The impact of adding an extra dimension to a preference-based measure

Bibliographic Data

ID4937480
AuthorsJohn Brazier (0000-0001-8645-4780, University of Sheffield, corresponding author), Donna Rowen (0000-0003-3018-5109, University of Sheffield), Akiko Tsuchiya (0000-0003-4245-5399, University of Sheffield), Aki Tsuchiya, Yaling Yang (0000-0002-9529-1685, Brunel University of London), Tracy A Young (University of Sheffield)
Year2011
Volume73
Issue2
Pages245-253
Publication date2011-07-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2011.05.026
PMID21689878
PMCIDPMC3566588
OpenAlexW2169790777
LanguageEN
Citations received3
References cited28

The ability to compare incremental changes in Quality Adjusted Life Years (QALYs) generated by different condition-specific preference-based measures (CSPBMs), or indeed between generic measures, is often criticised even where the valuation methods and source of values are the same. A key concern is the impact of excluding key dimensions from a descriptive system. This study examines the impact of adding a generic pain/discomfort dimension to a CSPBM, the AQL-5D (an asthma-specific CSPBM), by valuing samples of states from the AQL-5D with and without the new dimension using an interviewer administered time trade-off with a sample of the U.K. general public. 180 respondents provided 720 valuations for states with and without pain/discomfort. As expected the additional pain/discomfort dimension was found to have a significant and relatively large coefficient. More importantly for comparing changes in QALYs across populations the addition of pain/discomfort significantly impacts on the coefficients of the other dimensions and the degree of impact differs by dimension and severity level. The net effect on the utility value depends on the severity of their state: the addition of pain/discomfort at level 1 (no pain/discomfort) or 2 (moderate pain/discomfort) significantly increased the mean health state values in an asthma patient population; whereas level 3 pain/discomfort (extreme) reduced values. Comparability between measures requires that the impact of different dimensions on preferences is additive, whether or not they are included in the classification system. Our results cast doubt on this assumption, implying that the chosen measure must contain all important and relevant dimensions in its classification system

Actuarial science · Comparability · Cost effectiveness · Cronbach's alpha · Dimension (graph theory · Economics · Environmental health · EQ-5D · Physical therapy · Population · Preference · Psychometrics · Quality of life (healthcare · Quality-adjusted life year · Statistics · Valuation (finance · Clinical Psychology · Economic and Environmental Valuation · Global Health Care Issues · Health Systems, Economic Evaluations, Quality of Life · Mathematics · Medicine

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