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“Naming and Framing†: The Impact of Labeling on Health State Values for Multiple Sclerosis


  • Colin Green
  • Elizabeth Goodwin
  • Annie Hawton


Introduction. Health state valuation is a key input in many economic evaluations that inform resource allocation across competing healthcare interventions. Empirical evidence has shown that, in preference elicitation surveys, respondents may value a health state differently if they are aware of the condition causing it (‘labeling effects’). This study investigates the impact of including a multiple sclerosis (MS) label for valuation of MS health states. Methods. Health state values for MS were elicited using two internet-based surveys in representative samples of the UK population ( n = 1702; n = 1788). In one survey respondents were not informed that health states were caused by MS. The second survey included a condition label for MS. Surveys were identical in all other ways. Health states were described using a MS-specific eight-dimensional classification system (MSIS-8D), and the time trade-off valuation technique was used. Differences between values for labeled and unlabeled states were assessed using descriptive statistics and multivariate regression methods. Results. Adding a MS condition label had a statistically significant effect on mean health state values, resulting in lower values for labeled MS states v. unlabeled states. The data suggest that the MS label had a more significant effect on values for less severe states, and no significant effect on values for the most severe states. The inclusion of the MS label had a differential impact across the dimensions of the MSIS-8D. Across the MSIS-8D, predicted values ranged from 0.079 to 0.883 for unlabeled states, and 0.066 to 0.861 for labeled states. Conclusion. Differences reported in health state values, using labeled and unlabeled states, demonstrate that condition labels affect the results of valuation studies, and can have important implications in decision-analytic modelling and in economic evaluations.

Suggested Citation

  • Colin Green & Elizabeth Goodwin & Annie Hawton, 2017. "“Naming and Framing†: The Impact of Labeling on Health State Values for Multiple Sclerosis," Medical Decision Making, , vol. 37(6), pages 703-714, August.
  • Handle: RePEc:sae:medema:v:37:y:2017:i:6:p:703-714
    DOI: 10.1177/0272989X17705637

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    References listed on IDEAS

    1. Brazier, John & Ratcliffe, Julie & Salomon, Joshua & Tsuchiya, Aki, 2016. "Measuring and Valuing Health Benefits for Economic Evaluation," OUP Catalogue, Oxford University Press, edition 2, number 9780198725923.
    2. Elizabeth Goodwin & Colin Green, 2016. "A Systematic Review of the Literature on the Development of Condition-Specific Preference-Based Measures of Health," Applied Health Economics and Health Policy, Springer, vol. 14(2), pages 161-183, April.
    3. 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, February.
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