{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T20:36:37Z","timestamp":1788554197847,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Standard gamble (SG) directly measures patients\u2019 valuation of their health state. We compare in-hospital and day-90 SG utilities (SGU) among intracerebral hemorrhage patients and report a 3-way association between SGU, EuroQoL-5 dimension, and modified Rankin Scale at day 90.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              Patients with intracerebral hemorrhage underwent in-hospital and day-90 assessments for the modified Rankin Scale, EuroQoL-5 dimension, and SG. SG provides patients a choice between their current health state and a hypothetical treatment with varying chances of either perfect health or a painless death. Higher SGU (scale, 0\u20131) indicates lower risk tolerance and thus higher valuation of the current health state. Logistic regression was used to estimate the likelihood of low SGU (\u22640.6), and Wilcoxon paired signed-rank test compared in-hospital and day-90 SGU. In-hospital and day-90 SG was obtained from 381 and 280 patients, respectively, including 236 paired observations. Median (interquartile range) in-hospital and day-90 SGUs were 0.85 (0.40\u20130.98) and 0.98 (0.75\u20131.00;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In-hospital SGUs were lower with advancing age (\n              <jats:italic>P<\/jats:italic>\n              =0.007), higher National Institutes of Health Stroke Scale, and intracerebral hemorrhage scores (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Proxy-based assessments resulted in lower SGUs; median difference (95% CI), \u22120.2 (\u22120.33 to \u22120.07). After adjustment, higher National Institutes of Health Stroke Scale and proxy assessments were independently associated with lower SGU, along with an effect modification of age by race. Day-90 SGU and modified Rankin Scale were significantly correlated; however, SGUs were higher than the EuroQoL-5 dimension utilities at higher modified Rankin Scale levels.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Divergence between directly (SGU) and indirectly (EuroQoL-5 dimension) assessed utilities at high levels of functional disability warrant careful prognostication of intracerebral hemorrhage outcomes and should be considered in designing early end-of-life care discussions with families and patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.119.005606","type":"journal-article","created":{"date-parts":[[2019,9,13]],"date-time":"2019-09-13T09:00:36Z","timestamp":1568365236000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Direct Assessment of Health Utilities Using the Standard Gamble Among Patients With Primary Intracerebral Hemorrhage"],"prefix":"10.1161","volume":"12","author":[{"given":"Kristen B.","family":"Slaughter","sequence":"first","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellie G.","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvind B.","family":"Bambhroliya","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer R.","family":"Meeks","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wamda","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School (W.A., R.B.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritvij","family":"Bowry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, McGovern Medical School (W.A., R.B.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Behrouz","sequence":"additional","affiliation":[{"name":"Department of Neurology, UTHealth, San Antonio, TX (R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osman","family":"Mir","sequence":"additional","affiliation":[{"name":"Department of Neurology, Baylor Scott &amp; White, Dallas, TX (O.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Begley","sequence":"additional","affiliation":[{"name":"Department of Management, Policy, and Community Health, School of Public Health (C.B.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon E.","family":"Tyson","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence Based Medicine, McGovern Medical School (J.E.T., C.M.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Miller","sequence":"additional","affiliation":[{"name":"Center for Clinical Research and Evidence Based Medicine, McGovern Medical School (J.E.T., C.M.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Warach","sequence":"additional","affiliation":[{"name":"Department of Neurology, Dell Medical School, The University of Texas at Austin (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James C.","family":"Grotta","sequence":"additional","affiliation":[{"name":"Mobile Stroke Unit and Institute for Research and Innovation, Memorial Hermann Hospital, Texas Medical Center, Houston (J.C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise D.","family":"McCullough","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean I.","family":"Savitz","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhaan S.","family":"Vahidy","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute for Stroke and Cerebrovascular Diseases, McGovern Medical School (K.B.S., E.G.M., A.B.B., J.R.M., L.D.M., S.I.S., F.S.V.), UTHealth, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000519"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.538967"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010898"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987316683780"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.008547"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-014-0834-1"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-015-1196-z"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hec.1235"},{"key":"e_1_3_4_10_2","first-page":"207","article-title":"The standard gamble method: what is being measured and how it is interpreted.","volume":"29","author":"Gafni A","year":"1994","unstructured":"Gafni, A. 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