Resident Physician Massachusetts Eye and Ear Harvard Medical School Boston, Massachusetts
Background Androgenetic alopecia (AGA) is a common condition that can be surgically treated with hair transplantation. AGA can cause significant psychosocial distress.
Objectives Health utility measurements offer an objective and quantitative assessment of health-related quality of life (QOL) as estimates of individual preferences for a given state of health. We sought to use these to assess patient perception of their alopecia.
Design Type We performed a prospective cohort study on patients with AGA between January 1, 2018 and December 31, 2020 with available health utility measures data.
Method Patient metrics were compared with analogous layperson perception of alopecia, which was prospectively collected between August 1 and December 31, 2017. Health utility measures were quantified using the visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO) in quality-adjusted life-years (QALYs).
Results Twenty-nine patients were compared with 237 laypeople. Mean SG QALYs were significantly lower for patients compared to laypeople in the female alopecia state (0.801 vs. 0.946, p<0.01). Mean TTO QALYs were significantly lower for patients compared to laypeople in the male alopecia state (0.851 vs. 0.952, p=0.01). Mean VAS QALYs improved significantly in the post-transplant state for men (0.740 to 0.922, p<0.01), and this improvement was significantly greater for patients compared to laypeople (+0.182 vs. +0.089, p<0.01).
Conclusion These results suggest that AGA negatively influences QOL, and that the true patient experience is significantly more taxing than what is perceived by laypeople. Hair transplantation also significantly improves QOL more for patients than what is perceived by laypeople.