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Time to tweak the TTO. But how?


  • Versteegh, MM
  • Attema, AE
  • Oppe, M
  • Devlin, NJ
  • Stolk, EA


This paper examines the effect different specifications of the Time Tradeoff (TTO) task have on health state values. The new lead time TTO is compared to an equally viable method called lag time TTO, both in two time frames. We test whether the two methods yield comparable health state values and whether the relative importance of dimensions of health is similarly stable between TTO specifications. The tasks were applied online and compared to results from a study with identical TTO specifications but with a different mode of administration. Lag time TTO produced lower values than lead time TTO and the difference was larger in the longer time frame. The relative importance of different dimensions of health was affected by the duration of the health state. Generally, the lead time TTO performed in group sessions gave more favorable results than the online exercise based on feasibility and data quality.

Suggested Citation

  • Versteegh, MM & Attema, AE & Oppe, M & Devlin, NJ & Stolk, EA, 2012. "Time to tweak the TTO. But how?," MPRA Paper 37989, University Library of Munich, Germany.
  • Handle: RePEc:pra:mprapa:37989

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    References listed on IDEAS

    1. Arthur E. Attema & Matthijs M. Versteegh & Mark Oppe & Werner B. F. Brouwer & Elly A. Stolk, 2013. "Lead Time Tto: Leading To Better Health State Valuations?," Health Economics, John Wiley & Sons, Ltd., vol. 22(4), pages 376-392, April.
    2. Nancy Devlin & Ken Buckingham & Koonal Shah & Aki Tsuchiya & Carl Tilling & Grahame Wilkinson & Ben Hout, 2013. "A Comparison Of Alternative Variants Of The Lead And Lag Time Tto," Health Economics, John Wiley & Sons, Ltd., vol. 22(5), pages 517-532, May.
    3. Paul Dolan & Claire Gudex, 1995. "Time preference, duration and health state valuations," Health Economics, John Wiley & Sons, Ltd., vol. 4(4), pages 289-299, July.
    4. Nancy J. Devlin & Aki Tsuchiya & Ken Buckingham & Carl Tilling, 2011. "A uniform time trade off method for states better and worse than dead: feasibility study of the ‘lead time’ approach," Health Economics, John Wiley & Sons, Ltd., vol. 20(3), pages 348-361, March.
    5. 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.
    6. Brazier, John & Roberts, Jennifer & Deverill, Mark, 2002. "The estimation of a preference-based measure of health from the SF-36," Journal of Health Economics, Elsevier, vol. 21(2), pages 271-292, March.
    7. 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.
    8. L. M. Lamers & J. McDonnell & P. F. M. Stalmeier & P. F. M. Krabbe & J. J. V. Busschbach, 2006. "The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1121-1132.
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    More about this item


    Time tradeoff; lead time TTO; lag time TTO; EQ-5D;

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General

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