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Issues in Palliative Care Research$
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Russell K. Portenoy and Eduardo Bruera

Print publication date: 2003

Print ISBN-13: 9780195130652

Published to Oxford Scholarship Online: November 2011

DOI: 10.1093/acprof:oso/9780195130652.001.0001

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Usefulness of Utility in Making Decisions about Palliative Care

Usefulness of Utility in Making Decisions about Palliative Care

(p.219) 14 Usefulness of Utility in Making Decisions about Palliative Care
Issues in Palliative Care Research

Russell K. Portenoy

Eduardo Bruera

Oxford University Press

Utility can be used to rank treatments based on their effect and to calculate cost-utility ratios. Change in utility is difficult to show for palliative care interventions because the effects of the interventions are small, the effects of the disease are large, and current global instruments do not capture the benefit. This chapter suggests that the most practical use is to quantify the benefits and toxicities of various interventions and to illustrate the future health states that the patient is likely to experience. This may be useful in patient decision making but requires an informed, knowledge-seeking patient, who is willing to make choices informed by data. At present, utility and cost-utility are not useful in resource allocation, except as an implicit way to illustrate benefit for comparative cost and clinical decision making.

Keywords:   resource allocation, utility, cost-utility ratios, palliative care intervention, clinical decision making

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