Treatment selection for life-critical shared decision making under ranges of health-state utility scenarios

Triantaphyllou, Evangelos; Yanase, Juri

doi:10.1016/j.jbi.2020.103604

Cited by 1 publication

(2 citation statements)

References 43 publications

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“…The elicitation of reliable HSUVs is critical to ensure medical decisions that patients truly prefer. As shown in this paper, the three T-Y models 4,5 do not accurately account for individual preferences and the mathematical equivalence of HSUVs with probabilities elicited using the SG. Given consistent elicited HSUVs, it is not the function of clinicians to judge whether these are realistic or unrealistic.…”

Section: Discussionmentioning

confidence: 85%

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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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Section: Discussionmentioning

confidence: 85%

“…Inconsistent elicited HSUVs are adjusted after the fact. 4,5 The first approach requires trained and knowledgeable interviewers. The second approach requires realistic and mathematically valid models.…”

Section: Introductionmentioning

confidence: 99%

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

Kujawski¹

2022

F1000Res

View full text Add to dashboard Cite

show abstract

Treatment selection for life-critical shared decision making under ranges of health-state utility scenarios

Cited by 1 publication

References 43 publications

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

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

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