Vision-related quality-of-life estimates in adolescent youths

To estimate perceptions of quality-of-life (QOL) associated with vision loss in youths under age 21 and compare them with adult general community perceptions and those of ophthalmic patients with vision loss.

Cross-sectional, time tradeoff (TTO), utility analysis.

Consecutive youths aged 13-20 years who agreed to participate in the study.

Vision utilities were acquired from adolescents asked to estimate the QOL associated with 3 vision scenarios using a validated, reliable, interviewer-administered TTO utility instrument. The scenarios modeled included: (i) mild vision loss (20/40-20/60), (ii) moderate vision loss (20/70-20/100), and (iii) severe vision loss (≤20/200). Results were compared with utilities previously gathered from the adult general community and from vision-impaired patients with acuity loss to the level of the modeled scenarios.

Mean TTO vision utilities were: scenario 1: youths (0.96) versus patients (0.79) (p < 0.0001); scenario 2: youths (0.88) versus patients (0.72) (p < 0.0001); scenario 3: (analysis of variance p < 0.0001) Tukey's Honestly Significant Difference Test, youths (0.79) versus patients (0.60) (p < 0.01), youths (0.79) versus adult general community (0.85) (p < 0.01), adult general community (0.85) versus patients (0.60) (p < 0.01).

Adolescents underestimated the effects of mild, moderate, and severe vision loss upon QOL referent to patients with actual vision loss (p < 0.0001), and thus are not good patient surrogates for utilities used in cost-utility analysis. Nonetheless, youth estimates were closer to those of patients with vision loss than were adult general community estimates. These findings emphasize the importance of using patient utilities in cost-utility analysis.