Objective: To study the effect of religion on the imagination of death/shortening of life in time tradeoff questions and to explore the feasibility of open-question time tradeoff methods (TTO1), modified EQ-VT time tradeoff (TTO2), EQ-visual analog scale (VAS), EQ5D-5L, and HUI3 patientreported outcomes in elderly ophthalmic eye patients in Thailand.

Materials and Methods: Face-to-face interview, cross-sectional study.

Results: Among 40 ophthalmic patients, there were 16 diabetic retinopathy cases, 15 cataract cases, and 8 wet-age related macular degeneration cases with a mean age of 63, 58, and 72 years, respectively. The mean utility scores obtained from the TTO1, TTO2, EQ-5D-5L, and HUI3 were 0.5, 0.49, 0.80, and 0.61, respectively. The HUI3 required the longest mean interview time at 5.5 minutes, whereas the NEI-VFQ-25 required the shortest mean interview time at 1.08 minutes. Of the patients, 87.5%, 10%, and 2.5% reported a mild, moderate, and marked effect of their religion on their decisions made during TTO answering. The utility scores from the EQ-VAS, EQ-5D-5L, and HUI3 showed a significant positive correlation with the NEI-VFQ-25 quality of life score. The utility scores from the EQ-5D-5L and HUI3 were significantly associated with the severity of visual impairment. Four participants were not willing to trade in TTO1. TTO2 methods were less complicated to answer as compared with TTO1.

Conclusion: The HUI3 utility score was correlated with change in visual impairment and vision-specific quality of life, and its use is recommended in the utility assessment in eye disease. TTO1 is more complicated compared with TTO2. In clinical ophthalmic practice, the use of indirect utility assessment methods is preferred over direct methods.

Keywords: Tradeoff method; Religion; Quality of life; TTO

DOI: 10.35755/jmedassocthai.2022.05.13307

Received 24 January 2022 | Revised 25 March 2022 | Accepted 30 March 2022