Benign and Malignant Breast Disease

Abstract

The study purpose was to determine whether differences in the weights assigned to various dimensions of health by 90 women in three subgroups (benign breast disease, breast cancer receiving chemotherapy, and breast cancer receiving other therapies) were associated with differences in self-reported health status in these dimensions. Two methods, one direct and the other indirect, were used to elicit values for mobility, depression, and social support. Two different scales also provided self-reports of health status in each of these dimensions. These measures, in conjunction with sociodemographic variables, were used to test for status- value relationships. No statistically significant association between health values and health status was observed. The absence of any detectable association may have been a result of methodologic difficulties in assessing broadly defined dimensions of health. A possible solution would be to use "individualized" dimensions that are uniquely important to the individual, and to take into account such factors as possible influences of past health status and values, and possible gaps between expected health status and health status actually experienced. Key words: health status measurement; patients' values; utility assessment. (Med Decis Making 1991 ;11 :180-188)

Get full access to this article

View all access options for this article.

References

Christensen-Szalanski JJ Discount functions and the measurement of patients' values: women's decisions during childbirth. Med Decis Making. 1984;4:47-58.

Mohide EA , Torrance GW , Streiner DL , Pringle DM , Gilbert JR Measuring the well-being of family caregivers using the time trade-off technique . J Clin Epidemiol. 1988;41:475-82.

O'Connor Amc , Boyd NF , Warde P. , Stolbach L. , Till JE Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences. J Chron Dis. 1987;40:811-8.

Sackett DL , Torrance GW The utility of different health states as perceived by the general public . J Chron Dis. 1978;31:697-704.

Breslow L. A quantitative approach to the World Health Organization definition of health: physical, mental and social well-being. Int J Epidemiol. 1972;1:347-55.

Llewellyn-Thomas HA , Sutherland HJ , Ciampi A. , et al. The assessment of values in laryngeal cancer: reliability of measurement methods. J Chron Dis. 1985;37:283-91.

Hoepfl RT , Huber GP A study of self-explicated utility models. Behav Sci. 1970;15:408-14.

Parkerson GR , Gehlbach SH , Wagner EH , James SA , Clapp NE , Muhlbaier LH The Duke-UNC health profile: an adult health status instrument for primary care. Med Care. 1981;19:806-27.

Selby PJ , Chapman J-AW , Etezadi-Amoli J. , Dalley D. , Boyd NF The development of a method for assessing the quality of life of cancer patients . Br J Cancer. 1984;50:13-22.

10.

Ciampi A. , Lockwood G. , Sutherland HJ , Llewellyn-Thomas HA , Till JE Assessment of health-related quality of life: factor scales for patients with breast disease. J Psychosoc Oncol. 1989;6:1-19.

11.

Guilford JP Fundamental statistics in psychology and education. New York: McGraw-Hill, 1965.

12.

Bock RD Multivariate statistical methods in behavioral research. New York: McGraw-Hill, 1975.

13.

Brinton LA , Vessey MP , Flavel R. , Yeates D. Risk factors for benign breast disease. Am J Epidemiol. 1981;113:203-14.

14.

Cole P. , Elwood JM , Kaplan SD Incidence rates and risk factors of benign breast neoplasms. Am J Epidemiol. 1978;108:112-20.

15.

Nomura A. , Comstock GW , Tonascia JA Epidemiologic characteristics of benign breast disease. Am J Epidemiol. 1977;105:505-12.

16.

Soini I. , Aine R. , Lauslahti K. , Hakama M. Independent risk factors of benign and malignant breast lesions. Am J Epidemiol. 1981;114:507-14.

17.

Bombardier C. , Tugwell P. Sinclair A. , Dok C. , Anderson G. , Buchanan WW Preference for endpoint measures in clinical trials: results of structured workshops. J Rheumatol. 1982;9:798-806.

18.

Guyatt GH , Bombardier C. , Tugwell PX Measuring disease-specific quality of life in clinical trials. Can Med Assoc J. 1986;134:889-95.

19.

Tugwell P. , Bombardier C. A methodologic framework for developing and selecting endpoints in clinical trials. J Rheumatol. 1982;9:758-61.

20.

Tugwell P. , Bombardier C. , Buchanan W. , et al. The ability of the MACTAR Disability Questionnaire to detect sensitivity to change in rheumatoid arthritis. Clin Res. 1983;31:239A.

21.

Detsky AS , McLaughlin JR , Abrams HB , et al. Quality of life of patients on long-term total parenteral nutrition at home. J Gen Intern Med. 1986;1:26-33.

22.

Goldstein MS , Siegel JM , Boyer R. Predicting changes in perceived health status . AJPH. 1984;74:611-3.

23.

Kahneman D. , Tversky A. Choices, values, and frames. Am Psychol. 1984;39:341-50.

24.

Llewellyn-Thomas HA , Thiel EC , McGreal MJ Cancer patients evaluations of their current health state; the influence of expectations, comparisons, actual health status, and mood. Med Decis Making. (In press.)

25.

President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making health care decisions: a report on the ethical and legal implications of informed consent in the patient-practitioner relationship. Vol 1. Washington, DC: U.S. Government Printing Office, 1982.

26.

Elstein AS , Bordage G. Psychology of clinical reasoning. In: Stone GC , Cohen F , Adler FE , eds. Health psychology: a handbook. San Francisco: Jossey-Bass, 1980 .

27.

Fischhoff B. , Slovic P. , Lichtenstein S. Knowing what you want: measuring labile values. In: Wallsten TS , ed. Cognitive processes in choice and decision behavior. Hillsdale, NJ: Lawrence Erlbaum, 1980.