Methods: In an internet-based survey of a nationally representative sample of the US population, we measured standard gamble health values for subjects' own health and for cerebral aneurysm health state scenarios, and determined the effect of several methods for presenting aneurysmal risk. Published prospectively-collected data provided risks of future aneurysmal bleeding, stroke, and death. Aneurysm risks were presented by using annualized data, cumulative 20-year data, or both. The scenarios described cerebral aneurysms with low (0.25% annual; 5% 20-year), medium (2% annual; 26% 20-year), or high (7% annual; 75% 20-year) risks of future stroke and death from aneurysm bleeding.

Results: The 1,654 subjects matched US census data for age, race, sex, and geographic distribution. The mean survey completion time was 7 minutes, and the response rate was 9%. The subjects' mean (SD) health value for their current health was 0.82 (0.19) and for a cerebral aneurysm was 0.78 (0.19) (P<0.001). Mean low-, medium-, and high-risk aneurysm health values were 0.01, 0.06, and 0.13 lower than for current health, respectively (trend P<0.001). The average discrepancy between aneurysm health values and current health narrowed with age: 18-25 years, 0.09; 24-44 years, 0.06; 45-64 years, 0.03; and 65+ years, 0.01 (trend P<0.001). Subjects who received only annual risk data provided the highest mean aneurysm health values (0.81); those who received both annual and 20-year cumulative risk information gave intermediate values (0.79), and those who received only data on the cumulative 20-year risks provided the lowest values (0.76) (P<0.001).

Conclusions: Health values for cerebral aneurysms derived from the general public vary with the risk of catastrophic events, the method used to describe the future risk of stroke and death, and the age of the subject. Older patients and those with low-risk aneurysms perceive minimal differences between their current health and life with a cerebral aneurysm, suggesting that cerebral aneurysm treatment may not improve quality of life in these subgroups. Because the US PHS panel recommended using public health values in CEAs, our findings may prove useful in calibrating cerebral aneurysm CEA models.