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Plast Reconstr Surg. 2010 Aug;126(2):443-9. doi: 10.1097/PRS.0b013e3181e094fa.

Utility scores for facial disfigurement requiring facial transplantation [outcomes article].

Author information

1
Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University, Quebec, Canada. hani.sinno@mail.mcgill.ca

Abstract

BACKGROUND:

Controversy exists as to whether the benefits of facial transplantation outweigh the risk of continuous immunosuppression. Utility scores [range, 0 (death) to 1 (perfect health)] are a standardized tool with which to objectify health states or diseases and can help answer such controversy.

METHODS:

An Internet-based utility assessment study using visual analogue scale, time trade-off, and standard gamble was used to obtain utilities for facial disfigurement requiring facial transplantation from a sample of the general population and medical students at McGill University. Average utility scores were compared using t test, and linear regression was performed using age, race, and education as independent predictors of each of the utility scores.

RESULT:

A total of 307 people participated in the study. All measures (visual analogue scale, time trade off, and standard gamble) for facial disfigurement (0.46 + or - 0.02, 0.68 + or - 0.03, and 0.66 + or - 0.03, respectively) were significantly different (p < 0.001) from the corresponding ones for monocular blindness (0.62 + or - 0.02, 0.83 + or - 0.02, and 0.82 + or - 0.02, respectively) and binocular blindness (0.33 + or - 0.02, 0.62 + or - 0.03, and 0.61 + or - 0.03, respectively). Age was inversely proportional to the utility scores in all groups (p < 0.01), decreasing a utility score of 0.006 for every increase in year of age.

CONCLUSION:

A sample of the general population and medical students, if faced with facial disfigurement, would undergo a face transplant procedure with a 34 percent chance of death and be willing to trade 12 years of their life to attain perfect health.

PMID:
20679828
DOI:
10.1097/PRS.0b013e3181e094fa
[Indexed for MEDLINE]

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