Feasibility, comparability, and reliability of the standard gamble compared with the rating scale and time trade-off techniques in Korean population

Abstract

The standard gamble (SG) method is the gold standard for valuing health states as a utility, although it is accepted that it is difficult to valuate health states. This study was conducted in order to compare the SG with the rating scale (RS) and time trade-off (TTO) techniques in terms of their feasibility, comparability, and reliability in a valuation survey of the general Korean population. Five-hundred members of the general Korean population were recruited using a multi-stage quota sampling method in Seoul and its surrounding areas, Korea. Respondents evaluated 9 EQ-5D-5L health states using a visual analogue scale (VAS), SG, and TTO during a personal interview. Feasibility was assessed in aspects of the level of difficulty, administration time, and inconsistent responses. Comparability was evaluated using intraclass correlation coefficient (ICC) and the Bland-Altman approach. Test-retest reliability was analyzed using the ICC. Of the three methods, VAS was the easiest and quickest method to respond. The SG method did not differ significantly compared to the TTO method in administration time as well as the level of difficulty. The SG and TTO values were highly correlated (r=0.992), and the average mean difference between the SG and the TTO values was 0.034. The ICCs of the VAS, SG, and TTO scores were 0.906, 0.841, and 0.827, respectively. This study suggests that the SG method compared with the VAS and TTO method was feasible and offered a reliable tool for population-based, health state valuation studies in Korea.