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(Chest. 1998;114:998-1007.)
© 1998 American College of Chest Physicians

Integrating Patient Preferences Into Health Outcomes Assessment

The Multiattribute Asthma Symptom Utility Index

Dennis A. Revicki PhD1; Nancy Kline Leidy PhD1; Fiona Brennan-Diemer BA2; Sonja Sorensen MPH1; and Alkis Togias MD2

1 From the MEDTAP International, Inc, Bethesda, MD
2 From the Johns Hopkins Asthma and Allergy Center, Baltimore, MD.

Dennis Revicki, PhD, Center for Health Outcomes Research, MEDTAP International, Inc, 7101 Wisconsin Ave, Suite 600, Bethesda, MD 20814, e-mail: Revicki{at}Medtap.com

Study objective: To develop and evaluate a brief, easy-to-administer symptom assessment scale for use as a preference-based outcome measure in clinical trials and cost-effectiveness studies in asthma.

Design: Cross-sectional survey with 2-week reproducibility assessment.

Setting: Ambulatory care: university asthma and allergy center.

Participants: One hundred sixty-one adults with asthma, 59% female, mean age 35 ± 11 years. Mean FEV1 percent predicted was 86 ± 17%.

Interventions: The 11-item Asthma Symptom Utility Index (ASUI).

Measurements and results: Mean ASUI score for this sample was 0.71 ± 0.23, with a range from 0.02 to 1.0. The ASUI was reproducible (intraclass correlation coefficient = 0.74) and able to distinguish patients known to differ on disease severity according to clinician ratings (p < 0.001) and by an asthma disease severity scale score (p < 0.001). The instrument was also significantly correlated with FEV1 percent predicted (r = 0.27, p < 0.001), the Asthma Quality of Life Questionnaire (r = 0.77, p < 0.001), and the Health Utilities Index Mark 2 (r = 0.36, p < 0.001).

Conclusion: The results of this study support the reliability and validity of the ASUI, suggesting it will be a useful, complementary patient outcome measure for clinical trials and cost-effectiveness studies comparing treatment alternatives for persons with asthma.

Key Words: asthma-related symptoms • health preferences • quality of life • patient outcomes

Submitted on November 3, 1997
Accepted on May 7, 1998




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