The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature

Tsuchiya, Aki; Dolan, Paul

doi:10.1177/0272989x05276854

Cited by 86 publications

(58 citation statements)

References 36 publications

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“…These attempt to circumvent the problem of a lack of observable behaviour from which to derive judgements of utility by asking individuals about decisions they would make in hypothetical situations. These have similarly been used in cost-benefit analyses (see Fujiwara and Campbell 2011) and underpin programmes such as the 'natural capital' approach to valuing 'ecosystems services' (see, for example, de Groot, Brander, van der Ploeg, et al 2012) and the Quality Adjusted Life Years approach to valuing healthcare interventions (see Tsuchiya and Dolan 2005). These move preference-based approaches from the economic to the social domain, showing their potential as ways of expressing non-monetary value.…”

Section: Preference-based Approachesmentioning

confidence: 99%

Official statistic-making as a social practice: the UK 'Measuring National Well-being' programme

Jenkins¹

2018

Preprint

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The thesis examines the construction of official statistics using the qualitative case study of the UK Office for National Statistics' 'Measuring National Well-being' programme. Its major original contribution is to critically engage with the making of official statistics, theorising their construction as a social process. This provides novel ways of explaining the form and content of official statistics. It also furthers debates on 'wellbeing' through an examination of the concept's theoretical and institutional history.The research argues that official statistic-making is an activity conducted by actors with agency. This agency is not taken into account by existing accounts of the nature of official statistics, which are more abstract and which do not engage with the statisticmaking process. It is argued that attention to the social processes of official statisticmaking make a fuller understanding of the form and content of statistics possible. This argument is supported by an examination of the 'Measuring National Well-being' programme. The institutional and theoretical context for this programme presents a number of challenges to existing accounts, highlighting the need for agential action. This context is explored through semi-structured interviews with those involved in the creation of the programme, triangulated against secondary material such as meeting minutes produced by the Office for National Statistics and published statistical outputs.In the specific case of the 'Measuring National Well-being' programme, the research finds a high degree of autonomy for those constructing the programme. This freedom was used to position the programme within wider European and international statistical contexts, rather than domestic political ones. Despite being a programme in a new area of social research, the final content of the programme fitted within established ways of thinking partly as a result of path dependency created by the statisticians' preestablished ways of working.More generally, it is argued that approaching the construction of official statistics as a social process helps explain the form and content of the statistic. The research demonstrates that it is possible to trace linkages between the features of the final statistic and social interactions which gave rise to them. It is argued that this is applicable beyond the case study used and beyond statistic-making in the UK.i

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Section: Preference-based Approachesmentioning

confidence: 99%

Official statistic-making as a social practice: the UK 'Measuring National Well-being' programme

Jenkins¹

2018

Preprint

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“…In order to compute YLD, the GBD disability weights are then applied using the standard QALY/DALY model (SQM). The SQM assumes independence between duration and disability and it requires that the health state remains fixed over time [5][6][7]. For health states with dynamic and/ or complex patterns this assumption is untenable, since these health states in fact have to be separated into numerous parts.…”

Section: Introductionmentioning

confidence: 99%

Alternative approaches to derive disability weights in injuries: do they make a difference?

et al. 2009

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Background In burden of disease studies, several approaches are used to assess disability weights, a scaling factor necessary to compute years lived with disability (YLD). The aim of this study was to quantify disability weights for injury consequences with two competing approaches, (a) standard QALY/DALY model (SQM) which derives disability weights from patient survey data and (b) the annual profile model (APM) which derives weights for the same patient data valued by a panel. Methods Disability weights were assessed using (a) EQ-5D data from a postal survey among 8,564 injury patients 2, 5, and 9 months after attending the Emergency Department, and (b) preferences of 143 laymen elicited with the time trade-off method. Results Compared with APM, SQM disability weights were consistently higher. YLD calculated with SQM disability weights was more than three times higher compared with YLD calculated with APM disability weights, for mild injuries with short duration, this increase was six fold. Conclusions The APM seems the preferred method in burden of injury studies that includes mild conditions with a rapid course, since the SQM approach might overestimate the impact of the latter. The APM, however, might underestimate the impact of injury consequences, especially in case of severe injuries.

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“…Specifically, we show what the indifference curves for health and time would be like if the basic requirements of TTO valuations were to hold. We then consider the indifference curves suggested by a number of circumstances where these requirements will not hold, including -in the simplest case -the possibility of diminishing marginal utility in states of poor health and (more fundamentally) the existence of maximum endurable time (MET) (Sutherland et al, 1982;Dolan and Stalmeier, 2003;Tsuchiya and Dolan, 2005) and states worse than being dead (SWD) (Patrick et al, 1994;Macran and Kind P, 2001;Robinson and Spencer 2006).…”

Section: Introductionmentioning

confidence: 99%

A note on the nature of utility in time and health and implications for cost utility analysis

Buckingham

Devlin

2009

Social Science & Medicine

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SummaryTime Trade-Off valuations of health are widely used in economic evaluation of health care. Current approaches to eliciting TTO values, and their use in economic evaluation, rests on specific assumptions about the way utility relates to time and health. Both the assumptions themselves and evidence of violations of them are discussed in the literature -yet the issues appear not to be widely appreciated by those using and applying TTO. This paper adds to that literature by demonstrating both the requirements of TTO and violations of these assumptions in terms of the underlying indifference curve maps and utility functions. The advantage of this approach is that is demonstrates very clearly a number of fundamental problems for the way TTO values are currently elicited and used in Cost Utility Analysis. In essence, it is extremely unwise to assume that the current 'tariffs' of TTO values, such as those routinely used by NICE and other organisations, can be applied irrespective of the duration of the health states to which they are assigned. The estimates of QALYs that result will, quite often, simply be wrong. We suggest a number of solutions, including the provision of multiple value sets, for a range of durations. 3A note on the nature of utility in time and health and implications for cost utility analysis

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The QALY Model and Individual Preferences for Health States and Health Profiles over Time: A Systematic Review of the Literature

Cited by 86 publications

References 36 publications

Official statistic-making as a social practice: the UK 'Measuring National Well-being' programme

Official statistic-making as a social practice: the UK 'Measuring National Well-being' programme

Alternative approaches to derive disability weights in injuries: do they make a difference?

A note on the nature of utility in time and health and implications for cost utility analysis

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