Health outcome prioritization to elicit preferences of older persons with multiple health conditions

Patient Educ Couns. 2011 May;83(2):278-82. doi: 10.1016/j.pec.2010.04.032. Epub 2010 May 31.


Objective: To develop and test a simple tool to elicit the preferences of older persons based on prioritization of universal health outcomes.

Methods: Persons age ≥ 65 participating in a larger study were asked to rank 4 outcomes on a visual analogue scale: (1) maintaining independence, (2) staying alive, (3) reducing/eliminating pain, (4) reducing/eliminating other symptoms.

Results: Interviewers rated 73% of the 81 participants as having good to excellent understanding, and cognitive interviews demonstrated the tool captured how participants thought about trade-offs. Test-retest reliability was fair to poor for ranking most of the outcomes as either most or least important (kappa .28-1.0). Patient characteristics associated with ranking "keeping you alive" as most important have been shown to be associated with a preference for life-sustaining treatment, a related construct. There was substantial variability in the outcome ranked as most important.

Conclusions: The task of ranking 4 universal health outcomes was well understood, captured what was important when considering trade-offs, and demonstrated content validity. However, test-retest reliability was fair to poor.

Publication types

  • Validation Study

MeSH terms

  • Activities of Daily Living
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging
  • Chronic Disease
  • Decision Making
  • Feasibility Studies
  • Female
  • Geriatric Assessment / methods
  • Geriatric Assessment / statistics & numerical data
  • Health Services Accessibility / statistics & numerical data*
  • Health Services Needs and Demand / statistics & numerical data*
  • Health Status
  • Humans
  • Male
  • Patient Satisfaction*
  • Psychometrics
  • Reproducibility of Results
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • Treatment Outcome
  • United States