Utilities Should Not Be Multiplied
Evidence From the Preference-Based Scores in the United States
Bibliographic Data
| ID | 9101456 |
|---|---|
| Authors | Alex Z Fu (0000-0002-4020-6519, Cleveland Clinic), Michael W Kattan (0000-0002-3840-4161, Cleveland Clinic) |
| Year | 2008 |
| Volume | 46 |
| Issue | 9 |
| Pages | 984-990 |
| Publication date | 2008-09-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0b013e3181791a9c |
| PMID | 18725854 |
| OpenAlex | W2147967521 |
| Language | EN |
| Citations received | 4 |
| References cited | 36 |
OBJECTIVE: Several estimators exist when average utility scores are not available for patient populations with multiple disease conditions. The multiplicative estimator is a widespread choice among them. Our study is to empirically test the accuracy of the multiplicative estimator and compare it with other estimators. METHODS: The Medical Expenditure Panel Survey (MEPS) has a nationally representative sample of the US civilian noninstitutionalized population. Using the pooled 2001 and 2003 data, a sample of 40,846 individuals with EQ-5D index scores were categorized into 238 disease condition categories. The study focus was the difference between the estimated and the observed mean scores for each comorbid pair, with the observed one presumed to be the true value. RESULTS: The scores estimated by multiplying the 2 mean scores of the corresponding disease conditions on average had a statistically significantly larger difference (P < 0.0001) from the observed ones (-0.094) than simply picking the smaller mean of the 2 paired conditions (difference = 0.025), the larger mean of the 2 (difference = 0.071), the average of the 2 means (difference = 0.048), or the mean of the condition with smaller sample size of the pair (difference = 0.049). However, the multiplicative estimator performed better than the additive estimator (sum of the means minus 1, difference = -0.123). CONCLUSIONS: Multiplication is not a good estimate when the average utility score for patients with 2 disease conditions is not readily available. The lower of the 2 utility scores had the least error among those estimators that we compared. Further research with an experimental design is warranted before a specific alternative can be firmly recommended
Confidence interval · Econometrics · Estimator · Mean difference · Mean squared error · Multiplicative function · Population · Sample (material) · Sample size determination · Statistics · Demography · Economic and Environmental Valuation · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management · Mathematics · Medicine
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Comparing EQ-5D Scores for Comorbid Health Conditions Estimated Using 5 Different Methods
Quality-adjusted Life Years (Qaly) for 15 Chronic Conditions and Combinations of Conditions Among US Adults Aged 65 and Older
A Concordance Correlation Coefficient to Evaluate Reproducibility
Recommendations of the Panel on Cost-Effectiveness in Health and Medicine
Comparative quantification of health risks
Healthy life expectancy in 191 countries, 1999
Comparison of the EQ-5D and SF-12 in an adult US sample
US Valuation of the EQ-5D Health States
Comparison of the EQ-5D and SF-12 Health Surveys in a General Population Survey in Alberta, Canada
Modeling Valuations for EuroQol Health States
A National Catalog of Preference-Based Scores for Chronic Conditions in the United States
| Citations per year | 0.29 |
|---|---|
| Citation span | 2012 - 2020 (9) |
| Highly cited | No |