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Invariance and Inconsistency in Utility Ratings

Author

Listed:
  • Dena M. Bravata

    (Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, dbravata@stanford.edu)

  • Lorene M. Nelson

    (Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California)

  • Alan M. Garber

    (Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, VA Palo Alto Healthcare System, Palo Alto, California)

  • Mary K. Goldstein

    (Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, VA Palo Alto Healthcare System, Palo Alto, California, Division of Health Services Research, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California)

Abstract

Purpose . To assess utilities of composite health states for dependence in activities of daily living (ADLs) for invariance ( i.e., when subjects provide a utility of 1 for all health states) and order inconsistency ( i.e., when subjects order their utilities such that their utility for a combination of ADL dependencies is greater than their utility for any subset of the combination). Methods . Each of the 400 subjects, age 65 y and older, enrolled in one of several regional medical centers of the Kaiser Permanente Medical Care Program of Northern California and provided standard-gamble utilities for single ADL dependencies (e.g., bathing, dressing, continence) and for dependence in 8 other combinations of ADL dependencies. For order-inconsistent responses, the authors calculated the maximum magnitude of inconsistency as the maximum difference between the utility for the combined ADL dependence health state and that of its inconsistent subset. Results . A total of 76 subjects (19%) gave a utility of 1.0 for all health states presented to them; 19 (5%) gave the same utility other than 1.0 for all health states; 130 (33%) gave at least 1 utility

Suggested Citation

  • Dena M. Bravata & Lorene M. Nelson & Alan M. Garber & Mary K. Goldstein, 2005. "Invariance and Inconsistency in Utility Ratings," Medical Decision Making, , vol. 25(2), pages 158-167, March.
    • Handle: RePEc:sae:medema:v:25:y:2005:i:2:p:158-167
    DOI: 10.1177/0272989X05275399
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    References listed on IDEAS

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    1. 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.
    2. Keeney,Ralph L. & Raiffa,Howard, 1993. "Decisions with Multiple Objectives," Cambridge Books, Cambridge University Press, number 9780521438834.
    3. Dolan, P. & Gudex, C. & Kind, P. & Williams, A., 1996. "Valuing health states: A comparison of methods," Journal of Health Economics, Elsevier, vol. 15(2), pages 209-231, April.
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    Cited by:

    1. Eva Rodríguez Míguez & José María Abellán Perpiñán & José Carlos Álvarez Villamarín & José Manuel González Martínez & Antonio Rodríguez Sampayo, 2013. "Development of a new preference-based instrument to measure dependency," Working Papers 1301, Universidade de Vigo, Departamento de Economía Aplicada.
    2. Eve Wittenberg & Lisa Prosser, 2011. "Ordering errors, objections and invariance in utility survey responses," Applied Health Economics and Health Policy, Springer, vol. 9(4), pages 225-241, July.
    3. Rodríguez-Míguez, E. & Abellán-Perpiñán, J.M. & Alvarez, X.C. & González, X.M. & Sampayo, A.R., 2016. "The DEP-6D, a new preference-based measure to assess health states of dependency," Social Science & Medicine, Elsevier, vol. 153(C), pages 210-219.

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