Quantifying Value of Hope

Background‘Hope’ is a construct in patient-centered value frameworks, but few studies have attempted to measure the value of hope separately from treatment-related gains in quality of life and survival to support its application in economic evaluation.ObjectiveTo generate quantitative information on the “value of hope”.MethodsWe designed a discrete-choice experiment in which treatment alternatives varied the probability of achieving 10-year survival, expected survival as the weighted sum of short-term and long-term survival, health status, and out-of-pocket cost. Two-hundred patients with cancer or history of cancer recruited by Cancer Support Community each completed 10 choice questions. We used mixed-logit and latent-class models to analyze the choice data.ResultsRelative to fixed survival periods of two, three or five years with 0% chance of 10-year survival, participants positively valued treatments with 5% and 10% chances of 10-year survival. However, participants negatively valued a 20% chance of 10-year survival that required an offsetting 80% chance of shorter survival. This finding was particularly strong when expected survival was two years. Compared to a 0% chance, dollar-equivalent values of 5% and 10% chances of long-term survival were $5,975 and $12,421, respectively, independent of health status or expected survival. The corresponding value for 20% versus 0% chance of long-term survival was negative. Latent-class analysis revealed 4 groups with distinct preference patterns.ConclusionsOur findings affirm positive value for hope independent of expected survival and health status. However, this finding does not universally hold in all situations nor across all groups.     

Hope in Another Direction

This article examines compensation for work-related illness among women in the first sixty years of the twentieth century. Its first part (Vo1.15, No.1) discussed women's experience in the employers' liability system and their workers' compensation claims for poisonings. Part II in this issue examines compensation for infectious diseases, principally tuberculosis; litigation involving lung disease produced by berylium and asbestos; and women's workers' compensation claims for illnesses involving a mental component.     

Five Programs for Chronically Ill Children: Many Reasons for Hope

Hemangiomas are among the most common neoplasms of childhood and often found on the face head, and neck in a society that places great importance on physical appearance, sustaining a hemangioma can significantly influence the psychosocial development of children The purpose of this article is to briefly discuss the etiologv of hemangiomas and provide practical suggestions for educators, health care professionals, and parents to foster the psychosocial development of children with a hemangioma.