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Measurement of Short Term Health Effects in Economic Evaluations

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Summary

Short term health effects can significantly impact health-related quality of life (HR-QOL). Appropriate healthcare priorities can be set only if they are based on health status measurements which are consistent with how people value both short and long term health effects. This article discusses methods by which such health effects may be measured using health state utilities. The standard discounted quality-adjusted life-year model, in which the values of the various health states are weighted by the time spent in each state, generally fails to capture the true impact of temporary ill health on HR-QOL. Instead, a scenario approach is recommended in which valuations are based on holistic descriptions of health states which include all short and long term health effects experienced.

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References

  1. Torrance GW. Measurement of health-state utilities for economic appraisal: a review. J Health Econ 1986; 5: 1–30

    Article  PubMed  CAS  Google Scholar 

  2. Johannesson M, Jönsson B, Karlsson G. Outcome measurement in economic evaluation. Health Econ 1996; 5: 279–96

    Article  PubMed  CAS  Google Scholar 

  3. Fischer GW. Utility models for multiple objective decisions do they accurately represent human preferences. Decis Sci 1979; 10: 451–79

    Article  Google Scholar 

  4. Lipscomb J. Time preference for health in cost-effectiveness analysis. Med Care 1989; 27 (3 Suppl.): S233–53

    Article  Google Scholar 

  5. Richardson J, Hall J, Salkeld G. The measurement of utility in multiple health states. Int J Technol Assess Health Care 1996; 12: 151–62

    Article  PubMed  CAS  Google Scholar 

  6. Miller GA. The magical number seven plus or minus two: some limits on our own capacity for processing information. Psychol Rev 1956; 63: 81–97

    Article  PubMed  CAS  Google Scholar 

  7. Hadorn DC, Hays RD. Multitrait-multimethod analysis of health related quality of life measures. Med Care 1991; 29: 829–40

    Article  PubMed  CAS  Google Scholar 

  8. Feeny DH, Torrance GW. Incorporating utility-based quality-of-life assessment measures in clinical trials: two examples. Med Care 1989; 27 (3 Suppl.): S190–204

    Article  Google Scholar 

  9. Pliskin JS, Shepard DS, Weinstein MC. Utility functions for life years and health status. Oper Res 1980; 28: 206–24

    Article  Google Scholar 

  10. Broome J. QALYs. J Public Econ 1993; 13: 149–67

    Article  Google Scholar 

  11. Bleichrodt H, Johannesson M. The validity QALYs: and empirical test of constant proportional trade-off and utility independence. Med Decis Making 1996; 17: 21–32

    Article  Google Scholar 

  12. Sutherland JH, Llewellyn-Thomas H, Boyd NF, et al. Attitudes towards quality of survival: the concept of ‘maximal endurable time’. Med Decis Making 1982; 2: 299–309

    Article  PubMed  CAS  Google Scholar 

  13. Stalmeier PFM, Bezembinder TGG, Unic IJ. Proportional heuristics in time tradeoff and conjoint measurement. Med Decis Making 1996; 16: 36–44

    Article  PubMed  CAS  Google Scholar 

  14. Dolan P, Gudex C. Time preference, duration and health state valuations. Health Econ 1995; 4: 289–99

    Article  PubMed  CAS  Google Scholar 

  15. Bleichrod H, Gafni A. Time preference, the discounted utility model and health. J Health Econ 1996; 15: 49–66

    Article  Google Scholar 

  16. Mehrez A, Gafni A. Quality-adjusted life years, utility theory and health-years equivalents. Med Decis Making 1989; 9: 142–9

    Article  PubMed  CAS  Google Scholar 

  17. Loomes G. The myth of the HYE. J Health Econ 1995; 14: 1–8

    Article  PubMed  CAS  Google Scholar 

  18. Gafni A. HYEs: do we need them and can they fulfil the promise? Med Decis Making 1996; 16: 215–6

    Article  PubMed  CAS  Google Scholar 

  19. Gold MR, Patrick DL, Torrance GW, et al. Identifying and valuing outcomes. In: Gold MR, Siegel JE, Russell LB, et al., editors. Cost-effectiveness in health and medicine. New York: Oxford University Press, 1996: 82–134

    Google Scholar 

  20. Gafni A, Torrance GW. Risk attitude and time preference in health. Manage Sci 1984; 30: 440–51

    Article  Google Scholar 

  21. Gafni A. Time in health: can we measure individuals ‘pure time preferences’? Med Decis Making 1995; 15: 31–7

    Article  PubMed  CAS  Google Scholar 

  22. Smith R, Dobson M. Measuring utility values for QALYs: two methodological issues. Health Econ 1993; 2: 349–55

    Article  PubMed  CAS  Google Scholar 

  23. Gafni A. The standard gamble method: what is being measured and how is it being interpreted. Health Serv Res 1994; 29: 207–24

    PubMed  CAS  Google Scholar 

  24. Kupperman M, Shiboski S, Feeny D, et al. Can preference scores for discrete states be used to derive preference scores for an entire path of events? An application to prenatal diagnosis. Med Decis Making 1997; 17: 42–55

    Article  Google Scholar 

  25. Furlong W, Feeny D, Torrance GW, et al. Guide to design and development of health-state utility instrumentation [working paper]. Hamilton (Ontario): McMaster University, 1990

    Google Scholar 

Download references

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Correspondence to Ann M. Holmes.

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Holmes, A.M. Measurement of Short Term Health Effects in Economic Evaluations. Pharmacoeconomics 13, 171–174 (1998). https://doi.org/10.2165/00019053-199813020-00001

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  • DOI: https://doi.org/10.2165/00019053-199813020-00001

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