in these elicitations. Results: Two-thirds of patients considered Death to be the worst outcome; their Standard Gamble utility scores (SGu) and Rating Scale scores (RSs) were distributed along a Death-Good Health scale. One-third considered Quadriplegia to be the worst outcome; their SGu and RSs were distributed on a Quadriplegia-Good Health scale. For the temporary time frame, mean SGu and RSs were: Grade I patients: 0.81, 0.76; Grade II patients: 0.75, 0.60; Grade III patients: 0.66, 0.44; Grade IV patients: 0.71, 0.42. For the permanent time frame, mean SGu and RSs were: Grade I patients: 0.91, 0.75; Grade II patients: 0.85, 0.62, Grade III patients: 0.78, 0.48; Grade IV patients: 0.82, 0.47. Raw scores from patients responding on the Quadriplegia-Good Health scale were re-scaled onto the Death-Good Health scale. The transformations yielded mean SGu ranging from -10.00 to 1.00 and RSs ranging from -0.14 to 0.99, which implies that some patients considered their current health state to be worse than Death. [Multivariate analyses are currently under way to explore relationships between neck pain patients' SGu and RSs for their current health and selected baseline variables.] Conclusions: These scores – which are similar to those reported by patients with depressive symptoms and paraplegia - not only provide quality-of-life weights for economic analyses of neck pain treatments but also indicate that neck pain exerts a substantial burden on patients' quality-of-life.