Not seeing is believing

Doctors and the public considerably underestimate the negative impact of age related macular degeneration (ARMD) on health related quality of life. (

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The progressive nature of ARMD prevents participation in many everyday activities, such as reading and driving, and it is also the most common cause of blindness in elderly people.

A standardised questionnaire created to assess health related quality of life was sent to 115 ARMD patients, while a similar questionnaire was sent to 142 healthy volunteers and 62 doctors, all of whom were asked to pretend they had ARMD. The time-trade off method of utility assessment was used to evaluate the responses and the results were expressed as utility scores. Both the public and clinicians were unable to appreciate the severe impact of ARMD, returning similar utility scores of 0.857 and 0.821 respectively for the severe form of the condition, compared with the score of 0.566 returned by patients. This trend continued for moderate and mild varieties of the condition, with ARMD patients returning lower scores than the public and doctors.

The authors emphasise the importance of …