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Logical inconsistencies in survey respondents' health state valuations - a methodological challenge for estimating social tariffs


Author Info

  • Nancy J. Devlin

    (King's Fund, London, UK)

  • Paul Hansen

    (Department of Economics, University of Otago, New Zealand)

  • Paul Kind

    (Centre for Health Economics, University of York, UK)

  • Alan Williams

    (Centre for Health Economics, University of York, UK)


Logical inconsistencies in survey respondents' valuations of hypothetical health states - represented by the EQ-5D, for example - present a conundrum as to whether or not their responses ought to be included for estimating social 'tariffs'. A 'logical inconsistency' occurs when a state that 'in logical terms' is unambiguously less severe than another is assigned a lower value. Excluding such responses is defensible on data quality grounds but puts at risk the representativeness of the estimated tariff, given it is meant to represent the preferences of 'society'. This paper explores the rationale for and effect of excluding, to varying degrees, responses distinguished by the number of pairwise inconsistencies they contain, and reports equations for two tariffs that arise from contrasting approaches. The data are from a random sample of adult New Zealanders whose visual analogue scale valuations for a selection of EQ-5D states were collected in 1999 via a postal survey to which 1360 people responded (a 50% response rate). We conclude that there is no simple, generalisable 'rule' to guide exclusions and therefore researchers ought to explore the sensitivity of their estimated tariffs (and ultimately QALY estimates) to alternative treatments of logically inconsistent responses. Copyright © 2002 John Wiley & Sons, Ltd.

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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 12 (2003)
Issue (Month): 7 ()
Pages: 529-544

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Handle: RePEc:wly:hlthec:v:12:y:2003:i:7:p:529-544

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  1. Stefan Björk & Anna Norinder, 1999. "The weighting exercise for the Swedish version of the EuroQol," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 117-126.
  2. Claire Gudex & Paul Dolan, 1995. "Valuing health states: the effect of duration," Working Papers 143chedp, Centre for Health Economics, University of York.
  3. Badia, Xavier & Roset, Monserrat & Herdman, Michael, 1999. "Inconsistent responses in three preference-elicitation methods for health states," Social Science & Medicine, Elsevier, vol. 49(7), pages 943-950, October.
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Cited by:
  1. Parkin, D. & Devlin, N., 2004. "Is there a case for using Visual Analogue Scale valuations in Cost-Utility Analysis?," Working Papers 04/03, Department of Economics, City University London.
  2. Richard Norman & Paula Cronin & Rosalie Viney & Madeleine King & Deborah Street & John Brazier & Julie Ratcliffe, 2007. "Valuing EQ-5D health states: A review and analysis, CHERE Working Paper 2007/9," Working Papers 2007/9, CHERE, University of Technology, Sydney.
  3. Richard Edlin & Christopher McCabe & David Meads, 2013. "Assignment errors and the valuation of EQ-5D health states-do responses mean what we think they mean?," Working Papers 1304, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
  4. Versteegh, MM & Attema, AE & Oppe, M & Devlin, NJ & Stolk, EA, 2012. "Time to tweak the TTO. But how?," MPRA Paper 37989, University Library of Munich, Germany.
  5. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2012. "Using a discrete choice experiment to estimate health state utility values," Journal of Health Economics, Elsevier, vol. 31(1), pages 306-318.
  6. Bansback, Nick & Brazier, John & Tsuchiya, Aki & Anis, Aslam, 2010. "Using a discrete choice experiment to estimate societal health state utility values," MPRA Paper 29933, University Library of Munich, Germany.
  7. Irina Cleemput, 2010. "A social preference valuations set for EQ-5D health states in Flanders, Belgium," The European Journal of Health Economics, Springer, vol. 11(2), pages 205-213, April.
  8. Julie Chevalier & Gérard Pouvourville, 2013. "Valuing EQ-5D using Time Trade-Off in France," The European Journal of Health Economics, Springer, vol. 14(1), pages 57-66, February.


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