Elicitation of Informed General Population Health State Utility Values: A Review of the Literature

Abstract

Objective Within a health-care decision-making context, whose health state utility values (HSUVs) should be used is constantly debated. This discussion is important because patient and general population utilities can differ. These discrepancies may be due to the general population not being informed about the health states. This article investigates approaches used to inform the general population about the health states that they are valuing. Methods Studies reporting methods to obtain informed general population HSUVs were identified, outlined, and critically appraised. Results Fourteen studies were identified: seven used information sessions, two used simulation methods, two used reflection and deliberation techniques, and three used adaptation exercises. Conclusions This review demonstrated a range of approaches to elicit informed general population HSUVs. The majority of the studies indicated that informing the respondents significantly affected their opinions of the health states and hence their HSUVs. This suggests that the utilities that are currently used to guide health-care resource allocation decisions may not represent the general population's preferences for specific health states. This could result in decisions that do not maximize societal health benefits.