Abstract
Critical limb ischemia (CLI) has a significant impact on patients' quality of life
(QoL). Despite cost utility evaluations being required by different authorities, data
on patient health preferences and utilities for CLI are scarce. Hence, the objective
of this study was to assess the impact of CLI on health preferences and health status
of affected patients, and to generate health state utilities. In the International
Study, 200 patients with CLI (stages III and IV according to Fontaine scale) were
interviewed by trained interviewers with a discrete choice instrument, a standard
gamble (SG), and the EuroQol-five dimension (EQ-5D) questionnaires (Marten Meesweg,
Rotterdam, Netherland). Conjoint analysis showed that a planned amputation (33%) was
the most relevant health attribute followed by ambulatory function (25%) and chronic
pain (15%). Non-dependence on caregiver impacted on patient health state preference
considerably, whereas healing of ulcer/skin lesions had less impact. Preference values
obtained from the SG were 0.84, for an amputation subpopulation arriving at 0.70.
The EQ-5D index values as well as the EQ-5D visual analog scale for patients with
CLI were 0.56. The QoL data of patients with CLI result in decreased QoL and preference
values with a planned amputation.
Keywords
critical limb ischemia - peripheral artery disease - quality of life - utility - discrete
choice model
