Measuring preferences for schizophrenia outcomes with the time tradeoff method

Abstract

Measuring preferences for schizophrenia outcomes facilitates meaningful integration of multiple outcome measures and multiple perspectives on treatment outcomes. The Time Tradeoff (TTO) technique, specifically developed for measuring health state preferences, is used widely in health research, but some evidence suggests that the TTO may work less well with schizophrenia than with other health conditions. This study tested the hypotheses that tailoring the time frame of the standard TTO to the course of schizophrenia and simplifying its presentation format would improve its feasibility and efficiency. Forty clinicians provided TTO ratings using 1 of 4 combinations of time frame and presentation format. Numeric ratings and quantitative and qualitative measures of feasibility showed that while participants preferred the simpler format, none of the alterations improved feasibility. Participants' ratings were prone to logical inconsistencies and participants found all 4 versions of the TTO confusing and poorly suited to the context of schizophrenia treatment.

A Systematic Review of the Techniques Used to Value Temporary Health States

“…Among the 24 studies that used adapted methods, 20 justified their choice. Five of the studies that used modified TTO and/or SG cited the temporary nature of the HS being assessed [56,58,69,72] and the inappropriateness of classic conventional methods for THS valuation [74] as reasons for this. Brazier et al [66] used a modification of TTO [81], because they felt that the chained approach was likely to generate biased estimates.…”

“…Sixteen studies used data collected from respondents in the United States [26,27,39,41,[49][50][51][52][53][54][55][56][57][58][59][60]. Eight studies were conducted in the United Kingdom [61][62][63][64][65][66][67][68], six in the Netherlands [69][70][71][72][73][74], and three in Canada [75][76][77].…”

“…Twelve of these studies used the chained approach with TTO [63,73,79], SG [52,54,64,67,76,77], or both [65,70,72]. Eight studies used some modification of the conventional methods including SG [78] and TTO [53,56,58,66,69,71,74]. Three of the studies used WTO [39,49,50], whereas one used sleep trade-off [41] (Table 3).…”

Psychiatrists’ Judgments About Antipsychotic Benefit and Risk Outcomes and Formulation in Schizophrenia Treatment

“…Studies of schizophrenia treatment with public policy makers, consumers, families, and providers have shown that respondents value reduction of positive symptoms and improved social functioning over reduction of negative symptoms and EPS (5). Other studies have shown that medication side effects are of greater concern to patients and their families than to clinicians (6)(7)(8)(9)(10). Therefore, our research question was "Which key benefit and risk attributes of second-generation antipsychotics do physicians trade off and consider when balancing formulation and adherence as adherence changes?…”

Patients’ Preferences Related to Benefits, Risks, and Formulations of Schizophrenia Treatment

“…Previous studies of antipsychotic preference have demonstrated that patients, physicians, and family members collectively place greater importance on productive activity (work or school) compared with positive symptoms or social functioning and place less importance on negative symptoms and side effects (8,9). Medication side effects are of greater concern among patients and their families than among clinicians (10)(11)(12)(13)(14).…”