Patient Utilities for Advanced Cancer

BACKGROUND: Utilities are critical inputs to economic analyses, yet some things remain unclear about their elicitation and application, particularly the impact of health status on values. Prospect theory predicts that current health affects values, and that losses loom larger than gains. If true, the use of utilities requires that additional complexities be considered. OBJECTIVE: To determine the effect of current health on patient utilities for advanced cancer health states. RESEARCH DESIGN: The research was a cross-sectional survey (n=100 patients) of utilities for 4 hypothetical advanced cancer health states. Chained gamble utilities for gains and losses in health were compared, correlations between current health status and utilities were measured, and patient utilities for experienced versus hypothetical health states were compared. RESULTS: In this sample, gains in health were valued equivalently to losses, health status was not correlated with utility values, and patients' valuation of states equivalent to their current health did not differ from valuations of the same states by patients with better or worse current health. CONCLUSION: This research confirms the uncertainty surrounding the effect of health status on utilities and the question of whose values to use in analyses. The findings suggest that values for health states may be independent of current health status, supporting an objective view of utilities. This research also suggests that patients may be able to provide "experienced utilities" for states other than their own, expanding the population from whom such values can be elicited. These results may dispute prospect theory's predictions regarding health state valuations

MEDLINE · Political science · Computer Science · Economic and Financial Impacts of Cancer · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Medicine

• The Effect of Age, Race and Gender on Preference Scores for Hypothetical Health States

  Open Access•Eve Wittenberg, Elkan F Halpern et al.•Quality of Life Research•2006

  Añadir item

• Community Preferences for Health States Associated With Intimate Partner Violence

  Eve Wittenberg, Erika L Lichter et al.•Medical Care•2006

  Añadir item

• Valuing environmental resources

  Open Access•Rabia Gregory, Robin Gregory et al.•Journal of Risk and Uncertainty•1993

  Añadir item

• Measuring the quality of life of cancer patients

  Open Access•Walter O Spitzer, Annette J Dobson et al.•Journal of Chronic Diseases•1981

  Añadir item

• Advances in prospect theory

  Open Access•Amos Tversky, Daniel Kahneman•Journal of Risk and Uncertainty•1992

  Añadir item

• Prospect Theory

  Daniel Kahneman, Amos Tversky•Econometrica•1979

  Añadir item

• Value elicitation

  Baruch Fischhoff•American Psychologist•1991

  Añadir item

• Hi! How are you? Response shift, implicit theories and differing epistemologies

  Open Access•Geoffrey R Norman, Geoffrey Norman•Quality of Life Research•2003

  Añadir item

• Understanding differences between self-ratings and population ratings for health in the EuroQOL

  Open Access•Ralph P Insinga, Dennis G Fryback•Quality of Life Research•2003

  Añadir item

• Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public

  Open Access•Peter A Ubel, G Loewenstein et al.•Quality of Life Research•2003

  Añadir item

• Improving Value Measurement in Cost-Effectiveness Analysis

  Peter A Ubel, Erik Nord et al.•Medical Care•2000

  Añadir item

• Associations Between Health Status and Utilities Implications for Policy

  Leslie A Lenert, Leslie Lenert et al.•Medical Care•1999

  Añadir item

• Lottery winners and accident victims

  Philip Brickman, Dan Coates et al.•Journal of Personality and Social…•1978

  Añadir item