{
  "abstract": "Introduction Health authorities such as the FDA and NICE increasingly require new medical interventions to demonstrate quality-of-life improvements and cost-effectiveness through health economic assessments. 1 2 However, these assessments often overlook patient preferences concerning which outcomes they value most.3 While the impact of hospitalisations on quality of life is well established,4 minor healthcare-related events—such as doctor visits, medication adjustments, and remote monitoring interactions—also contribute to patient burden.5 Emerging evidence indicates that frequent minor daily life disruptions can significantly affect well-being, yet they remain underrepresented in the health economic model.6 This feasibility study incorporates these considerations into a heart failure trial in the UK, aiming to refine the methodology and expand its scope in future research. The ultimate goal is to ensure that patient perspectives are meaningfully integrated into the evaluation of new interventions, thereby enhancing the relevance and applicability of QALY-based assessments.Methods A structured questionnaire, developed with input from patient representatives, was administered to heart failure patients over a six-month period to assess their willingness to trade life expectancy for improved health states. The questionnaire included two key scenarios: (1) trading current health for perfect health over a shorter lifespan and (2) trading lifespan to avoid specific health-related events, such as hospitalisations, doctor visits, blood tests, medication adjustments, and remote interactions. To minimise respondent burden, questions were randomly assigned, with a maximum of seven questions asked in months 1, 3, and 6. Responses were analysed to determine utility decrements associated with each event and their cumulative impact on QALYs.Results Preliminary data were collected from 70 heart failure patients enrolled in the HF-TRACK trial in the UK ( NCT06334822). The average participant age was 76.7 years (standard deviation 12.9), with 47.4% female. The response rate was at least as high as that of the EQ-5D questionnaire, demonstrating participant engagement. Minor events such as weekly doctor visits, daily phone calls, and frequent medication changes had smaller per-event decrements compared to hospitalisations but accumulated significantly over time. Additionally, participants completed the EQ-5D questionnaire during the same period, allowing for direct comparison. The Time Trade-Off-derived utilities and existing QoL scores were broadly aligned, indicating consistency between the two methods.Conclusions This study demonstrates the feasibility of using TTO (Time Trade-Off) to assess the quality-of-life impact of both major and minor healthcare events in heart failure patients. The findings indicate that while hospitalisations have a substantial impact, frequent minor healthcare interactions also meaningfully contribute to patient burden. Incorporating these utility decrements into health economic models may enhance cost-effectiveness evaluations of interventions to reduce hospitalisations and optimise remote monitoring strategies. Future research should further validate these findings by cross-referencing results with established tools such as EQ-5D, KCCQ, and MLHFQ to provide a more comprehensive assessment of hospitalisation impact and healthcare interventions.References Neumann PJ, Cohen JT, Weinstein MC. Updating cost-effectiveness—The curious resilience of the $50,000-per-QALY threshold. N Engl J Med. 2014;371(9):796–797.Drummond MF, Sculpher MJ, Claxton K, Stoddart GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press; 2015.Husereau D, Drummond M, Petrou S, et al. Consolidated health economic evaluation reporting standards (CHEERS)—Explanation and elaboration: a report of the ISPOR health economic evaluation publication guidelines task force. Value in Health 2013;16(2):231–250.Dobre D, de Jongste MJ, Haaijer-Ruskamp FM, van Veldhuisen DJ. The impact of hospitalization on health status and quality of life in heart failure patients. Eur J Heart Fail. 2008;10(7):708–713.Boyne JJ, Vrijhoef HJ, Spreeuwenberg MD, et al. Effects of telemonitoring on health status and quality of life in heart failure patients: a randomized controlled trial. Eur J Cardiovasc Nurs. 2014;13(3):242–249.Basu A, Meltzer D. Value of information on preference heterogeneity and individualized care. Med Decis Making. 2005;25(5):510–521.",
  "authors": [
    {
      "affiliations": [],
      "name": "Oriane Chausiaux"
    },
    {
      "affiliations": [],
      "name": "Gareth Williams"
    },
    {
      "affiliations": [],
      "name": "Shamus Husheer"
    }
  ],
  "title": "5-008 Measuring the unseen: the real-life impact of minor healthcare disruptions in HF patients",
  "uid": "7dff7736-6856-5849-8196-da2248c28c22"
}