EuroQol Protocols for Time Trade-Off Valuation of Health Outcomes

Abstract

The time trade-off (TTO) valuation technique is widely used to determine utility values of health outcomes to inform quality-adjusted life-year (QALY) calculations for use in economic evaluation. Protocols for implementing TTO vary in aspects such as the trade-off framework, iteration procedure and its administration model and method, training of respondents and interviewers, and quality control of data collection. The most widely studied and utilized TTO valuation protocols are the Measurement and Valuation of Health (MVH) protocol, the Paris protocol and the EuroQol Valuation Technology (EQ-VT) protocol, all developed by members of the EuroQol Group. The MVH protocol and its successor, the Paris protocol, were developed for valuation of EQ-5D-3L health states. Both protocols were designed for a trained interviewer to elicit preferences from a respondent using the conventional TTO framework with a fixed time horizon of 10 years and an iteration procedure combining bisection and titration. Developed for valuation of EQ-5D-5L health states, the EQ-VT protocol adopted a composite TTO framework and made use of computer technology to facilitate data collection. Training and monitoring of interviewers and respondents is a pivotal component of the EQ-VT protocol. Research is underway aiming to further improve the EuroQol protocols, which form an important basis for the current practice of health technology assessment in many countries.

Transforming Latent Utilities to Health Utilities: East Does Not Meet West

“…The last module of the EQ-VT contains additional demographic questions. Details on the EQ-VT are described elsewhere Oppe et al, 2016;Xie et al, 2015).…”

Estimating an EQ-5D-5L Value Set for China

“…The TTO tasks used a "composite" TTO technique whereby "better than dead" and "worse than dead" health states were valued by conventional TTO and lead-time TTO, respectively [14,15]. The composite TTO was described in detail elsewhere [14,16]. Briefly, for an impaired health state considered better than dead, the task is to elicit the x (0-10) value at which a respondent is indifferent between two alternatives: 1) living in full health for x years followed by death and 2) living in the impaired health state for 10 years followed by death.…”

Fairness in cost-benefit analysis: A methodology for health technology assessment

“…From a broader perspective, all stated preferences studies may be subject to hypothetical bias (see, e.g., Jacquemet, Joule, Luchini, & Shogren, 2011). The methodological issues with evaluating (the value of) QALY's and with evaluating equivalent incomes are very similar (see, e.g., Oppe, Rand-Hendriksen, Shah, Romaos-Gonni, & Luo, 2016;Bleichrodt and Johannesson, 1997). Improving the estimation of individual preferences should be one of the first priorities on the research agenda.…”