The impact of adding an extra dimension to a preference-based measure
The ability to compare incremental changes in Quality Adjusted Life Years (QALYs) generated by different condition-specific preference-based measures (CSPBMs), or indeed between generic measures, is often criticised even where the valuation methods and source of values are the same. A key concern is the impact of excluding key dimensions from a descriptive system. This study examines the impact of adding a generic pain/discomfort dimension to a CSPBM, the AQL-5D (an asthma-specific CSPBM), by valuing samples of states from the AQL-5D with and without the new dimension using an interviewer administered time trade-off with a sample of the UK general public. 180 respondents provided 720 valuations for states with and without pain/discomfort. As expected the additional pain/discomfort dimension was found to have a significant and relatively large coefficient. More importantly for comparing changes in QALYs across populations the addition of pain/discomfort significantly impacts on the coefficients of the other dimensions and the degree of impact differs by dimension and severity level. The net effect on the utility value depends on the severity of their state: the addition of pain/discomfort at level 1 (no pain/discomfort) or 2 (moderate pain/discomfort) significantly increased the mean health state values in an asthma patient population; whereas level 3 pain/discomfort (extreme) reduced values. Comparability between measures requires that the impact of different dimensions on preferences is additive, whether or not they are included in the classification system. Our results cast doubt on this assumption, implying that the chosen measure must contain all important and relevant dimensions in its classification system.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 73 (2011)
Issue (Month): 2 (July)
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Julie Ratcliffe & John Brazier & Aki Tsuchiya & Tara Symonds & Martin Brown, 2009. "Using DCE and ranking data to estimate cardinal values for health states for deriving a preference-based single index from the sexual quality of life questionnaire," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1261-1276.
- Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
- Christopher McCabe & Katherine Stevens & Jennifer Roberts & John Brazier, 2005.
"Health state values for the HUI 2 descriptive system: results from a UK survey,"
John Wiley & Sons, Ltd., vol. 14(3), pages 231-244.
- McCabe, C & Stevens, K & Roberts, J & Brazier, JE, 2003. "Health state values for the HUI 2 descriptive system: results from a UK survey," MPRA Paper 29744, University Library of Munich, Germany.
- Claire Gudex, 1994. "Time trade-off user manual: props and self-completion methods," Working Papers 020cheop, Centre for Health Economics, University of York.
- Keeney,Ralph L. & Raiffa,Howard, 1993. "Decisions with Multiple Objectives," Cambridge Books, Cambridge University Press, number 9780521438834, December.
- Jack Dowie, 2002. "Decision validity should determine whether a generic or condition-specific HRQOL measure is used in health care decisions," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 1-8.
- Brazier, John & Ratcliffe, Julie & Salomon, Joshua A. & Tsuchiya, Aki, 2007. "Measuring and Valuing Health Benefits for Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198569824.
- John Brazier & Aki Tsuchiya, 2010. "Preference-based condition-specific measures of health: what happens to cross programme comparability?," Health Economics, John Wiley & Sons, Ltd., vol. 19(2), pages 125-129.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:73:y:2011:i:2:p:245-253. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.