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Radial Digit Amputation: An Assessment of Utility Outcomes
Ali Izadpanah1; Joshua Vorstenbosch1; Bernard T. Lee2; Samuel J. Lin2; Hani Sinno3
1McGill University Health Centre, Montreal, Canada; 2Beth Israel Deaconess Medical Center/Harvard University, Boston, MA; 3McGill University

Background: Radial digit amputation causes significant morbidity and psychological distress in affected individuals, resulting in a severely impaired quality of life. Utility outcome scores are becoming increasingly common as a means to objectively quantify health related quality of life. In the current study, we measured the utility scores associated with radial digit amputation to quantify its effect on health related quality of life.
Methods: We measured utility using the time trade-off (TTO), visual analogue scale (VAS), and standard gamble (SG) tests in radial digit amputation, monocular blindness, and binocular blindness in prospective participants recruited using Craigslist and McGill Classifieds. Utility scores were compared using paired t-test. Linear regression analysis was performed using gender, race, income, and education as independent predictors of utility.
Results: 58 participants have been enrolled in our study to date and have met inclusion criteria. The utility outcome scores for radial digit amputation (VAS, TTO, SG = 0.730.15, 0.890.17, 0.930.10) are significantly different when compared the scores assigned to monocular blindness (VAS, TTO, SG = 0.630.14, 0.860.14, 0.890.13) and binocular blindness (VAS, TTO, SG = 0.370.17, 0.690.22, 0.740.23). There was no difference in utility scores when assessed by linear regression based on gender, race, income or education.
Conclusions: We have determined the health utility outcome of living with a radial digit amputation (VAS, TTO, SG = 0.730.15, 0.890.17, 0.930.10), which has a similar effect on quality of life as patients affected by monocular blindness and severe breast hypertrophy. We have found that if faced with an amputated radial digit, the population surveyed here would trade 3.9 years of life or undergo a procedure such as digit replantation or transplantation with a 7% risk of mortality to surgically correct their condition.


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