Automated Tool for Health Utility Assessments: The Gambler II

Adejare, Adeboye; Eckman, Mark H.

doi:10.1177/2381468320914307

Cited by 8 publications

(8 citation statements)

References 56 publications

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“…We used The Gambler II to perform health utility assessments [ 11 ]. For survey data collection, we used REDCap, a web-based survey platform designed to capture users’ data with web forms [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

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Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Adejare¹,

Duncan²,

Motz³

et al. 2022

JMIR Form Res

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Background Patients with end-stage kidney disease (ESKD) wait roughly 4 years for a kidney transplant. A potential way to reduce wait times is using hepatitis C virus (HCV)–viremic kidneys. Objective As preparation for developing a shared decision-making tool to assist patients with ESKD with the decision to accept an HCV-viremic kidney transplant, our initial goal was to assess the feasibility of using The Gambler II, a health utility assessment tool, in an ambulatory dialysis clinic setting. Our secondary goals were to collect health utilities for patients with ESKD and to explore whether the use of race-matched versus race-mismatched exemplars impacted the knowledge gained during the assessment process. Methods We used The Gambler II to elicit utilities for the following ESKD-related health states: hemodialysis, kidney transplant with HCV-unexposed kidney, and transplantation with HCV-viremic kidney. We created race exemplar video clips describing these health states and randomly assigned patients into the race-matched or race-mismatched video arms. We obtained utilities for these 3 health states from each patient, and we evaluated knowledge about ESKD and HCV-associated health conditions with pre- and postintervention knowledge assessments. Results A total of 63 patients with hemodialysis from 4 outpatient Dialysis Center Inc sites completed the study. Mean adjusted standard gamble utilities for hemodialysis, transplant with HCV-unexposed kidney, and transplantation with HCV-viremic kidney were 82.5, 89, and 75.5, respectively. General group knowledge assessment scores improved by 10 points (P<.05) following utility assessment process. The use of race-matched exemplars had little effect on the results of the knowledge assessment of patients. Conclusions Using The Gambler II to collect utilities for patients with ESKD in an ambulatory dialysis clinic setting proved feasible. In addition, educational information about health states provided as part of the utility assessment process tool improved patients’ knowledge and understanding about ESKD-related health states and implications of organ transplantation with HCV-viremic kidneys. A wide variation in patient health state utilities reinforces the importance of incorporating patients’ preferences into decisions regarding use of HCV-viremic kidneys for transplantation.

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Section: Methodsmentioning

confidence: 99%

“…The Gambler II is a health utility assessment software platform that can use a variety of assessment techniques to gather patients’ utilities [ 10 , 11 ]. These include the visual analog scale (VAS), standard gamble (SG), and time trade-off (TTO) [ 12 ] ( Multimedia Appendix 1 A).…”

Section: Introductionmentioning

confidence: 99%

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Adejare¹,

Duncan²,

Motz³

et al. 2022

JMIR Form Res

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“…The direct choice exercise will be followed by three value elicitation exercises (rank ordering, visual analogue scale and standard gamble) 50 that will be completed using Gambler II software. 51 Women will consider the four health states listed above. For the ranking exercise, women will rank the health states from most to least preferred.…”

Section: Methods and Analysismentioning

confidence: 99%

Decision Analysis in SHared decision making for Thromboprophylaxis during Pregnancy (DASH-TOP): a sequential explanatory mixed methods pilot study protocol

et al. 2021

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IntroductionDecision analysis is a quantitative approach to decision making that could bridge the gap between decisions based solely on evidence and the unique values and preferences of individual patients, a feature especially important when existing evidence cannot support clear recommendations and there is a close balance between harms and benefits for the treatments options under consideration. Low molecular weight heparin (LMWH) for the prevention of venous thromboembolism (VTE) during pregnancy represents one such situation. The objective of this paper is to describe the rationale and methodology of a pilot study that will explore the application of decision analysis to a shared decision-making process involving prophylactic LMWH for pregnant women or those considering pregnancy who have experienced a VTE.Methods and analysisWe will conduct an international, mixed methods, explanatory, sequential study, including quantitative data collection and analysis followed by qualitative data collection and analysis. In step I, we will ask women who are pregnant or considering pregnancy and have experienced VTE to participate in a shared decision-making intervention for prophylactic LMWH. The intervention consists of three components: a direct choice exercise, a values elicitation exercise and a personalised decision analysis. After administration of the intervention, we will ask women to make a treatment decision and measure decisional conflict, self-efficacy and satisfaction. In step II, which follows the analysis of quantitative data, we will use the results to inform the qualitative interview. Step III will be a qualitative descriptive study that explores participants’ experiences and perceptions of the intervention. In step IV, we will integrate findings from the qualitative and quantitative analyses to obtain meta-inferences.Ethics and disseminationSite-specific ethics boards have approved the study. All participants will provide informed consent. The research team will take an integrated approach to knowledge translation.

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“…Assuming point estimates causes false confidence in the analysis results. 21,22 Data availability Underlying data Figshare: Elicited and adjusted HSUVs using T-Y models. https://doi.org/10.6084/m9.figshare.21651911.…”

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confidence: 99%

How adjusting elicited health utilities after the fact can adversely affect shared decision making

Kujawski¹

2022

F1000Res

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Background: The elicitation of inconsistent health-state utility values (HSUVs) is a prevalent problem. There are two approaches to address this problem: (1) intervention during the elicitation process to ensure that patients estimate consistent HSUVs; (2) no intervention during the elicitation process and inconsistent HSUVs are adjusted after the fact. This paper studies three models recently proposed for adjusting inconsistent HSUVs and consistent HSUVs that some may consider unrealistic. Analysis: The three models are analyzed using a sound theoretical framework: the mathematical equivalence of HSUVs elicited using the standard gamble and probabilities, the Fréchet bounds, and preference theory. It is proven that none of these models accounts for the Fréchet lower bound and health conditions that are preference substitutes. Results: A clinical vignette proves these models may recommend treatments that result in premature death over treatments that cause acceptable adverse effects. Conclusions: The three models are incorrect and may mislead patients and physicians to poor medical decisions. In the spirit of shared decision making, patients should be given the opportunity to reassess inconsistent HSUVs and confirm that the revised HSUVs reflect their preferences.

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Automated Tool for Health Utility Assessments: The Gambler II

Cited by 8 publications

References 56 publications

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Implementing a Health Utility Assessment Platform to Acquire Health Utilities in a Hemodialysis Outpatient Setting: Feasibility Study

Decision Analysis in SHared decision making for Thromboprophylaxis during Pregnancy (DASH-TOP): a sequential explanatory mixed methods pilot study protocol

How adjusting elicited health utilities after the fact can adversely affect shared decision making

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