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Sensitivity and perspective in the valuation of health status: whose values count?

  • G. Ardine De Wit
  • Jan J.V. Busschbach

    (Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Netherlands)

  • Frank Th. De Charro

    (Center for Health Policy and Law, Erasmus University, Rotterdam, Netherlands)

Registered author(s):

    The literature was studied on the existence of differences in valuation for hypothetical and actual health states between patients and other-rater groups. It was found that nine different study designs have been used to study this question and two of these designs were applied in a study involving dialysis patients and other rater groups. In the first study, both dialysis patients and students had to value hypothetical health states with Standard Gamble (SG) and Time Trade Off (TTO). Patients assigned higher values to hypothetical health states than students did. In the second study, dialysis patients who were being treated with four different dialysis modalities were asked to value their own health state with SG, TTO and a visual analogue scale (EQ VAS ), and to describe their health state on the EQ-5D profile . Several EQ-5D index values (health index values derived from general population samples) were calculated for the four dialysis treatment groups, based on the EQ-5D profile . These health indexes could discriminate between treatment groups, according to clinical impressions. Treatment groups could not be differentiated based on patients' valuations of own health state. The results suggest that general population samples, using EQ-5D index values, may be more able to discriminate between patient groups than the patients themselves are. The implications of this finding for valuation research and policy-making are discussed. Copyright © 2000 John Wiley & Sons, Ltd.

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    Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

    Volume (Year): 9 (2000)
    Issue (Month): 2 ()
    Pages: 109-126

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    Handle: RePEc:wly:hlthec:v:9:y:2000:i:2:p:109-126
    Contact details of provider: Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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    1. John C. Hershey & Howard C. Kunreuther & Paul J. H. Schoemaker, 1982. "Sources of Bias in Assessment Procedures for Utility Functions," Management Science, INFORMS, vol. 28(8), pages 936-954, August.
    2. Busschbach, Jan J. V. & McDonnell, Joseph & Essink-Bot, Marie-Louise & van Hout, Ben A., 1999. "Estimating parametric relationships between health description and health valuation with an application to the EuroQol EQ-5D," Journal of Health Economics, Elsevier, vol. 18(5), pages 551-570, October.
    3. Niklas Zethraeus & Magnus Johannesson, 1999. "A comparison of patient and social tariff values derived from the time trade-off method," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 541-545.
    4. Essink-Bot, Marie-Louise & Bonsel, Gouke J. & van der Maas, Paul J., 1990. "Valuation of health states by the general public: Feasibility of a standardized measurement procedure," Social Science & Medicine, Elsevier, vol. 31(11), pages 1201-1206, January.
    5. Hadorn, David C., 1991. "The role of public values in setting health care priorities," Social Science & Medicine, Elsevier, vol. 32(7), pages 773-781, January.
    6. Jenkinson, Crispin & Fitzpatrick, Ray & Argyle, Michael, 1988. "The Nottingham health profile: An analysis of its sensitivity in differentiating illness groups," Social Science & Medicine, Elsevier, vol. 27(12), pages 1411-1414, January.
    7. 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.
    8. Nord, Erik, 1992. "Methods for quality adjustment of life years," Social Science & Medicine, Elsevier, vol. 34(5), pages 559-569, March.
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