Assessment of the Time-tradeoff Val ues for Prophylactic Mastectomy of Women with a Suspected Genetic Predisposition to Breast Cancer

Unić, Ivana; Stalmeier, Peep F. M.; Verhoef, Lia C.G.; Daal, W.A.J. van

doi:10.1177/0272989x9801800303

Cited by 34 publications

(30 citation statements)

References 28 publications

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“…Instead, we used a choice task to better approximate the choice-based nature of economic practice. Our results suggest that loss aversion for short durations is far less important for choice tasks than matching tasks, in accordance with other studies [9, 23]. In particular, the shortest durations ( n β = 1,3,7) did not yield higher TTO scores than the other durations, suggesting that a choice based design causes subjects to put less emphasis on the maximization of remaining lifetime.…”

Section: Discussionsupporting

confidence: 91%

Constantly Proving The Opposite? A test of CPTO using a broad time horizon and correcting for discounting

Attema

Brouwer

2011

Qual Life Res

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PurposeAn important assumption underlying the quality-adjusted life year (QALY) model is that people trade off life years against health in the same proportion irrespective of the number of remaining life years. This is known as the constant proportional trade-offs (CPTO) condition. Previous studies have produced mixed empirical evidence about the validity of CPTO. This paper is the first to test CPTO using the time trade-off (TTO) method for a broad time horizon.MethodsIn a sample of 83 students, we use a choice based TTO protocol to elicit TTO scores for back pain, using ten different gauge durations ranging between 1 and 46 years. The TTO scores are corrected for discounting, which is elicited by means of the direct method.ResultsWe find average TTO scores varying between 0.72 and 0.81. Although the scores do not differ much for different durations in absolute terms, some differences are significant, rejecting CPTO, with and without correcting for discounting. No clear relationship between TTO scores and gauge duration is found. An anchoring and rounding heuristic to some extent explains our results.ConclusionsOur findings highlight the importance of elicitation methods and context dependencies in QALY measurement and warrant detailed investigation of their influence.

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Section: Discussionsupporting

confidence: 91%

Constantly Proving The Opposite? A test of CPTO using a broad time horizon and correcting for discounting

Attema

Brouwer

2011

Qual Life Res

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“…Secondly, disease experience seems to be of influence: patients are more willing than the general public or medical staff to accept toxic treatment (Slevin et al, 1990;Degner and Sloan, 1992;Brundage et al, 1997). Thirdly, various demographic variables such as age, living with others and having children may also have an impact on treatment preferences of patients (Kiebert et al, 1994;Unic et al, 1998).…”

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confidence: 99%

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

et al. 2003

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In palliative cancer treatment, the choice between palliative chemotherapy and best supportive care may be difficult. In the decisionmaking process, giving information as well as patients' values and preferences become important issues. Patients, however, may have a treatment preference before they even meet their medical oncologist. An insight into the patient's decision-making process can support clinicians having to inform their patients. Patients (n ¼ 207) with metastatic cancer, aged 18 years or older, able to speak Dutch, for whom palliative chemotherapy was a treatment option, were eligible for the study. We assessed the following before they consulted their medical oncologist: (1) socio-demographic characteristics, (2) disease-related variables, (3) quality-of-life indices, (4) attitudes and (5) preferences for treatment, information and participation in decision-making. The actual treatment decision, assessed after it had been made, was the main study outcome. Of 207 eligible patients, 140 patients (68%) participated in the study. At baseline, 68% preferred to undergo chemotherapy rather than wait watchfully. Eventually, 78% chose chemotherapy. Treatment preference (odds ratio (OR) ¼ 10.3, confidence interval (CI) 2.8 -38.0) and a deferring style of decision-making (OR ¼ 4.9, CI 1.4 -17.2) best predicted the actual treatment choice. Treatment preference (total explained variance ¼ 38.2%) was predicted, in turn, by patients' striving for length of life (29.5%), less striving for quality of life (6.1%) and experienced control over the cause of disease (2.6%). Patients' actual treatment choice was most strongly predicted by their preconsultation treatment preference. Since treatment preference is positively explained by striving for length of life, and negatively by striving for quality of life, it is questionable whether the purpose of palliative treatment is made clear. This, paradoxically, emphasises the need for further attention to the process of information giving and shared decision-making.

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“…Most studies (implicitly) assumed no discounting. Of these, the majority found a violation of CPTO (Buckingham et al, 1996;Dolan and Stalmeier, 2003;Sackett and Torrance, 1978;Stalmeier et al, 1997Stalmeier et al, , 2001Stiggelbout et al, 1995;Unic et al, 1998), but some others did not find a violation (Bleichrodt and Johannesson, 1997;Cook et al, 1994;Hall et al, 1992). Stalmeier et al (1997Stalmeier et al ( , 2001 attributed the violation of CPTO in their experiments to MET combined with a proportional heuristic; i.e., subjects regard some poor health states as BTD for some time but WTD afterwards, whereas when responding to a TTO task they simply double their answer when the time horizon has been doubled.…”

Section: Related Literaturementioning

confidence: 99%

A test of independence of discounting from quality of life

Attema

Brouwer

2012

Journal of Health Economics

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Assessment of the Time-tradeoff Val ues for Prophylactic Mastectomy of Women with a Suspected Genetic Predisposition to Breast Cancer

Abstract: Assessment of individual preferences by the TTO in this patient group is feasible and reliable. Therefore, the TTO can be used in clinical settings to elicit treatment preferences of women proven or suspected to have a genetic predisposition to breast cancer.

Cited by 34 publications

References 28 publications

Constantly Proving The Opposite? A test of CPTO using a broad time horizon and correcting for discounting

Constantly Proving The Opposite? A test of CPTO using a broad time horizon and correcting for discounting

Palliative chemotherapy or best supportive care? A prospective study explaining patients' treatment preference and choice

A test of independence of discounting from quality of life

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