Abstract
BackgroundStandard methods for eliciting the preference data upon which ‘value sets’ are based generally have in common an aim to ‘uncover’ people’s preferences by asking them to evaluate a subset of health states, then using their responses to infer their preferences over all dimensions and levels. An alternative approach is to ask people directly about the relative importance to them of the dimensions, levels and interactions between them. This paper describes a new stated preference approach for directly eliciting personal utility functions (PUFs), and reports a pilot study to test its feasibility for valuing the EQ-5D.MethodsA questionnaire was developed, designed to directly elicit PUFs from general public respondents via computer-assisted personal interviews, with a focus on helping respondents to reflect and deliberate on their preferences. The questionnaire was piloted in England.ResultsSeventy-six interviews were conducted in December 2015. Overall, pain/discomfort and mobility were found to be the most important of the EQ-5D dimensions. The ratings for intermediate improvements in each dimension show heterogeneity, both within and between respondents. Almost a quarter of respondents indicated that no EQ-5D health states are worse than dead.DiscussionThe PUF approach appears to be feasible, and has the potential to yield meaningful, well-informed preference data from respondents that can be aggregated to yield a value set for the EQ-5D. A deliberative approach to health state valuation also has the potential to complement and develop existing valuation methods. Further refinement of some elements of the approach is required.
Highlights
IntroductionThe end product of stated preference valuation studies for patient-reported outcome (PRO) instruments is a value set (calculated via an algorithm) describing, on average for a given population, the utility decrements associated with varying levels of problems on each item (that is, each dimension, domain or attribute of health investigated) and, potentially, interaction effects between them
BackgroundThe end product of stated preference valuation studies for patient-reported outcome (PRO) instruments is a value set describing, on average for a given population, the utility decrements associated with varying levels of problems on each item and, potentially, interaction effects between them
The aim of this paper is to describe this approach for directly eliciting personal utility functions (PUFs), and to report the methods and findings of a pilot study to test its feasibility and acceptability for valuing a widely used generic PRO, the EQ-5D [8]
Summary
The end product of stated preference valuation studies for patient-reported outcome (PRO) instruments is a value set (calculated via an algorithm) describing, on average for a given population, the utility decrements associated with varying levels of problems on each item (that is, each dimension, domain or attribute of health investigated) and, potentially, interaction effects between them. This generates a ‘value set’: every possible health state that can be described by the items and response options available in the PRO can be summarised by a number
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