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Health Utility Measures Among Patients with Androgenetic Alopecia After Hair Transplant

  • Original Article
  • Facial Surgery
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Abstract

Background

Hair loss causes significant psychosocial distress to patients. Health utility measurements offer an objective, quantitative assessment of health-related quality of life (QOL).

Methods

We performed a prospective cohort study on patients with hair loss between January 1, 2018 and December 31, 2020. Patient metrics were compared with layperson perception of alopecia, prospectively collected between August 1 and December 31, 2017. Health utility measures were quantified using the visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO) in quality-adjusted life-years (QALYs) and relative to the minimal clinically important difference (MCID). Bonferroni correction to the significance threshold was performed.

Results

Thirty-one patients with alopecia were compared with 237 laypeople. Patient metrics for female hair loss were all significantly lower than laypeople measures (VAS QALYs 0.65 ± 0.21 vs. 0.83 ± 0.18, p = 0.0001). Mean SG QALYs were lower for patients in the male alopecia state (0.86 ± 0.23 vs. 0.96 ± 0.12, p = 0.0278). Post-hair transplant improvement in TTO was significantly greater for patients (+ 0.08 ± 0.12 vs. + 0.02 ± 0.09, p = 0.0070) and significantly more often exceeded the MCID (45.2% vs. 16.9%, p = 0.0006).

Conclusions

Alopecia negatively impacts QOL, and the true patient experience is more taxing than what is perceived by laypeople. Hair transplantation improves QOL more for male patients than common perception.

Level of Evidence IV

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Data Availability

Dr. Xiao and Ms. Yau had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Acknowledgements

The authors would like to acknowledge Jessica Occhiogrosso, BS and Alyssa Heiser, BA for their contributions in data collection.

Funding

This project was not supported by any external grants or funds. The authors assume full responsibility for the accuracy and completeness of the ideas presented.

Author information

Authors and Affiliations

  1. Department of Otolaryngology, Massachusetts Eye and Ear, Boston, MA, USA

    Roy Xiao, Ciersten A. Burks, Jenny Yau, Adeeb Derakhshan, Rui Han Liu, Nate Jowett & Linda N. Lee

  2. Department of Otolaryngology, Harvard Medical School, Boston, MA, USA

    Roy Xiao, Ciersten A. Burks, Adeeb Derakhshan, Rui Han Liu, Nate Jowett & Linda N. Lee

  3. Department of Dermatology, Lahey Hospital & Medical Center, Boston, MA, USA

    Maryanne M. Senna

  4. Lahey Hair Loss Center of Excellence and Research Unit, Boston, MA, USA

    Maryanne M. Senna

  5. Department of Dermatology, Massachusetts General Hospital, Boston, MA, USA

    Mariko R. Yasuda

  6. Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, 243 Charles Street, Boston, MA, 02114, USA

    Nate Jowett & Linda N. Lee

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  1. Roy Xiao
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  9. Linda N. Lee
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Contributions

Dr. Xiao, Dr. Burks, and Ms. Yau were responsible for the conception and design of this work, as well as drafting the manuscript. Ms. Yau was responsible for data acquisition. Dr. Xiao was responsible for statistical analysis. All authors participated in the analysis and interpretation of the data and critically revised the manuscript for important intellectual content.

Corresponding author

Correspondence to Linda N. Lee.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical Approval

The authors obtained approval from the MGB IRB prior to performing the reported research (protocol #2019P003415).

Informed Consent

All included laypersons and patients completing surveys for analyzed data provided informed consent prior to doing so.

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Xiao, R., Burks, C.A., Yau, J. et al. Health Utility Measures Among Patients with Androgenetic Alopecia After Hair Transplant. Aesth Plast Surg 47, 631–639 (2023). https://doi.org/10.1007/s00266-022-03066-4

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