Work-in-Progress Toward Incorporating Patients' Preferences in Practice Guidelines for Imaging Aneurysmal Subarachnoid Hemorrhage

Patient-centered care has become a primary focus in clinical practice. In developing practice guidelines for clinical care, the patients' perspective is an important component.Patients' preferences are represented in a decision analytic model as quality-of-life weights for different health states associated with the aneurysmal subarachnoid hemorrhage population. The time-tradeoff method is used to obtain the individual patients' preferences, which are directly measured in quality-adjusted life years. An individualized care model is explained as a means of implementing a patient-centered approach into practice guidelines for clinical care. A method for calculating the expected value for societal benefit from improved decision making using an individualized care model is reviewed.We discuss our work-in-progress towards incorporating patients' preferences in a decision analytic model for aneurysmal subarachnoid hemorrhage patients. The main methodologic concerns for using patients' preferences in cost-effectiveness analyses for developing practice guidelines are discussed.Emphasis is placed on using patients' preferences and patient-centered outcome measures in cost-effectiveness analyses.