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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].

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Division of Plastic and Reconstructive Surgery, Department of Surgery, McGill University, Quebec, Canada.



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.


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.


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.


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.

[Indexed for MEDLINE]

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