Valuing health-related quality of life. A review of health state valuation techniques.

Given the growing need to value health-related quality of life, a review of the literature relating to health state valuation techniques was undertaken to appraise the current theoretical and empirical evidence available to inform on the techniques, to identify consensus, identify disagreement and identify important areas for future research. A systematic search of the literature was conducted, covering standard gamble (SG), time trade-off (TTO), visual analogue scale (VAS), magnitude estimation (ME) and person trade-off (PTO) techniques. The basic concepts of practicality, reliability, theoretical validity and empirical validity formed the criteria for reviewing the performance of valuation techniques. In terms of practicality and reliability, we found little evidence relating to ME and PTO. SG, TTO and VAS have been shown to be practical on a range of populations. There is little difference between the reliability of SG, TTO and VAS, and present evidence does not offer a basis to differentiate between them. When considering the theoretical basis of techniques, we conclude that choice-based methods (i.e. SG, TTO and PTO) are best placed to reflect the strength of preference for health, with the choice between these techniques depending on the study characteristics and the perspective employed. Empirical evidence relating to the theoretical perspective of the techniques has shown that there are problems with all techniques in terms of descriptive validity.

[1]  S. van der Linden,et al.  Patient utilities in fibromyalgia and the association with other outcome measures. , 1995, The Journal of rheumatology.

[2]  R. Kane,et al.  Methodology for measuring health-state preferences--II: Scaling methods. , 1989, Journal of clinical epidemiology.

[3]  J D Habbema,et al.  The "utility" of the Time Trade-Off method in cancer patients: feasibility and proportional Trade-Off. , 1995, Journal of clinical epidemiology.

[4]  M K Goldstein,et al.  Measurement of the validity of utility elicitations performed by computerized interview. , 1997, Medical care.

[5]  G W Torrance,et al.  Utility approach to measuring health-related quality of life. , 1987, Journal of chronic diseases.

[6]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[7]  B. Gage,et al.  The Effect of Stroke and Stroke Prophylaxis With Aspirin or Warfarin on Quality of Life , 1996 .

[8]  E. Nord,et al.  The validity of a visual analogue scale in determining social utility weights for health states. , 1991, The International journal of health planning and management.

[9]  G. Torrance,et al.  Measurement of quality of life in end-stage renal disease: the time trade-off approach. , 1987, Clinical and investigative medicine. Medecine clinique et experimentale.

[10]  A Gafni,et al.  The standard gamble method: what is being measured and how it is interpreted. , 1994, Health services research.

[11]  J. Brazier,et al.  A checklist for judging preference-based measures of health related quality of life: learning from psychometrics. , 1999, Health economics.

[12]  G. Loomes,et al.  The use of QALYs in health care decision making. , 1989, Social science & medicine.

[13]  P. Dolan,et al.  The time trade-off method: results from a general population study. , 1996, Health economics.

[14]  M. Kuppermann,et al.  Can Preference Scores for Discrete States Be Used to Derive Preference Scores for an Entire Path of Events? , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[15]  D. Feeny,et al.  Utilities and Quality-Adjusted Life Years , 1989, International Journal of Technology Assessment in Health Care.

[16]  R M Kaplan,et al.  Health Status Index: Category Rating versus Magnitude Estimation for Measuring Levels of Well-Being , 1979, Medical care.

[17]  G. Torrance.  Measurement of health state utilities for economic appraisal. , 1986, Journal of health economics.

[18]  P. Dolan,et al.  Valuing health states: a comparison of methods. , 1996, Journal of health economics.

[19]  Maureen,et al.  Methodological Issues of Patient Utility Measurement Experience From Two Clinical Trials , 1995, Medical care.

[20]  D. Feeny,et al.  Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. , 1996, Medical care.

[21]  E. Nord.  The Person-trade-off Approach to Valuing Health Care Programs , 1995, Medical decision making : an international journal of the Society for Medical Decision Making.

[22]  A. Tversky,et al.  The Psychology of Preferences , 1982 .

[23]  J. Kenneth Buckingham,et al.  Comparing Three Versions of the Time Tradeoff , 1996, Medical decision making : an international journal of the Society for Medical Decision Making.

[24]  H. Kunreuther,et al.  Sources of Bias in Assessment Procedures for Utility Functions , 1982 .

[25]  R. Sugden,et al.  Regret Theory: An alternative theory of rational choice under uncertainty Review of Economic Studies , 1982 .

[26]  George W. Torrance,et al.  Social preferences for health states: An empirical evaluation of three measurement techniques , 1976 .

[27]  S. van der Linden,et al.  Feasibility of utility assessment by rating scale and standard gamble in patients with ankylosing spondylitis or fibromyalgia. , 1994, The Journal of rheumatology.

[28]  G. Bonsel,et al.  Valuation of health states by the general public: feasibility of a standardized measurement procedure. , 1990, Social science & medicine.

[29]  R. Klein,et al.  The Beaver Dam Health Outcomes study , 1993, Medical decision making : an international journal of the Society for Medical Decision Making.

[30]  P. Walter.  Quality of Life after Open Heart Surgery , 1992, Developments in Cardiovascular Medicine.

[31]  Harold C. Sox,et al.  Variation in Patient Utilities for Outcomes of the Management of Chronic Stable Angina: Implications for Clinical Practice Guidelines , 1995 .

[32]  H. Fineberg,et al.  Preferences for Health Outcomes , 1984, Medical decision making : an international journal of the Society for Medical Decision Making.

[33]  A Gafni,et al.  Evaluating health related quality of life: an indifference curve interpretation for the time trade-off technique. , 1990, Social science & medicine.

[34]  D A Redelmeier,et al.  Variability among methods to assess patients' well-being and consequent effect on a cost-effectiveness analysis. , 1992, Journal of clinical epidemiology.

[35]  F. D. de Charro,et al.  Measuring the quality of life before and after bilateral lung transplantation in patients with cystic fibrosis. , 1994, Chest.

[36]  B. O'brien,et al.  Willingness to Pay , 1994, Medical decision making : an international journal of the Society for Medical Decision Making.

[37]  D L Patrick,et al.  Methods for measuring levels of well-being for a health status index. , 1973, Health services research.

[38]  C. Gudex,et al.  Comparing scaling methods for health state valuations - Rosser revisited , 1993 .

[39]  J L Pinto Prades,et al.  Is the person trade-off a valid method for allocating health care resources? , 1997, Health economics.

[40]  L A Lenert,et al.  The side effects of antipsychotic drugs and patients' quality of life: patient education and preference assessment with computers and multimedia. , 1993, Proceedings. Symposium on Computer Applications in Medical Care.

[41]  M. Johannesson,et al.  Outcome measurement in economic evaluation. , 1996, Health economics.

[42]  J. Habbema,et al.  Patient participation in clinical decision-making for treatment of T3 laryngeal cancer: a comparison of state and process utilities. , 1995, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[43]  G. Loewenstein,et al.  Individual Utilities Are Inconsistent with Rationing Choices , 1996, Medical decision making : an international journal of the Society for Medical Decision Making.

[44]  R. Bourne,et al.  What Is the Best Way of Assessing Outcome After Total Knee Replacement? , 1996, Clinical orthopaedics and related research.

[45]  J. Richardson,et al.  Cost utility analysis: what should be measured? , 1994, Social science & medicine.

[46]  P. Shackley,et al.  Decision Making with Respect to Diagnostic Testing , 1996, Medical decision making : an international journal of the Society for Medical Decision Making.

[47]  J. de Haes,et al.  Utility Assessment in Cancer Patients , 1994, Medical decision making : an international journal of the Society for Medical Decision Making.

[48]  R L Kane,et al.  Methodology for measuring health-state preferences--III: Population and context effects. , 1989, Journal of clinical epidemiology.

[49]  K C Cain,et al.  Measuring Preferences for Health States Worse than Death , 1994, Medical decision making : an international journal of the Society for Medical Decision Making.

[50]  A. Mehrez,et al.  The Healthy-years Equivalents , 1991, Medical decision making : an international journal of the Society for Medical Decision Making.

[51]  J. Neumann,et al.  Theory of Games and Economic Behavior. , 1945 .

[52]  B. Littenberg,et al.  Assessing the preferences of patients with psoriasis. A quantitative, utility approach. , 1995, Archives of dermatology.

[53]  L. Lenert,et al.  Incorporating Risk Attitude into Markov-process Decision Models: , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[54]  A. Gafni,et al.  Preferences for outcomes in economic evaluation: an economic approach to addressing economic problems. , 1995, Social science & medicine.

[55]  E. Nord.  The trade-off between severity of illness and treatment effect in cost-value analysis of health care. , 1993, Health policy.

[56]  R. Tibshirani,et al.  The Measurement of Patients' Values in Medicine , 1982, Medical decision making : an international journal of the Society for Medical Decision Making.

[57]  N F Boyd,et al.  Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences. , 1987, Journal of chronic diseases.

[58]  P. Schoemaker.  The Expected Utility Model: Its Variants, Purposes, Evidence and Limitations , 1982 .

[59]  G W Torrance,et al.  A utility maximization model for evaluation of health care programs. , 1972, Health services research.

[60]  G. Torrance,et al.  The utility of different health states as perceived by the general public. , 1978, Journal of chronic diseases.

[61]  M Johannesson,et al.  An Experimental Test of a Theoretical Foundation for Rating-scale Valuations , 1997, Medical decision making : an international journal of the Society for Medical Decision Making.

[62]  W M O'Fallon,et al.  A cost-utility analysis of misoprostol prophylaxis for rheumatoid arthritis patients receiving nonsteroidal antiinflammatory drugs. , 1994, Arthritis and rheumatism.

[63]  S. S. Stevens.  Issues in psychophysical measurement. , 1971 .

[64]  S G Pauker,et al.  Screening for prostate cancer. A decision analytic view. , 1994, JAMA.

[65]  P. Dolan,et al.  Time preference, duration and health state valuations. , 1995, Health economics.

[66]  P. Glasziou,et al.  Quality of life six months after myocardial infarction treated with thrombolytic therapy , 1994, The Medical journal of Australia.

[67]  M. Rabin.  Psychology and Economics , 1997 .

[68]  P. Dolan,et al.  Valuing health status using VAS and TTO: what lies behind the numbers? , 1997, Social science & medicine.

[69]  P. Kind,et al.  A scale of valuations of states of illness: is there a social consensus? , 1978, International journal of epidemiology.

[70]  R. Rosser,et al.  Impact of diagnosis on utilities assigned to states of illness. , 1993, Journal of the Royal Society of Medicine.

[71]  Rakesh K. Sarin,et al.  RELATIVE RISK AVERSION. , 1982 .

[72]  S. Fihn,et al.  Symptom Severity and Patients' Values in the Decision to Perform a Transurethral Resection of the Prostate , 1988, Medical decision making : an international journal of the Society for Medical Decision Making.

[73]  J. Bosch,et al.  The Relationship between Descriptive and Valuational Quality-of-life Measures in Patients with Intermittent Claudication , 1996, Medical decision making : an international journal of the Society for Medical Decision Making.

[74]  D A Revicki,et al.  Relationship between health utility and psychometric health status measures. , 1992, Medical care.