Reliability of the time trade-off technique of utility assessment in patients with retinal disease

Can J Ophthalmol. 2001 Jun;36(4):202-9. doi: 10.1016/s0008-4182(01)80041-7.


Background: Studies in medical fields other than ophthalmology have given conflicting results regarding the reliability of the time trade-off technique of utility assessment. We performed a study to determine the test-retest reliability of the time trade-off technique for assessing utilities in patients with ocular diseases of the retina and to investigate possible factors associated with differences in utility over time.

Methods: Patients referred to the retina service of a tertiary care hospital in eastern Canada were eligible for the initial interview if they had best corrected vision of 20/30 or worse in at least one eye and were deemed competent to answer the required questions. Patients were interviewed prospectively between December 1999 and March 2000 during a normal 30-minute period needed for pharmacologic mydriasis to occur. Demographic, clinical (including Snellen visual acuity) and time trade-off utility information was collected through chart review and standardized interview. Patients who completed the interview successfully were called back 28 days later for follow-up.

Results: Of the 138 eligible patients 112 (81.2%) completed the initial interview. Of the 112, 96 (85.7%) completed the second interview. Half of the respondents were women, and all but one respondent were white. The mean age was 65.3 years. The primary reasons for visual loss included diabetic retinopathy (59 patients [61.4%]) and age-related macular degeneration (14 patients [14.6%]). The intraclass correlation coefficient between the initial and follow-up visual utilities was 0.7634 (95% confidence interval 0.6655-0.8355).

Interpretation: Our results show excellent reliability of the time trade-off technique of utility assessment in patients with ocular diseases of the retina.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Delivery of Health Care / statistics & numerical data*
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Ophthalmology / methods*
  • Ophthalmology / standards
  • Prospective Studies
  • Quality of Life
  • Reproducibility of Results
  • Retinal Diseases / diagnosis*
  • Utilization Review / methods*