Time trade-off with someone to live for: impact of having significant others on time trade-off valuations of hypothetical health states

Abstract Background The TTO task involves giving up life years, i.e. living a shorter life, to avoid an undesirable health state. Despite being a hypothetical task, some respondents take other life factors into account when completing the task. This study explored the effect of having children and/or a partner on TTO valuations of hypothetical EQ-5D-5L health states in a valuation study of the general population. Methods The study used TTO data collected in a Norwegian EQ-5D-5L valuation study in 2019–2020, by one-to-one pc-assisted interviews following the EQ-VT protocol. We used regression modelling to determine the effect of significant others (having children or a partner) on disutility per health state from the TTO valuations. Results 430 respondents were included [mean age 43.8 (SD 15.9) years, 58% female, 48% with children, 68% with a partner, 25% with neither children nor partner]. Having children and/or a partner was associated with lowered willingness to trade life years translating to higher elicited health state utilities (p < 0.01). Conclusion Having significant others, or the lack of having significant others, was associated with respondents’ valuation of hypothetical health states using TTO, more so than traditional sampling variables such as age and sex. Inadequate representativeness in terms of having significant others could bias health state preference values in valuation studies.

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Conducting a Time Trade-Off Study Alongside a Clinical Trial: A Case Study and Recommendations

PharmacoEconomics - Open ◽

10.1007/s41669-018-0084-1 ◽

2018 ◽

Vol 3 (1) ◽

pp. 5-20 ◽

Cited By ~ 2

Author(s):

Jing Shen ◽

Sarah Hill ◽

David Mott ◽

Matthew Breckons ◽

Luke Vale ◽

...

Keyword(s):

Clinical Trial ◽

Health State ◽

Health States ◽

Trade Off ◽

Life Years ◽

Related Quality ◽

Health Related ◽

Health State Utilities

Abstract Time trade-off (TTO) is an established method in health economics to elicit and value individuals’ preferences for different health states. These preferences are expressed in the form of health-state utilities that are typically used to measure health-related quality of life and calculate quality-adjusted life-years in an economic evaluation. The TTO approach to directly elicit health-state utilities is particularly valuable when generic instruments (e.g. EQ-5D) may not fully capture changes in utility in a clinical trial. However, there is limited guidance on how a TTO study should be conducted alongside a clinical trial despite it being a valuable tool. We present an account of the design and development of a TTO study within a clinical trial as a case study. We describe the development of materials needed for the TTO interviews, the piloting of the TTO materials and interview process, and recommendations for future TTO studies. This paper provides a practical guide and reference for future applications of the TTO method alongside a clinical trial.

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A Multinational Study of Health State Preference Values Associated with Chronic Myelogenous Leukemia

Value in Health ◽

10.1111/j.1524-4733.2009.00573.x ◽

2010 ◽

Vol 13 (1) ◽

pp. 103-111 ◽

Cited By ~ 20

Author(s):

Shelagh M. Szabo ◽

Adrian R. Levy ◽

Catherine Davis ◽

Tessa L. Holyoake ◽

Jorge Cortes

Keyword(s):

Chronic Myelogenous Leukemia ◽

Myelogenous Leukemia ◽

Health State ◽

Multinational Study ◽

Health State Preference ◽

State Preference ◽

Health State Preference Values

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Treatment of Early-Stage Breast Cancer in the Elderly

Medical Decision Making ◽

10.1177/0272989x9801800210 ◽

1998 ◽

Vol 18 (2) ◽

pp. 213-219 ◽

Cited By ~ 39

Author(s):

Kimbroe J. Carter ◽

Nathan P. Ritchey ◽

Frank Castro ◽

Leonard P. Caccamo ◽

Edward Kessler ◽

...

Keyword(s):

Health Care Professionals ◽

Transition Probabilities ◽

Early Stage ◽

Treatment Options ◽

The Elderly ◽

Health State ◽

Health States ◽

Life Years ◽

Simple Mastectomy ◽

Health State Utilities

Purpose. To evaluate the post-lumpectomy treatment of a nonpalpable, stage I, T1b tumor, mammographically detected, in a 74-year-old woman without comorbidities. Methods. A Markov process, through 120 monthly cycles, was used to model patient progression through a treatment program, employing literature data and a health-outcome utility. Treatments considered were: observation; radiation totaling 5,000 cGy over six weeks; tamoxifen, 20 mg/day, for five years; simple mastectomy; and radiation therapy plus tamoxifen. Health states included absence of disease (NED), loco-regional recurrence, distant metastasis, age-sex-race (ASR)-adjusted death, cancer mortality, treatment complications, and post-mastectomy death. Transition probabilities were established from the literature. Health-state utilities were determined from the responses of health care professionals to a basic reference gamble. Results. Quality-adjusted life years (QALYs) were determined to be 8.19 for radiation plus tamoxifen, decreasing to 8.04 for mastectomy, a difference of only a 0.15 years (1.8 months). Sensitivity analysis, however, showed relative stability in the ranking among treatment options. Conclusion. Although the model showed little difference between QALYs with the treatments, the combination of radiation and tamoxifen provides the optimal therapy for this case.

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EP1.06-04 Differences in Health State Preference Values for Malignant Pleural Mesothelioma and Glioblastoma Multiforme

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2019.08.2178 ◽

2019 ◽

Vol 14 (10) ◽

pp. S991

Author(s):

C. Proescholdt ◽

J. Kelly

Keyword(s):

Glioblastoma Multiforme ◽

Malignant Pleural Mesothelioma ◽

Pleural Mesothelioma ◽

Health State ◽

Health State Preference ◽

State Preference ◽

Health State Preference Values

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NCOG-36. FIRST HEALTH UTILITIES OF GLIOBLASTOMA PATIENTS USING TTFIELDS TREATMENT

Neuro-Oncology ◽

10.1093/neuonc/noaa215.574 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii137-ii137

Author(s):

Gordon Chavez ◽

Christina Proescholdt

Keyword(s):

Population Sample ◽

National Health System ◽

Medical Decision ◽

Economic Evaluations ◽

Health State ◽

High Quality ◽

Health States ◽

Tumor Treating Fields ◽

Health State Utilities ◽

The Uk

Abstract BACKGROUND Despite the importance of Health State Utilities for health policy and medical decision making, there are no publications that provide high quality utility values estimated from glioblastoma multiforme (GBM) patients. Published health economic evaluations for GBM treatments rely on utilities determined by Garside et al. (2007), which used the standard gamble method in healthy panel members of the UK National Health System. There are no published utilities for GBM estimated from a general population sample, and there are no utility estimates whatsoever for Tumor Treating Fields (TTFields) users. METHODS We designed a study to remedy this major deficit by eliciting utilities directly from GBM patients using the EuroQol 5-Dimension (EQ-5D) survey. The EQ-5D is a widely used and NICE-recommended tool for the estimation of health state utilities. The survey is composed of a questionnaire that asks patients to specify their health state along 5 dimensions: Mobility, Self-Care, Usual Activities, Pain/Discomfort, and Anxiety/Depression. Statistical models provided by EuroQol’s network of researchers convert this data into health state utility estimates. RESULTS The EQ-5D questionnaire is administered to active patients using TTFields treatment during the study duration, allowing the elicitation of health preference measures for different glioblastoma health states based on: progression status (progressed vs. non-progressed), current treatments (TTFields only vs. TTFields + others) and time-from-diagnosis (0-12 months vs. > 12 months) CONCLUSION These results are important for understanding the patient preferences using TTFields treatment and communicating these preferences to decision makers. This study is the first to provide direct, high quality utility measures in glioblastoma patients using TTFields treatment.

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Valuation of the EQ-5D-3L in Russia

Quality of Life Research ◽

10.1007/s11136-021-02804-6 ◽

2021 ◽

Author(s):

Vitaly Omelyanovskiy ◽

Nuriya Musina ◽

Svetlana Ratushnyak ◽

Tatiana Bezdenezhnykh ◽

Vlada Fediaeva ◽

...

Keyword(s):

Health Problems ◽

Cost Utility ◽

Economic Evaluations ◽

Computer Assisted ◽

Health State ◽

Primary Analysis ◽

Health States ◽

Value Set ◽

Model Combining ◽

Life Years

Abstract Purpose The most widely used generic questionnaire to estimate the quality of life for yielding quality-adjusted life years in economic evaluations is EQ-5D. Country-specific population value sets are required to use EQ-5D in economic evaluations. The aim of this study was to establish an EQ-5D-3L value set for Russia. Methods A representative sample aged 18+ years was recruited from the Russia`s general population. Computer-assisted face–to–face interviews were conducted based on the standardized valuation protocol using EQ-Portable Valuation Technology. Population preferences were elicited utilizing both composite time trade-off (cTTO) and discrete choice experiment (DCE) techniques. To estimate the value set, a hybrid regression model combining cTTO and DCE data was used. Results A total of 300 respondents who successfully completed the interview were included in the primary analysis. 120 (40.0%) respondents reported no health problems of any dimension, and 56 (18.7%) reported moderate health problems in one dimension of the EQ‐5D‐3L. Median self-rated health using EQ‐VAS was 80 with IQR 70–90. Comparing cTTO and DCE-predicted values for 243 health states resulted in a similar pattern. This supports the use of hybrid models. The predicted value based on the preferred model for the worst health state “33333” was −0.503. Mobility dimension had the most significant impact on the utility decrement, and anxiety/depression had the lowest decrement. Conclusion Determining a Russian national value set may be considered the first step towards promoting cost-utility analysis use to increase comparability among studies and improve the transferability of healthcare decision-making in Russia.

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