Validity of utilities of patients with esophageal cancer

2005 ◽  
Vol 21 (1) ◽  
pp. 113-118 ◽  
Author(s):  
Peep F. M. Stalmeier ◽  
Angela G. E. M. de Boer ◽  
Mirjam A. G. Sprangers ◽  
Hanneke C. J. M. de Haes ◽  
Jan J. B. van Lanschot
Keyword(s):  
Esophageal Cancer ◽  
Convergent Validity ◽  
Standard Gamble ◽  
Health State ◽  
Health States ◽  
Curative Intent ◽  
Individual Level ◽  
Vas Scores ◽  
Actual Health ◽  
Good Agreement

Objectives: The convergent validity between utility assessment methods was assessed.Methods: Investigated were patients with esophageal cancer treated surgically with curative intent. Patients were interviewed in a period from 3 to 12 months after surgical resection. Patients evaluated their actual health and seven other states. Visual analogue scale (VAS) and standard gamble (SG) utilities were obtained for the health states in an interview. Patients also indicated whether or not they preferred death to living in a health state (worse than dead [WTD] preferences).Results: Fifty patients completed the interview. Convergent validity was excellent at the aggregate and individual level. However, the relation between VAS and SG differed strongly across individuals. On a scale from 0 (dead) to 100 (perfect health), SG scores were lower for patients with WTD preferences (mean difference d=35; p=.002); however, VAS scores did not vary by WTD preferences.Conclusions: In general, there is good agreement between VAS and SG measures, although patients disagree about how the VAS and SG are related. The standard gamble varied by WTD preferences, however, the VAS did not.

scholarly journals The Online Elicitation of Personal Utility Functions (OPUF) tool: a new method for valuing health states

2022 ◽  
Vol 7 ◽  
pp. 14
Author(s):  
Paul Schneider ◽  
Ben van Hout ◽  
Marike Heisen ◽  
John Brazier ◽  
Nancy Devlin
Keyword(s):  
Utility Functions ◽  
Health State ◽  
Group Level ◽  
Health States ◽  
Online Tool ◽  
Value Set ◽  
Individual Level ◽  
Personal Utility ◽  
Value Sets ◽  
The Individual

Introduction Standard valuation methods, such as TTO and DCE are inefficient. They require data from hundreds if not thousands of participants to generate value sets. Here, we present the Online elicitation of Personal Utility Functions (OPUF) tool; a new type of online survey for valuing EQ-5D-5L health states using more efficient, compositional elicitation methods, which even allow estimating value sets on the individual level. The aims of this study are to report on the development of the tool, and to test the feasibility of using it to obtain individual-level value sets for the EQ-5D-5L. Methods We applied an iterative design approach to adapt the PUF method, previously developed by Devlin et al., for use as a standalone online tool. Five rounds of qualitative interviews, and one quantitative pre-pilot were conducted to get feedback on the different tasks. After each round, the tool was refined and re-evaluated. The final version was piloted in a sample of 50 participants from the UK. A demo of the EQ-5D-5L OPUF survey is available at: https://eq5d5l.me Results On average, it took participants about seven minutes to complete the OPUF Tool. Based on the responses, we were able to construct a personal EQ-5D-5L value set for each of the 50 participants. These value sets predicted a participants' choices in a discrete choice experiment with an accuracy of 80%. Overall, the results revealed that health state preferences vary considerably on the individual-level. Nevertheless, we were able to estimate a group-level value set for all 50 participants with reasonable precision. Discussion We successfully piloted the OPUF Tool and showed that it can be used to derive a group-level as well as personal value sets for the EQ-5D-5L. Although the development of the online tool is still in an early stage, there are multiple potential avenues for further research.

scholarly journals Manipulating the 5 Dimensions of the EuroQol Instrument: The Effects on Self-Reporting Actual Health and Valuing Hypothetical Health States

2019 ◽  
Vol 39 (4) ◽  
pp. 380-392 ◽  
Author(s):  
Aki Tsuchiya ◽  
Nick Bansback ◽  
Arne Risa Hole ◽  
Brendan Mulhern
Keyword(s):  
Discrete Choice ◽  
Online Survey ◽  
Self Report ◽  
Discrete Choice Experiments ◽  
Health State ◽  
Health States ◽  
Different Types ◽  
Health State Valuations ◽  
The Uk ◽  
Actual Health

Background. The EQ-5D instrument has 5 dimensions. This article reports on the effects of manipulating a) the order in which the 5 dimensions are presented (appearing first v. last), b) splitting of the composite dimensions (“pain or discomfort” and “anxiety or depression”), and c) removing or “bolting off” 1 of the 5 EQ-5D dimensions at a time. The effects were examined in 2 contexts: 1) self-reporting health and 2) health state valuations. Methods. Three different types of discrete choice experiments (DCE) including a duration attribute were designed. An online survey with 12 subtypes, each with 10 DCE tasks, was designed and completed by 2494 members of the UK general public. Results. Of the 3 manipulations in the self-reporting context, only b) splitting anxiety or depression had a significant effect. In the health state valuation context, b) splitting level 5 pain or discomfort (relative to pain) and splitting level 5 anxiety or depression (relative to anxiety) had significant effects as did c) bolting off dimensions. Conclusions. We find that the values given to certain health dimensions are sensitive to the way in which it is described and the other health dimensions presented. Of particular interest is the effect of splitting composite dimensions: a given EQ-5D(-5L) profile may mean different things depending on whether the profile is used to self-report one’s health or to value hypothetical states, so that the health state values of EQ-5D(-5L) in population tariffs may not correspond to the states that patients self-report themselves in.

scholarly journals Patient Preferences for Side Effects Associated With Cervical Cancer Treatment

2014 ◽  
Vol 24 (6) ◽  
pp. 1077-1084 ◽  
Author(s):  
Charlotte Sun ◽  
Alaina J. Brown ◽  
Anuja Jhingran ◽  
Michael Frumovitz ◽  
Lois Ramondetta ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Cancer Treatment ◽  
Patient Preferences ◽  
Health State ◽  
Health States ◽  
Dietary Changes ◽  
Vas Scores ◽  
Moderate Nausea

ObjectivesThe aim of this study was to assess patient preferences regarding side effects associated with cervical cancer treatment.Methods/MaterialsThe visual analog scale (VAS) and modified standard gamble (SG) were used to elicit preferences of women with no evidence of disease after primary treatment of cervical cancer. Higher scores on VAS and SG indicated more favorable ratings for a given health state. Health states (HS) included vaginal shortening, diarrhea, dietary changes, menopause, moderate nausea/vomiting, rectal bleeding, sexual dysfunction, and urinary self-catheterization. Descriptive statistics, Kruskal-Wallis, Mann-WhitneyU, and Wilcoxon signed-ranks tests and correlation coefficients were used for statistical analysis.ResultsSeventy-eight patients participated in the study. Median age was 44.1 years (range, 24.9–67.8 years). Median time since treatment completion was 31.2 months (range, 1.0–113.3 months). The HSs rated as most favorable by VAS were also rated as most favorable by SG. Increasing age was associated with higher VAS scores for menopause and vaginal shortening (P= 0.04 and 0.036). African Americans had higher VAS scores for dietary changes (P= 0.05), sexual dysfunction (P= 0.028), and diarrhea (P= 0.05) when compared with Hispanic and non-Hispanic white patients. Women receiving radiation had more favorable VAS scores for menopause compared with women undergoing radical hysterectomy (P= 0.05). Women receiving chemotherapy rated urinary self-catheterization less favorably by VAS score compared with those not receiving chemotherapy (P= 0.045).ConclusionsMultiple demographic and clinical factors influence the severity of treatment-related adverse effects perceived by women surviving cervical cancer. A better understanding of factors influencing patient preferences regarding treatment side effects will allow providers to formulate care better tailored to the individual desires of each patient.

L'effetto dell'esperienza della malattia sulla valutazione degli stati di salute

2009 ◽  
pp. 19-42
Author(s):  
Carmela Di Mauro ◽  
Daniela Giammanco ◽  
Eleonora Miano
Keyword(s):  
Standard Gamble ◽  
Rating Scale ◽  
Adaptive Behaviour ◽  
Health State ◽  
Health States ◽  
Current Health ◽  
Duration Of Illness ◽  
Experience Of Illness ◽  
The Impact ◽  
Health Valuation

- The issue of how respondents' characteristics influence preference-based valuations of health states has been addressed by the literature with a particular emphasis on the analysis of the effects of experience of illness. This study investigates the impact of experience of illness and of current health state on valuations provided by patients through three techniques, Standard Gamble, Rating Scale, and Time Trade-Off. This analysis complements the existing literature on the duration of illness and on adaptive behaviour, and sheds light on the way experience may affect health valuation according to the technique adopted. We use responses from 130 interviews administered to consecutively admitted patients of two cardiology units. Results show that the impact of the time elapsed since diagnosis is technique-specific: only in Standard Gamble estimates we find evidence that, the further away in time is the diagnosis, the lower the utility of the state.

scholarly journals Patients' Utilities for Cancer Treatments

1998 ◽  
Vol 18 (4) ◽  
pp. 391-399 ◽  
Author(s):  
Sylvia J.T. Jansen ◽  
Anne M. Stiggelbout ◽  
Peter P. Wakker ◽  
Thea P.M. Vliet Vlieland ◽  
Jan-Willem H. Leer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Standard Gamble ◽  
Early Stage ◽  
Health State ◽  
Breast Cancer Patients ◽  
Health States ◽  
Breast Cancer Chemotherapy ◽  
Time Tradeoff ◽  
Significant Difference ◽  
Temporary Health

Objective. Temporary health states cannot be measured in the traditional way by means of techniques such as the time tradeoff (TTO) and the standard gamble (SG), where health states are chronic and are followed by death. Chained methods have been developed to solve this problem. This study assesses the feasibility of a chained TTO and a chained SG, and the consistency and concordance between the two meth ods. Patients and methods. Seventy female early-stage breast cancer patients were interviewed. In using both chained methods, the temporary health state to be evaluated was weighed indirectly with the aid of a temporary anchor health state. The patients were asked to evaluate their actual health states, a hypothetical radiotherapy scenario, and a hypothetical chemotherapy scenario. Results. Sixty-eight patients completed the interview. The use of the anchor health state yielded some problems. A significant difference between the means of the TTO and the SG was found for the anchor health state only. For the other health states, the results were remarkably close, because the design avoided some of the bias effects in traditional measurements. Conclusion. The feasibility and the consistency of the chained procedure were satisfactory for both methods. The problems regarding the anchor health state can be solved by adapting the methods and by the use of a carefully chosen anchor health state. The chained method avoids biases present in the conventional method, and thereby the TTO and the SG may be reconciled. Moreover, there are several psychological advantages to the method, which makes it useful for diseases with uncertain prognoses. Key words: utility assessment; time tradeoff; standard gamble; breast cancer; chemotherapy; ra diotherapy. (Med Decis Making 1998;18:391-399)

scholarly journals Quality-adjusted life year weights and treatment bias: Theory and evidence from cognitive interviews

2019 ◽  
Vol 7 ◽  
pp. 205031211985698 ◽  
Author(s):  
Bryan N Patenaude ◽  
Till Bärnighausen
Keyword(s):  
Standard Gamble ◽  
Stated Preference ◽  
Preference Elicitation ◽  
Quality Adjusted Life Year ◽  
Health State ◽  
Cognitive Interviews ◽  
Thought Processes ◽  
Health States ◽  
Treatment Bias ◽  
Quality Adjusted Life

Objectives: The purpose of this research is to understand the thought processes that underpin responses to stated preference approaches for eliciting quality of life, in particular the standard gamble. Methods: We utilize standard gamble preference elicitation survey techniques to elicit quality-adjusted life year weights for two reduced health states: chronic severe depression and total blindness. After the survey, we conduct open-ended qualitative interviews with respondents to determine their thought processes while taking the surveys and to shed light on what their quality-adjusted life year weight is capturing. Survey responses were coded and analyzed for themes in NVivo, the results of which were then formalized in the terminology of decision sciences. Results: The qualitative results of the cognitive interviews present systematic evidence for a type of cognitive bias present in standard gamble quality-adjusted life year weight elicitation, which has not been previously highlighted and which we call treatment bias. We define this treatment bias as the consideration of salient treatment alternatives correlated with a reduced health state, when these alternatives are not explicitly posed in the question. Our formalization of this cognitive behavior demonstrates that treatment bias will always bias the elicited health state utility of treating the illness in question downward. Conclusion: The treatment bias highlighted in this study has implications for economic evaluation when comparing treatment for illnesses where alternative treatments are widely publicized versus those that are not. For example, comparing the effectiveness of treating depression versus arthritis may be biased against depression if advertisements for anti-depressants are more widely viewed by survey respondents than advertisements for arthritis treatments. We propose a statement to be imbedded in all questionnaires regarding stated preference elicitation of quality-adjusted life year weights in order to correct for this bias in future stated preference surveys.

Estimating General-population Utilities Using One Binary-gamble Question per Respondent

1998 ◽  
Vol 18 (4) ◽  
pp. 381-390 ◽  
Author(s):  
Johanna L. Bosch ◽  
James K. Hammitt ◽  
Milton C. Weinstein ◽  
Maria G.M. Hunink
Keyword(s):  
Standard Gamble ◽  
Major Amputation ◽  
Binary Choice ◽  
Health State ◽  
Health States ◽  
Peripheral Arterial ◽  
Societal Preferences ◽  
Choice Method ◽  
Disease Specific

This study used a single binary-gamble question per health state per respondent to obtain societal preferences for the health states intermittent claudication and major amputation and compare those with Health Utilities Indices obtained from patients, to test the feasibility of this method, and to investigate whether the utility depends on the presentation of a vignette as generic vs disease-specific. A random sample of the general U.S. population (n = 1,003) was randomly divided into ten subgroups. In tel ephone interviews, subjects answered one binary-gamble question in a standard-gam ble format for each of two health states. The risks of death varied across subgroups but not between health states. Mean utility was estimated by the area above the pro portional distribution of responses indicating acceptance of the gamble. The method is based on the binary-choice method used in contingent-valuation studies of willing ness to pay. The health states were alternatively described by generic and disease- specific vignettes in two subsamples. The results suggest that the binary-gamble ques tion can be used to obtain societal preferences for health states, and that disease-specific descriptions yield lower utilities compared with generic descriptions of health states. Key words: peripheral arterial occlusive disease, intermittent claudica tion ; quality of life; standard gamble; utility assessment. (Med Decis Making 1998;18: 381-390)

Measurement of Health Preferences among Patients with Tuberculous Infection and Disease

2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 102-114 ◽  
Author(s):  
Marie-Josée Dion ◽  
Pierre Tousignant ◽  
Jean Bourbeau ◽  
Dick Menzies ◽  
Kevin Schwartzman
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Standard Gamble ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Tuberculous Infection ◽  
Foreign Born ◽  
Health States ◽  
Intraclass Correlation Coefficients ◽  
Vas Scores

Health preferences have not previously been investigated among patients with tuberculous infection or disease. The authors assessed the reliability of visual analogue scale (VAS) and standard gamble (SG) measurements in this patient population. Participants were interviewed 3 times in English or French, at weekly intervals. They evaluated their own health status, as well as 3 marker health states, derived by consensus among tuberculosis (TB) practitioners. For the VAS, health states were assigned a duration of 6 months, whereas for the SG, the duration was 10 years. One hundred eighty-six potentially eligible individuals were identified from the TB clinic database of the Montreal Chest Institute. One hundred twelve (60%) were successfully located; of these, 106 were confirmed eligible. Sixty-seven (63%) agreed to participate, and 50 completed all study measurements (25 treated for latent TB, 17 treated for active TB, and 8 with previous active TB); 38 out of 50 were foreign-born. Intraclass correlation coefficients for the marker states were 0.57 to 0.81 for the VAS, and 0.75 to 0.87 for the SG. For respondents’ own health, the coefficients were 0.60 and 0.87, respectively. Median VAS scores for respondents’ own health were 85.0 to 88.0 for the 3 interviews, whereas the median utility score was 97.5 for all 3. Administration of the visual analogue scale and standard gamble instruments appeared reliable in a selected group of tuberculosis patients. Major barriers to recruitment were language and mobility in this largely foreign-born population.

Estimating Utility Values for Health States of DFU Patients Using EQ-5D-5L and cTTO

2021 ◽  
pp. 153473462110143
Author(s):  
Morteza Arab-Zozani ◽  
Hossein Safari ◽  
Zoha Dori ◽  
Somayeh Afshari ◽  
Hosein Ameri ◽  
...  
Keyword(s):  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Economic Modeling ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
The Mean ◽  
The Difference ◽  
Diabetes Center ◽  
Health State Utility Values

Health-state utility values of diabetic foot ulcer (DFU) patients are necessary for clinical praxis and economic modeling. The purpose of this study was to estimate utility values in DFU patients using the EuroQol-5-dimension-5-level (EQ-5D-5L) and composite time trade-off (cTTO). The EQ-5D-5L and cTTO were used for estimating utility values. Data were collected from 228 patients referred to the largest governmental diabetes center in the South of Iran, Yazd province. When appropriate, independent sample t-test or analysis of variance test was used to test the difference in the utility values in each of the demographic and clinical characteristics of the patients. Finally, the BetaMix was used to identify predictors of the utility values. The means of EQ-5D-5L and cTTO values were 0.55( SD 0.21) and 0.67( SD 0.23), respectively. Anxiety and pain were the most common problems reported by the patients. The difference between the mean EQ-5D-5L values was significant for age, grade of ulcer, number of comorbidities, and having complications. In addition, variables of gender, age, grade of ulcer, and having complications were significant predictors of the EQ-5D-5L. The difference between the mean cTTO values was significant for age, employment status, grade of ulcer, number of comorbidities, and having complications. Moreover, variables of gender, age, grade of ulcer, number of comorbidities, and developing complications were significant predictors of cTTO. The current study provided estimates of utility values for DFU patients for clinical praxis and economic modeling. These estimates, similar to utilities reported in other studies, were low. Identifying strategies to decrease anxiety/depression and pain in patients is important to improve the utility values.

scholarly journals The measurement performance of the EQ-5D-5L versus EQ-5D-3L in patients with hidradenitis suppurativa

2021 ◽  
Author(s):  
Alex Bató ◽  
Valentin Brodszky ◽  
L. Hunor Gergely ◽  
Krisztián Gáspár ◽  
Norbert Wikonkál ◽  
...  
Keyword(s):  
Convergent Validity ◽  
Hidradenitis Suppurativa ◽  
Clinical Care ◽  
Intraclass Correlation ◽  
Life Quality ◽  
Measurement Properties ◽  
Economic Evaluations ◽  
Health State ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that affects up to 1% of the population in Europe. The EQ-5D is the most commonly used generic instrument for measuring health-related quality of life among HS patients. This study aims to compare the measurement properties of the two adult versions of EQ-5D (EQ-5D-3L and EQ-5D-5L) in patients with HS. Methods We recruited 200 consecutive patients with HS (mean age 37 years, 38% severe or very severe HS) to participate in a multicentre cross-sectional survey. Patients completed the EQ-5D-3L, EQ-5D-5L, Dermatology Life Quality Index (DLQI) and Skindex-16 questionnaires. Results More than twice as many different health state profiles occurred in the EQ-5D-5L compared to the EQ-5D-3L (101 vs. 43). A significant reduction in ceiling effect was found for the mobility, self-care and usual activities dimensions. A good agreement was established between the EQ-5D-3L and EQ-5D-5L with an intraclass correlation coefficient of 0.872 (95% CI 0.830–0.903; p < 0.001) that was confirmed by a Bland-Altman plot. EQ-5D-5L improved both the absolute and relative informativity in all dimensions except for anxiety/depression. EQ-5D-3L and EQ-5D-5L demonstrated similar convergent validity with DLQI and Skindex-16. EQ-5D-5L was able to better discriminate between known groups of patients based on the number of comorbidities and disease severity (HS-Physician's Global Assessment). Conclusion In patients with HS, the EQ-5D-5L outperformed the EQ-5D-3L in feasibility, ceiling effects, informativity and known-groups validity for many important clinical characteristics. We recommend using the EQ-5D-5L in HS patients across various settings, including clinical care, research and economic evaluations.

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