Utilities for major stroke: results from a survey of preferences among persons at increased risk for stroke.

Journal Article (Journal Article;Multicenter Study)

BACKGROUND: Patient beliefs, values, and preferences are crucial to decisions involving health care. In a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke. METHODS AND RESULTS: Respondents were obtained from the Academic Medical Center Consortium (n = 621), the Cardiovascular Health Study (n = 321 ), and United Health Care (n = 319). Preferences were primarily assessed by using the time trade off (TTO). Although major stroke is generally considered an undesirable event (mean TTO = 0.30), responses were varied: although 45% of respondents considered major stroke to be a worse outcome than death, 15% were willing to trade off little or no survival to avoid a major stroke. CONCLUSIONS: Providers should speak directly with patients about beliefs, values, and preferences. Stroke-related interventions, even those with a high price or less than dramatic clinical benefits, are likely to be cost-effective if they prevent an outcome (major stroke) that is so undesirable.

Full Text

Duke Authors

Cited Authors

  • Samsa, GP; Matchar, DB; Goldstein, L; Bonito, A; Duncan, PW; Lipscomb, J; Enarson, C; Witter, D; Venus, P; Paul, JE; Weinberger, M

Published Date

  • October 1998

Published In

Volume / Issue

  • 136 / 4 Pt 1

Start / End Page

  • 703 - 713

PubMed ID

  • 9778075

International Standard Serial Number (ISSN)

  • 0002-8703

Digital Object Identifier (DOI)

  • 10.1016/s0002-8703(98)70019-5


  • eng

Conference Location

  • United States