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Geertje van der Sterre, H.M. van der Meulen-Schot, Ellen Abma-Bustraan, Huibert Jan Simonsz; Intergenerational utility in parents of children with amblyopia. Invest. Ophthalmol. Vis. Sci. 2021;62(8):152.
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© ARVO (1962-2015); The Authors (2016-present)
The cost-effectiveness of screening and treatment for amblyopia is uncertain. Gain of quality of life in adulthood is experienced long after amblyopia has been detected and treated. Possible functional loss of the only good eye occurs even later in life. There are few immediate benefits for the child when its amblyopia is treated. Yet the detection and treatment of amblyopia is not abolished because the parents decide on this. We think that the reduction of quality of life of the parents because of the amblyopia of their child, should be included in the cost-utility analysis.We measured the loss of disease-related quality of life in parents whose child was treated for amblyopia.
In our study we ask the parents of a child who has had occlusion therapy for six weeks two questions. Two questions that measure their loss of utility. First, how many years of their life they are willing to give up (Time Trade-Off), and secondly, how much risk of unilateral blindness they are willing to take (Standard Gamble) in exchange for their child having good vision in both eyes.
So far we have been able to interview 10 parents.Against expectations, the responses to the Time Trade-Off question showed parents were willing to give up the maximum of 5 years of their life in exchange for the amblyopic eye of their child to be healthy. Clearly a ceiling effect had occurred.This result was the reason to expand the options in the Time Trade-Off method by 10 years, 20 years and 30 years.As we initially had not included the Standard Gamble question, only three parents have been interviewed with this question. One parent who was willing to risk 10% had amblyopia himself.
These highly suprising results necessitate an inventory of possible confounders.We are considering:- desire to give socially acceptable answers- innate striving for reproductive success- religious beliefs about sacrificing your own life- social context and family structure: can others care for the child- co-morbidity of the child
This is a 2021 ARVO Annual Meeting abstract.
Interview results, per case: age and gender of the children, age and gender of the interviewed parent, whether or not this parent is amblyopic, Time Trade-Off in years, Standard Gamble chance.
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