MR and conventional angiography: Work in progress toward assessing utility in radiology

Rationale and Objectives. The authors assessed health related quality of life changes associated with peripheral x-ray angiography and magnetic resonance (MR) angiography. Materials and Methods. Utility (the desirability or preference that individuals exhibit for a particular health state) was assessed in 30 patients with peripheral vascular disease referred for angiography by using a rating scale, additional categoric scaling questions to separate preference from experience, a willingness-to-pay technique, functional and cognitive status questions, and a MR angiography and x-ray angiography. Results. Patients reported significantly (P < .05) less anxiety after the test, less pain after the test, fewer new physical limitations, and less effect on performance of daily activities with MR angiography. Findings from the overall rating scale and categoric scaling questions also significantly (P < .05) favored MR angiography. Patients were willing to pay a mean of 2.12% of annual income to avoid MR angiography and a mean of 7.41% to avoid x-ray angiography. The median quality-adjusted life gain required by patients to undergo the procedures was 52.5-60 days for x-ray angiography and 10.5 days for MR angiography, without discounting. Conclusion. X-ray angiography has more profound short-term adverse effects on quality on life than does MR angiography. Preference-based measures can be adapted to elicit patient values for short-term health states as seen in radiology.