IDEAS home Printed from https://ideas.repec.org/p/cty/dpaper/04-03.html
   My bibliography  Save this paper

Is there a case for using Visual Analogue Scale valuations in Cost-Utility Analysis?

Author

Abstract

This paper critically reviews theoretical and empirical propositions regarding visual analogue scale (VAS) valuations of health states and their use in Cost Utility Analysis. An oft-repeated conclusion in the economic evaluation literature is the inferiority, on theoretical grounds, of VAS valuations. Common criticisms are that VAS lacks a theoretical foundation; that VAS values are not ‘choice based’; that VAS values are not consistent with utility-under-uncertainty requirements; and that context and range effects observed in VAS valuation data mean that they cannot even be considered to represent measurable value functions.We address each of the above points, critically reviewing the economic and psychometric literature relating to theories of utility and theories of utility measurement, and the welfarist and non-welfarist literature relating to social choices and QALYs.We conclude that there are strong grounds, both theoretical and empirical, for challenging the apparently emerging consensus that VAS valuations should not be used in economic assessments. The theoretical appeal of alternatives such as the standard gamble is valid only at the level of individuals, rather than social decision-making. Further, the non-welfarist foundations of CUA do not require health state valuations to be grounded in any particular theory of utility, suggesting that the selection of the appropriate valuation method should be based on empirical performance. The VAS has important advantages over rival techniques such as standard gamble and time trade-off. However, we identify a number of areas in which further research is required to establish and consolidate the potential of VAS as a valuation method.

Suggested Citation

  • Parkin, D. & Devlin, N., 2004. "Is there a case for using Visual Analogue Scale valuations in Cost-Utility Analysis?," Working Papers 04/03, Department of Economics, City University London.
  • Handle: RePEc:cty:dpaper:04/03
    as

    Download full text from publisher

    File URL: https://openaccess.city.ac.uk/id/eprint/1428/1/0403_parkin-devlin.pdf
    Download Restriction: no

    Other versions of this item:

    References listed on IDEAS

    as
    1. Parkin, David & Rice, Nigel & Jacoby, Ann & Doughty, Julie, 2004. "Use of a visual analogue scale in a daily patient diary: modelling cross-sectional time-series data on health-related quality of life," Social Science & Medicine, Elsevier, vol. 59(2), pages 351-360, July.
    2. James S. Dyer & Rakesh K. Sarin, 1982. "Relative Risk Aversion," Management Science, INFORMS, vol. 28(8), pages 875-886, August.
    3. Kahneman, Daniel & Tversky, Amos, 1979. "Prospect Theory: An Analysis of Decision under Risk," Econometrica, Econometric Society, vol. 47(2), pages 263-291, March.
    4. Rachel Baker & Angela Robinson, 2004. "Responses to standard gambles: are preferences ‘well constructed’?," Health Economics, John Wiley & Sons, Ltd., vol. 13(1), pages 37-48, January.
    5. Buckingham, K. & Devlin, N. & Tabberer, M., 2004. "A theoretical framework for TTO valuations and a taxonomy of TTO approaches: results from a pilot study," Working Papers 04/07, Department of Economics, City University London.
    6. Nancy J. Devlin & Paul Hansen & Paul Kind & Alan Williams, 2003. "Logical inconsistencies in survey respondents' health state valuations ‐ a methodological challenge for estimating social tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 529-544, July.
    7. Loomes, Graham & Sugden, Robert, 1982. "Regret Theory: An Alternative Theory of Rational Choice under Uncertainty," Economic Journal, Royal Economic Society, vol. 92(368), pages 805-824, December.
    8. Culyer, A J, 1989. "The Normative Economics of Health Care Finance and Provision," Oxford Review of Economic Policy, Oxford University Press, vol. 5(1), pages 34-58, Spring.
    9. Nancy Devlin & Paul Hansen & Peter Herbison & Susan Macran, 2005. "A ‘new and improved’ EQ-5D valuation questionnaire?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 73-82, March.
    10. N J Devlin & P Hansen & P Kind & A H Williams, 2000. "The health state preferences and logistical inconsistencies of New Zealanders: a tale of two tariffs," Working Papers 180chedp, Centre for Health Economics, University of York.
    11. Nord, Erik, 1993. "The trade-off between severity of illness and treatment effect in cost-value analysis of health care," Health Policy, Elsevier, vol. 24(3), pages 227-238, August.
    12. 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.
    13. Stefan Björk & Anna Norinder, 1999. "The weighting exercise for the Swedish version of the EuroQol," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 117-126, March.
    14. Sen, Amartya K, 1977. "Social Choice Theory: A Re-examination," Econometrica, Econometric Society, vol. 45(1), pages 53-89, January.
    15. Richardson, J., 1994. "Cost utility analysis: What should be measured?," Social Science & Medicine, Elsevier, vol. 39(1), pages 7-21, July.
    16. Schoemaker, Paul J H, 1982. "The Expected Utility Model: Its Variants, Purposes, Evidence and Limitations," Journal of Economic Literature, American Economic Association, vol. 20(2), pages 529-563, June.
    Full references (including those not matched with items on IDEAS)

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:cty:dpaper:04/03. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Research Publications Librarian). General contact details of provider: http://edirc.repec.org/data/decituk.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.