Ongoing discussions about the source of utilities for studies of comparative and cost-effectiveness are likely to increase in importance with the movement toward patient centered research. This study examined the relationship of utilities for spinal radiculopathy obtained from community members using a standard gamble (SG) technique versus those reported in the literature, typically obtained from patients using the EQ-5D.
Methods:
We used the standard gamble to obtain from 200 community members utility scores for a range of radiculopathies. Additionally, we used a random-effects, inverse variance-weighted meta analytic model to pool values of utility scores reported in 57 published studies of radiculopathy.
Results:
There were no differences in the utilities obtained with SG by position of radiculopathy, nor by respondent sex or age. However, for all levels, utilities from the SG were much higher (.76-.8) than were corresponding utilities reported in the literature (.37-.55).
Conclusion:
There may be several reasons for the observed differences including the younger, more educated community population; the use of SG rather than the EQ-5D, the content of the scenarios presented by the investigators and their concordance with patient experience. Understanding sources of variation and how to compare utilities obtained using different sources or methods will be increasing important as the patient experience plays an increasingly central role in clinical research.