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Exploring challenges to TTO utilities: valuing states worse than dead

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  • Angela Robinson
  • Anne Spencer

Abstract

The conventional time trade off (TTO) method relies on fundamentally different procedures to assess states better than and worse than dead. Arbitrary transformation mechanisms are then applied to worse than dead scores in order to achieve symmetry with those rated as better than dead. We use a ‘life profile’ approach along with a ranking procedure in order to show how states rated worse than dead may be assessed in exactly the same manner as better than dead scores. We then explore a common issue associated with states worse than dead that has received some attention recently: maximal endurable time. Our results showed that, although the severe health state was commonly rated as worse than dead, there were relatively few respondents that exhibited MET preferences. We discuss the implications of our findings for the use of the TTO method in deriving values for states that are worse than dead. Copyright © 2005 John Wiley & Sons, Ltd.

Suggested Citation

  • Angela Robinson & Anne Spencer, 2006. "Exploring challenges to TTO utilities: valuing states worse than dead," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 393-402, April.
  • Handle: RePEc:wly:hlthec:v:15:y:2006:i:4:p:393-402
    DOI: 10.1002/hec.1069
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    File URL: https://doi.org/10.1002/hec.1069
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    References listed on IDEAS

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    1. Dolan, Paul & Stalmeier, Peep, 2003. "The validity of time trade-off values in calculating QALYs: constant proportional time trade-off versus the proportional heuristic," Journal of Health Economics, Elsevier, vol. 22(3), pages 445-458, May.
    2. Robinson, Angela & Dolan, Paul & Williams, Alan, 1997. "Valuing health status using VAS and TTO: What lies behind the numbers?," Social Science & Medicine, Elsevier, vol. 45(8), pages 1289-1297, October.
    3. George Loewenstein & Drazen Prelec, 1992. "Anomalies in Intertemporal Choice: Evidence and an Interpretation," The Quarterly Journal of Economics, Oxford University Press, vol. 107(2), pages 573-597.
    4. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
    5. Hall, Jane & Gerard, Karen & Salkeld, Glenn & Richardson, Jeff, 1992. "A cost utility analysis of mammography screening in Australia," Social Science & Medicine, Elsevier, vol. 34(9), pages 993-1004, May.
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