Utilities for major stroke: Results from a survey preferences among persons at increased risk for stroke

Background Patient beliefs, valves, and preferences are crucial to decisions involving health care. in a large sample of persons at increased risk for stroke, we examined attitudes toward hypothetical major stroke. Methods and Results Respondents were obtained from the Academic Medical Center Consortium (n = 621), the Cardiovascular Health Study (n = 321), and United Health Care (n = 319). Preferences were primarily assessed by using the time trade off (TTO), Although major stroke is generally considered an undesirable event (mean TTO = 0.30), responses were varied: although 45% of respondents considered major stroke to be a worse outcome than death, 15% were willing to trade off little or no survival to avoid a major stroke. Conclusions Providers should speak directly with patients about beliefs, values, and preferences. Stroke-related interventions, even those with a high price or less than dramatic clinical benefits, are likely to be cost-effective if they prevent an outcome (major stroke) that is so undesirable.