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Editorial |

Integrating Patient Preferences With Health Utilities A Variation on Health-Related Quality of Life

Marta J. VanBeek, MD, MPH
Arch Dermatol. 2008;144(8):1037-1041. doi:10.1001/archderm.144.8.1037.
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In this issue of the Archives, Chen et al1 describe acne-related health utility states among adolescents. The study illustrates the value of health utilities in measuring patient preferences for treatment-related outcomes as a metric of health-related quality of life (HRQOL). Like acne, many dermatologic diseases are chronic conditions, characterized by fluctuations in clinical severity. Treatments for such diseases may produce incremental improvements in lieu of a cure. Because most skin diseases do not wax or wane with clinical tests or laboratory values, determination of efficacy relies on subjective assessments of response by both physicians and patients. Health utility states, or patient preference–based HRQOL, are cogent subjective assessments from the patient perspective.2

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Figure 1.

Conceptual framework of health-related quality-of-life (HRQOL) domains.

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Figure 2.

Conceptual framework of quality of life (QOL) and health-related quality of life (HRQOL) interface.

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Figure 3.

Contrasting the impact of specific, health-related quality-of-life (HRQOL) domains among patients. The figure illustrates how one HRQOL domain may obscure another in a person's HRQOL.

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Figure 4.

Conceptual framework of the health utility global measure.

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Figure 5.

Conceptual framework of the burden of skin disease. HRQOL indicates health-related quality of life. Adapted from an unpublished figure developed for the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) “Core Measures of the Burden of Skin Diseases,” contract No. N01-AR-4-227, final report prepared by IQ Solutions, Rockville, Maryland.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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