Skip to main content
Log in

Health state preference scores of children with spina bifida and their caregivers

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Cost-effectiveness evaluations of interventions to prevent or treat spin a bifida require quality of life information measured as preference scores. Preference scores of care givers also may be relevant. This study tested whether the preference scores of children with spin a bifida and their care givers would decrease as disability in the child increased. Families of children aged 0–17 with spin a bifida (N=98) were iden ti fied using a birth defect surveillance sys tem in the state of Arkansas. Primary care giv ers of chil dren with spin a bifida identified other families with an unaffected child (N=49). Preference scores for child health states were determined using the Health Utilities Index – Mark 2 (HUI2). Care giver preference scores were determined using the Quality of Well-Being (QWB) scale. Children with spin a bifida were categorized into three disability levels according to the location of the child’s lesion. Mean preference scores declined for both affected children and the primary care giver as disability in the child increased. In multivariate analysis, the preference score of the child was a significant and positive predictor of the primary care giver’s preference score. A more modest association was found for care giver health preference scores by lesion location. The findings can inform cost-effec tiveness evaluations of interventions to treat or prevent spin a bifida.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

CEA:

cost-effectiveness analysis

HUI:

health utilities index

PCHM:

panel on cost-effectiveness in health and medicine

QALY:

quality adjusted life year

QWB:

quality of well-being

References

  1. MR Gold JE Siegel LB Russell MC. Weinstein (1996) Cost-Effectiveness in Health and Medicine Oxford University Press New York, Oxford

    Google Scholar 

  2. AE Kelly AC Haddix KS Scanlon CG Helmick J Mulinare (1996) Cost-effectiveness of strategies to prevent neural tube defects JE Siegel LB Russell MC Weinstein MR Gold (Eds) Cost-Effectiveness in Health and Medicine Oxford University Press New York, Oxford 312–349

    Google Scholar 

  3. InstitutionalAuthorNamePrevention of neural tube defects: Results of the Medical Research Council Vitamin Study (1991) ArticleTitleMRC Vitamin Study Research Group Lancet 338 IssueID8760 131–137

    Google Scholar 

  4. AE. Czeizel (2000) ArticleTitlePrimary prevention of neural-tube defects and some other major congenital abnormalities: Recommendations for the appropriate use of folic acid during pregnancy Paediatr Drugs 2 IssueID6 437–449 Occurrence Handle1:STN:280:DC%2BD3M%2Fps1Wrtw%3D%3D Occurrence Handle11127844

    CAS  PubMed  Google Scholar 

  5. RJ Berry Z Li JD Erickson et al. (1999) ArticleTitlePrevention of neural-tube defects with folic acid in China. China-U.S. Collaborative Project for Neural Tube Defect Prevention (corrected; erratum to be published) N Engl J Med 341 IssueID20 1485–1490 Occurrence Handle1:CAS:528:DyaK1MXnslGitr8%3D Occurrence Handle10559448

    CAS  PubMed  Google Scholar 

  6. S. Dorner (1975) ArticleTitleThe relationship of physical handicap to stress in families with an adolescent with spina bifida Dev Med Child Neurol 17 765–776 Occurrence Handle1:STN:280:CSmD1M3nvVU%3D Occurrence Handle1107105

    CAS  PubMed  Google Scholar 

  7. N Breslau KS Staruch E. Mortimer (1982) ArticleTitlePsychological distress in mothers of disabled children Am J Dis Child 136 682–686 Occurrence Handle1:STN:280:Bi2B2Mzns1Q%3D Occurrence Handle6213143

    CAS  PubMed  Google Scholar 

  8. DS Salkever (1985) Parental oppurtunity costs and other economic costs of children’s disabling conditions N Hobbs JM Perrin (Eds) Issues in the care of children with chronic illness: A Sourcebook on Problems, Services, and Policies Jassey-Bass Inc., Publishers San Francisco, California 864–879

    Google Scholar 

  9. M McCormick EB Charney MM. Stemmler (1986) ArticleTitleAssessing the impact of a child with spina bifida on the family Dev Med Child Neurol 28 IssueID1 53–61 Occurrence Handle1:STN:280:BimC3sjgvFA%3D Occurrence Handle3512350

    CAS  PubMed  Google Scholar 

  10. JM Tilford JM Robbins CA. Hobbs (2001) ArticleTitleImproving estimates of caregiver time cost and family impact associated with birth defects Teratology 64 IssueID(Suppl 1 S37–S41 Occurrence Handle11745843

    PubMed  Google Scholar 

  11. NJ Waitzman RM Scheffler PS. Romano (1996) The Costs of Birth Defects: Estimates of the Value of Prevention University Press of America Inc. New York, London, Lanham

    Google Scholar 

  12. PJ Neumann KM Kuntz J Leon et al. (1999) ArticleTitleHealth utilities in Alzheimer’s disease: A cross-sectional study of patients and caregivers Med Care 37 IssueID1 27–32 Occurrence Handle1:STN:280:DyaK1MzjvFOgtg%3D%3D Occurrence Handle10413389

    CAS  PubMed  Google Scholar 

  13. GW Torrance DH Feeny WJ Furlong RD Barr Y Zhang Q. Wang (1996) ArticleTitleMultiattribute utility function for a comprehensive health status classification system Health Utilities Index Mark. Med Care 2 34 IssueID7 702–722 Occurrence Handle1:STN:280:BymA3Mrks1A%3D

    CAS  Google Scholar 

  14. DH Feeny W Furlong M Boyle GW. Torrance (1995) ArticleTitleMulti-attribute health status classification systems: Health Utilities Index Pharmaco Econ 7 490–502 Occurrence Handle1:STN:280:BymD2cjptVM%3D

    CAS  Google Scholar 

  15. GW Torrance W Furlong DH Feeny M. Boyle (1995) ArticleTitleMulti-attribute preference functions: Health utilities index Pharmacoeconomics 9 503–520

    Google Scholar 

  16. CM Bell SS Araki PJ. Neumann (2001) ArticleTitleThe association between caregiver burden and caregiver health-related quality of life in Alzheimer disease Alzheimer Dis Assoc Disord 15 IssueID3 129–136 Occurrence Handle1:STN:280:DC%2BD3MrgsFKgtg%3D%3D Occurrence Handle11522930

    CAS  PubMed  Google Scholar 

  17. RM Kaplan JP Anderson (1996) The general health policy model: An integrated approach B Spiker (Eds) Quality of Life and Pharmeaeconomics in Clinical Trials Lippincott-Raven Publishers Philadelphia 309–322

    Google Scholar 

  18. RM Kaplan JP. Anderson (1988) ArticleTitleA general health policy model: Update and Applications Health Serv Res 23 IssueID2 203–235 Occurrence Handle1:STN:280:BieB2MnmslU%3D Occurrence Handle3384669

    CAS  PubMed  Google Scholar 

  19. JM Pyne G Sullivan R Kaplan DK. Williams (2003) ArticleTitleComparing the sensitivity of generic effectiveness measures with symptom improvement in persons with schizophrenia Med Care 41 IssueID2 208–217 Occurrence Handle12555049

    PubMed  Google Scholar 

  20. JM Pyne WJ Sieber K David RM Kaplan RM Hyman WD. Keith (2003) ArticleTitleUse of the quality of well-being self-administered version (QWB-SA) in assessing health-related quality of life in depressed patients J Affect Disord 76 IssueID1–3 237–247 Occurrence Handle12943954

    PubMed  Google Scholar 

  21. JM Pyne TL Patterson RM Kaplan JC Gillin WL Koch I. Grant (1997) ArticleTitleAssessment of the quality of life of patients with major depression Psychiatr Serv 48 IssueID2 224–230 Occurrence Handle1:STN:280:ByiC2szpvVw%3D Occurrence Handle9021855

    CAS  PubMed  Google Scholar 

  22. S Saigal D Feeny W Furlong P Rosenbaum E Burrows G. Torrance (1994) ArticleTitleComparison of the health-related quality of life of extremely low birth weight children and a reference group of children at age eight years J Pediatr 125 418–425 Occurrence Handle1:STN:280:ByuA2M7ktlY%3D Occurrence Handle8071752

    CAS  PubMed  Google Scholar 

  23. DG. Altman (1991) Practical Statistics for Medical Research Chapman & Hall London

    Google Scholar 

  24. J. Cuzick (1985) ArticleTitleA Wilcoxon-type test for trend Stat Med 4 87–90 Occurrence Handle1:STN:280:BiqC1M3gsVE%3D Occurrence Handle3992076

    CAS  PubMed  Google Scholar 

  25. J Brazier J Roberts M. Deverill (2002) ArticleTitleThe estimation of a preference-based measure of health from the SF-36 J Health Econ 21 IssueID2 271–292 Occurrence Handle11939242

    PubMed  Google Scholar 

  26. RM Kaplan JW Bush CC. Berry (1976) ArticleTitleHealth status: Types of validity and the index of well-being Health Serv Res 11 IssueID4 478–507 Occurrence Handle1:STN:280:CSiC28vns1c%3D Occurrence Handle1030700

    CAS  PubMed  Google Scholar 

  27. MR Gold DL Patrick DC Hadorn et al. (1996) Identifying and Valuing Outcomes AC Haddix JE Siegel LB Russell MC Weinstein (Eds) Cost-Effectiveness in Health and Medicine Oxford University Press New York, Oxford 82–134

    Google Scholar 

  28. P Grootendorst D Feeny W. Furlong (2000) ArticleTitleHealth Utilities Index Mark 3: Evidence of construct validity for stroke and arthritis in a population health survey Med Care 38 IssueID3 290–299 Occurrence Handle1:STN:280:DC%2BD3c7otFarsA%3D%3D Occurrence Handle10718354

    CAS  PubMed  Google Scholar 

  29. M. Drummond (2001) ArticleTitleIntroducing economic and quality of life measurements into clinical studies Ann Med 33 IssueID5 344–349 Occurrence Handle1:STN:280:DC%2BD3MvksFWqsA%3D%3D Occurrence Handle11491193

    CAS  PubMed  Google Scholar 

  30. C Bombardier J Ware IJ Russell M Larson A Chalmers JL. Read (1986) ArticleTitleAuranofin therapy and quality of life in patients with rheumatoid arthritis: Results of a multicenter trial Am J Med 81 IssueID4 565–578 Occurrence Handle1:STN:280:BiiD38zgvFw%3D Occurrence Handle3532786

    CAS  PubMed  Google Scholar 

  31. DL Patrick SD Ramsey AC Spencer S Kinne B Belza TD. Topolski (2001) ArticleTitleEconomic evaluation of aquatic exercise for persons with osteoarthritis Med Care 39 IssueID5 413–424 Occurrence Handle1:STN:280:DC%2BD3M3ntFCrsA%3D%3D Occurrence Handle11317090

    CAS  PubMed  Google Scholar 

  32. WBF Brouwer NJA Exel ParticleVan MA Koopmanschap FFH. Rutten (1999) ArticleTitleThe valuation of informal care in economic appraisal Int J Technol Assess Health Care 15 IssueID1 147–160 Occurrence Handle1:STN:280:DyaK1MzjsF2itQ%3D%3D Occurrence Handle10407602

    CAS  PubMed  Google Scholar 

  33. SK Parsons SE Barlow SL Levy SE Supran SH. Kaplan (1999) ArticleTitleHealth-related quality of life in pediatric bone marrow transplant survivors: according to whom Int J Cancer (Suppl) 12 46–51 Occurrence Handle1:STN:280:DC%2BD3c7ksFyrsw%3D%3D

    CAS  Google Scholar 

  34. RM Kaplan (1998) Implications of quality of life assessment in public policy for adolescent health D Drotar (Eds) Measuring Health-related Quality of Life in Children and Adolescents Implications for Research and Practice Lawrence Erlbaum Associates Publishers New Jersey 63–84

    Google Scholar 

  35. JM. Tilford (2001) ArticleTitleCost-effectiveness analysis and emergency medical services for children: Issues and applications Ambulatory Pediatr 2 IssueID4 330–336

    Google Scholar 

  36. K. Chwalisz (1992) ArticleTitlePerceived stress and caregiver burden after brain injury: A theoretical integration Rehabilitation Psychol 37 IssueID3 189–203

    Google Scholar 

  37. AP Fengler N. Goodrich (1979) ArticleTitleWives of elderly disabled men: the hidden patients Gerontologist 19 IssueID2 175–183 Occurrence Handle1:STN:280:BiuB1cnos10%3D Occurrence Handle162534

    CAS  PubMed  Google Scholar 

  38. L Longworth S. Bryan (2003) ArticleTitleAn empirical comparison of EQ-5D and SF-6D in liver transplant patients Health Econ 12 IssueID12 1061–1067 Occurrence Handle14673814

    PubMed  Google Scholar 

  39. BJ O’Brien M Spath G Blackhouse JL Severens P Dorian J. Brazier (2003) ArticleTitleA view from the bridge: Agreement between the SF-6D utility algorithm and the Health Utilities Index Health Econ 12 IssueID11 975–981 Occurrence Handle14601159

    PubMed  Google Scholar 

  40. KT Lucke H Coccia JS Goode JF. Lucke (2004) ArticleTitleQuality of life in spinal cord injured individuals and their caregivers during the initial 6 months following rehabilitation Qual Life Res 13 IssueID1 97–110 Occurrence Handle15058792

    PubMed  Google Scholar 

  41. J Brazier T Usherwood R. Harper (1998) ArticleTitleDeriving a preference-based single index from the UK SF-36 Health Survey J Epidemiol 51 1115–1128 Occurrence Handle1:STN:280:DyaK1M%2Fjt1Siuw%3D%3D

    CAS  Google Scholar 

  42. D Feeny W Furlong G. Torrance (2002) ArticleTitleMultiattribute and single-attribute utility functions for the health utilities index mark 3 system Med Care 40 113–128 Occurrence Handle11802084

    PubMed  Google Scholar 

  43. D. Feeny (2000) ArticleTitleA utility approach to the assessment of health-related quality of life Med Care 38 IssueID9 Suppl II151–II154 Occurrence Handle1:STN:280:DC%2BD3cvntlOkuw%3D%3D Occurrence Handle10982100

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John M. Tilford.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tilford, J.M., Grosse, S.D., Robbins, J.M. et al. Health state preference scores of children with spina bifida and their caregivers. Qual Life Res 14, 1087–1098 (2005). https://doi.org/10.1007/s11136-004-3305-2

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-004-3305-2

Keywords

Navigation