This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lenert, L. A. Articles by Soetikno, R. M. Search for Related Content PubMed PubMed Citation Articles by Lenert, L. A. Articles by Soetikno, R. M.

Automated Computer Interviews to Elicit Utilities

Potential Applications in the Treatment of Deep Venous Thrombosis

Affiliations of the authors: Division of Clinical Pharmacology, Department of Medicine, Stanford University School of Medicine, Stanford, CA (LAL); Division of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Stanford, CA (RMS).

Correspondence and reprints: Leslie A. Lenert, MD, Division of Clinical Pharmacology, Stanford University Medical Center, Room S169, Stanford, CA 94305. E-mail: lenert{at}camis.stanford.edu

Abstract Objective: To assess the practicality of an automated computer interview as a method to assess preferences for use in decision making. To assess preferences for outcomes of deep vein thrombosis (DVT) and its treatment.

Study Design: A multimedia program was developed to train subjects in the use of different preference assessment methods, presented descriptions of mild post-thrombotic syndrome (PTS), severe PTS and stroke and elicited subject preferences for these health states. This instrument was used to measure preferences in 30 community volunteers and 30 internal medicine physicians. We then assessed the validity of subject responses and calculated the number of quality-adjusted life years (QALYs) for each individual for each alternative.

Results: All subjects completed the computerized survey instrument without assistance. Subjects generally responded positively to the program, with volunteers and physicians reporting similar preferences. Approximately 26.5% of volunteers and physicians had preferences that would be consistent with the use of thrombolysis. Individualization of therapy would lead to the most QALYs.

Conclusions: Utilization of computerized survey instruments to elicit patient preferences appears to be a practical and valid approach to individualize therapy. Application of this method suggests that there may be many patients with DVT for whom treatment with a thrombolytic drug would be optimal.

This article has been cited by other articles:

				N. V. Dawson, M. E. Singer, L. Lenert, M. B. Patterson, S. A. Sami, I. Gonsenhouser, H. A. Lindstrom, K. A. Smyth, M. J. Barber, and P. J. Whitehouse Health State Valuation in Mild to Moderate Cognitive Impairment: Feasibility of Computer-Based, Direct Patient Utility Assessment Med Decis Making, April 1, 2008; 28(2): 220 - 232. [Abstract] [PDF]

				D. Aujesky, K. J. Smith, J. Cornuz, and M. S. Roberts Cost-Effectiveness of Low-Molecular-Weight Heparin for Treatment of Pulmonary Embolism Chest, September 1, 2005; 128(3): 1601 - 1610. [Abstract] [Full Text] [PDF]

				S. Cykert, N. Phifer, and C. Hansen Tamoxifen for Breast Cancer Prevention: A Framework for Clinical Decisions Obstet. Gynecol., September 1, 2004; 104(3): 433 - 442. [Abstract] [Full Text] [PDF]

				L. J. Damschroder, J. Baron, J. C. Hershey, D. A. Asch, C. Jepson, and P. A. Ubel The Validity of Person Tradeoff Measurements: Randomized Trial of Computer Elicitation Versus Face-to-Face Interview Med Decis Making, March 1, 2004; 24(2): 170 - 180. [Abstract] [PDF]

				C. M. Ruland, T. White, M. Stevens, G. Fanciullo, and S. M. Khilani Effects of a Computerized System to Support Shared Decision Making in Symptom Management of Cancer Patients: Preliminary Results J. Am. Med. Inform. Assoc., November 1, 2003; 10(6): 573 - 579. [Abstract] [Full Text] [PDF]

				P. N. Post, A. M. Stiggelbout, and P. P. Wakker The Utility of Health States After Stroke : A Systematic Review of the Literature Stroke, June 1, 2001; 32(6): 1425 - 1429. [Abstract] [Full Text] [PDF]

				T. O. Tengs, M. Yu, E. Luistro, and H. B. Bosworth Health-Related Quality of Life After Stroke A Comprehensive Review Editorial Comment : Health-Related Quality Of Life After Stroke: A Comprehensive Review Stroke, April 1, 2001; 32(4): 964 - 972. [Abstract] [Full Text] [PDF]

				C. M. Ruland Decision Support for Patient Preference-based Care Planning: Effects on Nursing Care and Patient Outcomes J. Am. Med. Inform. Assoc., July 1, 1999; 6(4): 304 - 312. [Abstract] [Full Text] [PDF]

				M. K. Gould, A. D. Dembitzer, G. D. Sanders, and A. M. Garber Low-Molecular-Weight Heparins Compared with Unfractionated Heparin for Treatment of Acute Deep Venous Thrombosis: A Cost-Effectiveness Analysis Ann Intern Med, May 18, 1999; 130(10): 789 - 799. [Abstract] [Full Text] [PDF]

				P. F. Brennan and I. Strombom Improving Health Care by Understanding Patient Preferences: The Role of Computer Technology J. Am. Med. Inform. Assoc., May 1, 1998; 5(3): 257 - 262. [Abstract] [Full Text]

				R. M. Soetikno, R. Mrad, V. Pao, and L. A. Lenert Quality-of-Life Research on the Internet: Feasibility and Potential Biases in Patients with Ulcerative Colitis J. Am. Med. Inform. Assoc., November 1, 1997; 4(6): 426 - 435. [Abstract] [Full Text] [PDF]