Assessing the Performance of Utility Techniques in the Absence of a Gold Standard

Giesler, Reiner; Ashton, Carol M.; Brody, Baruch A.; Byrne, Margaret M.; Cook, Karon F.; Geraci, Jane M.; Hanita, Makoto; Souchek, Julianne; Wray, Nelda P.

doi:10.1097/00005650-199906000-00007

Cited by 48 publications

(29 citation statements)

References 25 publications

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“…This is in contrast to previous work on preferences elicitation methods such as time trade-off and standard gamble [50e52]. These studies found low levels of differentiation among scenarios and higher levels of inconsistency, from 10% for willingness to pay to 28% for time trade-off [50]. Conjoint methodology seems to minimize these problems.…”

Section: Discussioncontrasting

confidence: 73%

Racial/ethnic differences in preferences for total knee replacement surgery

Byrne

Souchek

Richardson

et al. 2006

Journal of Clinical Epidemiology

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Section: Discussioncontrasting

confidence: 73%

Racial/ethnic differences in preferences for total knee replacement surgery

Byrne

Souchek

Richardson

et al. 2006

Journal of Clinical Epidemiology

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“…The rating scale is simpler and more straightforward than other methods of eliciting health-related quality of life or health state preferences, such as the time tradeoff and standard gamble methods (21). Rating scales have been shown to outperform other utility measures in differentiating among alternative health states (22)(23)(24). Although ratings are not used as a measure under conditions of uncertainty, other investigators have reported them to be a reliable and consistent method for assessment of quality of life, noting that rating-scale values tend to be lower than those elicited by the standard gamble and other utility measures (25)(26)(27)(28)(29)(30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Impact of disease severity and gastrointestinal side effects on the health state preferences of patients with osteoarthritis

Chang¹,

Kauf²,

Mahajan³

et al. 2005

Arthritis & Rheumatism

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Objective. To describe the health state preferences of patients with osteoarthritis (OA) according to the level of pain and disability and the extent of gastrointestinal side effects from nonsteroidal antiinflammatory drugs (NSAIDs).Methods. Using combinations of 5 OA health states (4 specifying medication use) and 6 gastrointestinal side effect profiles, we developed 25 scenarios. In an Internet survey, adults with OA evaluated 5 randomly chosen health state-side effect scenarios (in addition to scenarios for congestive heart failure and wearing dentures, as benchmarks). They rated the scenarios on a 0-100 scale, in which 100 corresponds to best imaginable health. Unadjusted mean ratings were calculated using a difference-in-difference approach. A generalized linear model was used to estimate the effects of disease severity and side effect severity on the ratings, after controlling for patient characteristics.Results. A total of 4,386 respondents whose mean age was 55.3 years, of whom 3,107 (70.8%) were women and 4,007 (91.4%) were white, completed the survey. Mean adjusted ratings for health state-side effect scenarios ranged from 94.9 for the mildest scenario to 25.3 for the most severe scenario. Severity of NSAID side effects had a greater negative influence on the ratings in milder OA states than in more severe OA states. Ratings were lower among men (P < 0.001) and among respondents with OA pain in the previous 24 hours (P < 0.001). Disease severity had a greater effect on ratings than did side effect severity. Conclusion.Patients consider pain and functional limitations associated with OA to be important determinants of well-being. Future research should attempt to determine whether patients prefer reductions in their OA-related pain and disability over improvements in treatment side effect profiles.Arthritis and other rheumatic conditions are leading causes of disability in the US, affecting 1 of every 3 noninstitutionalized adults (1,2). The prevalence of osteoarthritis (OA), the most common form of arthritis, increases with age and is highest among persons ages Ͼ45 years (3). With the aging of the US population, the prevalence of OA is expected to increase substantially by 2030 (4).Pain from OA is commonly treated with nonsteroidal antiinflammatory drugs (NSAIDs), including cyclooxygenase 2 (COX-2) inhibitors. All NSAIDs are associated with side effects. Patients' ratings of OA health states and/or side effects from medications have not been reported widely in the literature, and few studies in any therapeutic area have examined the influence of treatment-related side effects on patients' assessments of health states or health utilities, a concept similar to health-related quality of life (5-8). Researchers generally have studied side effects as separate health states

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“…A measure such as this serves as a common denominator, allowing not only the impact of each strategy on multiple different health states to be incorporated into the outcome measure of the analysis, but also the comparison of this outcome with cost-effectiveness ratios for other medical (eg, beta-blocker use for myocardial infarction) and nonmedical (eg, seatbelt use) interventions (23). Because some medical interventions may not result in a change in life expectancy, but may alter the quality of life, other measures of effectiveness such as QALYs, allow both survival and quality of survival to be incorporated into a single outcome measure (24). Indeed, because of these advantages, QALYs are frequently used as a measure of health effectiveness in cost-effectiveness analyses (25).…”

Section: What Are the Inputs Into A Decision Analysis And Where Do Thmentioning

confidence: 99%