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Inconsistent responses in three preference-elicitation methods for health states

Author

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  • Badia, Xavier
  • Roset, Monserrat
  • Herdman, Michael

Abstract

Values for health states obtained from the general population can be used in the development of cost-utility algorithms such as Quality Adjusted Life Years (QALYs) to aid in resource allocation decisions. These values are obtained using methods such as the visual analogue scale, the time trade-off or the standard gamble. However, all of these methods suffer, to some extent, from the problem of inconsistent responses. In this paper, we examine the degree to which three preference-elicitation methods--ranking, VAS and TTO--produce inconsistent responses, the effect of sociodemographic and health variables on the numbers of inconsistencies produced, and the effect of including inconsistent responses on the ordering of health states in EQ-5D VAS and TTO tariffs. Health states valued were a sub-set of 43 health states generated by the EuroQol-5D instrument, which were valued as part of a larger study to obtain a tariff of VAS and TTO values for use with the Spanish version of the EQ-5D. Two types of inconsistency--internal and criterion inconsistency--were tested, and both the numbers of inconsistencies produced by each method, and the 'size' of those inconsistencies, i.e. the distance in terms of severity between health states rated inconsistently, were tested. The study showed that although the TTO produces higher numbers of inconsistent responses, the numbers of inconsistent responses in all methods were low, and did not affect rankings in the final tariff of values. Older respondents and those with lower levels of education produced significantly higher numbers of inconsistencies, though health characteristics were not significant. On the ranking and VAS methods, the number of inconsistencies doubled between the two interviewers. Efforts should be made to reduce inconsistencies, particularly among older and lesser educated respondents. Future research should concentrate on determining how inconsistencies might affect the values assigned to health states in the final tariff, and not simply the order of those states.

Suggested Citation

  • Badia, Xavier & Roset, Monserrat & Herdman, Michael, 1999. "Inconsistent responses in three preference-elicitation methods for health states," Social Science & Medicine, Elsevier, vol. 49(7), pages 943-950, October.
    • Handle: RePEc:eee:socmed:v:49:y:1999:i:7:p:943-950
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    Citations

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    Cited by:

    1. Eve Wittenberg & Lisa Prosser, 2011. "Ordering errors, objections and invariance in utility survey responses," Applied Health Economics and Health Policy, Springer, vol. 9(4), pages 225-241, July.
    2. Zoltán Hermann & Márta Péntek & László Gulácsi & Irén Anna Kopcsóné Németh & Zsombor Zrubka, 2022. "Measuring the acceptability of EQ-5D-3L health states for different ages: a new adaptive survey methodology," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1243-1255, September.
    3. Franz Ombler & Michael Albert & Paul Hansen, 2018. "How Significant Are “High†Correlations Between EQ-5D Value Sets?," Medical Decision Making, , vol. 38(6), pages 635-645, August.
    4. Rodríguez-Míguez, E. & Abellán-Perpiñán, J.M. & Alvarez, X.C. & González, X.M. & Sampayo, A.R., 2016. "The DEP-6D, a new preference-based measure to assess health states of dependency," Social Science & Medicine, Elsevier, vol. 153(C), pages 210-219.
    5. Brousselle, Astrid & Lessard, Chantale, 2011. "Economic evaluation to inform health care decision-making: Promise, pitfalls and a proposal for an alternative path," Social Science & Medicine, Elsevier, vol. 72(6), pages 832-839, March.
    6. Zhihao Yang & Jan van Busschbach & Reinier Timman & M F Janssen & Nan Luo, 2017. "Logical inconsistencies in time trade-off valuation of EQ-5D-5L health states: Whose fault is it?," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-10, September.
    7. Whynes, David K. & Frew, Emma & Wolstenholme, Jane L., 2003. "A comparison of two methods for eliciting contingent valuations of colorectal cancer screening," Journal of Health Economics, Elsevier, vol. 22(4), pages 555-574, July.
    8. Garry R. Barton & Tracey H. Sach & Anthony J. Avery & Claire Jenkinson & Michael Doherty & David K. Whynes & Kenneth R. Muir, 2008. "A comparison of the performance of the EQ‐5D and SF‐6D for individuals aged ≥ 45 years," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 815-832, July.
    9. Eva Rodríguez Míguez & José María Abellán Perpiñán & José Carlos Álvarez Villamarín & José Manuel González Martínez & Antonio Rodríguez Sampayo, 2013. "Development of a new preference-based instrument to measure dependency," Working Papers 1301, Universidade de Vigo, Departamento de Economía Aplicada.
    10. N J Devlin & P Hansen & P Kind & A H Williams, 2000. "The health state preferences and logistical inconsistencies of New Zealanders: a tale of two tariffs," Working Papers 180chedp, Centre for Health Economics, University of York.
    11. Mônica Viegas Andrade & Kenya Noronha & Paul Kind & Carla de Barros Reis & Lucas Resende de Carvalho, 2016. "Logical Inconsistencies in 3 Preference Elicitation Methods for EQ-5D Health States," Medical Decision Making, , vol. 36(2), pages 242-252, February.
    12. Benjamin M. Craig & Sulabha Ramachandran, 2006. "Relative risk of a shuffled deck: a generalizable logical consistency criterion for sample selection in health state valuation studies," Health Economics, John Wiley & Sons, Ltd., vol. 15(8), pages 835-848, August.
    13. Nancy J. Devlin & Paul Hansen & Paul Kind & Alan Williams, 2003. "Logical inconsistencies in survey respondents' health state valuations ‐ a methodological challenge for estimating social tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 12(7), pages 529-544, July.
    14. Garry Barton & Tracey Sach & Michael Doherty & Anthony Avery & Claire Jenkinson & Kenneth Muir, 2008. "An assessment of the discriminative ability of the EQ-5D index , SF-6D, and EQ VAS, using sociodemographic factors and clinical conditions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(3), pages 237-249, August.
    15. Dena M. Bravata & Lorene M. Nelson & Alan M. Garber & Mary K. Goldstein, 2005. "Invariance and Inconsistency in Utility Ratings," Medical Decision Making, , vol. 25(2), pages 158-167, March.
    16. Leida M. Lamers & Peep F. M. Stalmeier & Paul F. M. Krabbe & Jan J. V. Busschbach, 2006. "Inconsistencies in TTO and VAS Values for EQ-5D Health States," Medical Decision Making, , vol. 26(2), pages 173-181, March.
    17. Benjamin M. Craig, 2009. "The duration effect: a link between TTO and VAS values," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 217-225, February.
    18. Mark Oppe & Kim Rand-Hendriksen & Koonal Shah & Juan M. Ramos‐Goñi & Nan Luo, 2016. "EuroQol Protocols for Time Trade-Off Valuation of Health Outcomes," PharmacoEconomics, Springer, vol. 34(10), pages 993-1004, October.
    19. Franz Ombler & Michael Albert & Paul Hansen, 2017. "The true significance of ‘high’ correlations between EQ-5D value sets," Working Papers 1704, University of Otago, Department of Economics, revised Mar 2017.

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