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Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation

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Listed:
  • Ole Marten

    (School of Public Health, Bielefeld University, Bielefeld, Germany)

  • Brendan Mulhern

    (Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia)

  • Nick Bansback

    (School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada)

  • Aki Tsuchiya

    (School of Health and Related Research, University of Sheffield, Sheffield, UK)

Abstract

The EQ-5D is made up of health state dimensions and levels, in which some combinations seem less “plausible†than others. If “implausible†states are used in health state valuation exercises, then respondents may have difficulty imagining them, causing measurement error. There is currently no standard solution: some valuation studies exclude such states, whereas others leave them in. This study aims to address 2 gaps in the literature: 1) to propose an evidence-based set of the least prevalent two-way combinations of EQ-5D-5L dimension levels and 2) to quantify the impact of removing perceived implausible states from valuation designs. For the first aim, we use data from 2 waves of the English General Practitioner Patient Survey ( n = 1,639,453). For the second aim, we remodel a secondary data set of a Discrete Choice Experiment (DCE) with duration that valued EQ-5D-5L and compare across models that drop observations involving different health states: 1) implausible states as defined in the literature, 2) the least prevalent states identified in stage 1, and 3) randomly select states, alongside 4) a model that does not drop any observations. The results indicate that two-way combinations previously thought to be implausible actually exist among the general population; there are other combinations that are rarer, and removing implausible states from an experimental design of a DCE with duration leads to value sets with potentially different characteristics depending on the criterion of implausible states. We advise against the routine removal of implausible states from health state valuation studies.

Suggested Citation

  • Ole Marten & Brendan Mulhern & Nick Bansback & Aki Tsuchiya, 2020. "Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation," Medical Decision Making, , vol. 40(6), pages 735-745, August.
  • Handle: RePEc:sae:medema:v:40:y:2020:i:6:p:735-745
    DOI: 10.1177/0272989X20940673
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    References listed on IDEAS

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