A new method for valuing health: directly eliciting personal utility functions

Devlin, Nancy; Shah, Koonal; Mulhern, Brendan; Pantiri, K; Hout, Ben van

doi:10.1007/s10198-018-0993-z

Cited by 30 publications

(34 citation statements)

References 30 publications

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“…Also other, novel approaches to estimating health state utilities (e.g. personal utility function presented in Devlin et al 2019) require locating being dead in a set of ranked states; our finding supports this task can be done rather credibly.…”

Section: Discussionsupporting

confidence: 68%

Elicitation and modelling of imprecise utility of health states

Jakubczyk

Golicki

2019

Theory Decis

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Utilities of health states are often estimated to support public decisions in health care. People's preferences may be imprecise, for lack of actual trade-off experience. We show how to elicit the utilities accounting for imprecision (using fuzzy sets), discover the main drivers of imprecision, and compare several approaches to modelling health state utility data in the fuzzy setting. We extended the time trade-off (TTO) questionnaire, to elicit utilities of states defined in the EQ-5D-3L descriptive system (health described by five dimensions) in184 respondents. Our study demonstrates that respondents are capable of assessing their own imprecision and rigorous mathematical modelling is possible. The imprecision is larger than as inferred from the standard TTO method and is larger than estimation error, even in our smallish sample. Nontrading in TTO often results from imprecision, rather than lexicographic preferences for longevity over quality. People are especially imprecise in assessing the impact of usual activities (one of the dimensions) on utility; also, the internal inconsistency of a health state increases the imprecision. Fuzzy least squares method seems best suited to assign disutilities to individual dimensions, while separately modelling the location of utility and amount of imprecision seems best to produce value sets. If crisp parameters are estimated, accounting for imprecision changes the results little.

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Section: Discussionsupporting

confidence: 68%

Elicitation and modelling of imprecise utility of health states

Jakubczyk

Golicki

2019

Theory Decis

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“…VAS is a relatively simple, non-choice-based method, generally agreed to represent the most feasible of the various valuation techniques [12]. The fourth method-LOD-is a novel technique [13] considered promising by the authors for the purpose of establishing the location of the dead within a descriptive system.…”

Section: Valuation Techniquesmentioning

confidence: 99%

“…The LOD exercise, developed as part of the PUF approach, seeks to locate each respondent's position of the dead within a descriptive system. It is a simplified version of the approach used by Devlin et al [13] and comprised two parts. First, a ranking task was presented requiring respondents to rank level 1 descriptors for each of the EQ-5D dimensions (e.g.…”

Section: Lodmentioning

confidence: 99%

An exploration of methods for obtaining 0 = dead anchors for latent scale EQ-5D-Y values

et al. 2020

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Objectives Discrete choice experiments (DCEs) can be used to obtain latent scale values for the EQ-5D-Y, but these require anchoring at 0 = dead to meet the conventions of quality-adjusted life year (QALY) estimation. The primary aim of this study is to compare four preference elicitation methods for obtaining anchors for latent scale EQ-5D-Y values. Methods Four methods were tested: visual analogue scale (VAS), DCE (with a duration attribute), lag-time time trade-off (TTO) and the location-of-dead (LOD) approach. In computer-assisted personal interviews, UK general public respondents valued EQ-5D-3L health states from an adult perspective and EQ-5D-Y health states from a 10-year-old child perspective. Respondents completed valuation tasks using all four methods, under both perspectives. Results 349 interviews were conducted. Overall, respondents gave lower values under the adult perspective compared to the child perspective, with some variation across methods. The mean TTO value for the worst health state (33333) was about equal to dead in the child perspective and worse than dead in the adult perspective. The mean VAS rescaled value for 33333 was also higher in the child perspective. The DCE produced positive child perspective values and negative adult perspective values, though the models were not consistent. The LOD median rescaled value for 33333 was negative under both perspectives and higher in the child perspective. Discussion There was broad agreement across methods. Potential criteria for selecting a preferred anchoring method are presented. We conclude by discussing the decision-making circumstances under which utilities and QALY estimates for children and adults need to be commensurate to achieve allocative efficiency.

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“…There are also a number of biases related to VAS that might influence health state valuation [ 23 , 29 ]. However, the VAS has been defended as a preference elicitation method for eliciting health state values under certainty [ 30 ] and valuation methods that are similar to those of the 15D have been recently applied in a new method for valuing health [ 31 ]. Another aspect that has been criticized is that an additive model is used to estimate 15D health state values.…”

Section: Discussionmentioning

confidence: 99%

A Norwegian 15D value algorithm: proposing a new procedure to estimate 15D value algorithms

et al. 2018

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Purpose So far there is no Norwegian value algorithm to inform healthcare decision making. The 15D health state values estimated with the original 15D valuation procedure tend to be higher than the values of other generic preference-based health-related quality of life (HRQoL) instruments. The main purpose of this study was to use a new 15D valuation procedure to estimate Norwegian 15D health state values and to explore their empirical performance. Methods The visual analogue scale was used to collect 15D valuation data in a representative sample of the Norwegian general population. The new procedure used fewer valuation tasks and anchored the 15D health state values in an empirically assessed range. The Norwegian 15D health state values were compared to the values of five HRQoL instruments which were provided by Norwegian residents belonging to seven disease groups and a healthy population. Results The Norwegian 15D health state values ranged from 1 to − 0.52. Compared to 15D health state values estimated with the original procedure, the Norwegian 15D health state values were lower and more in line with values of other HRQoL instruments. Conclusions The new 15D valuation procedure is simpler, links the 15D health state values better to the requirements of the QALY model, and provides an empirically-based range. We recommend using the new valuation procedure in future 15D valuation studies, and the Norwegian health state values for use in 15D-based health economic analyses in Norway.

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A new method for valuing health: directly eliciting personal utility functions

Cited by 30 publications

References 30 publications

Elicitation and modelling of imprecise utility of health states

Elicitation and modelling of imprecise utility of health states

An exploration of methods for obtaining 0 = dead anchors for latent scale EQ-5D-Y values

A Norwegian 15D value algorithm: proposing a new procedure to estimate 15D value algorithms

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