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Whose Utilities for Decision Analysis?

Author

Listed:
  • Norman F. Boyd
  • Heather J. Sutherland
  • Karen Z. Heasman
  • David L. Tritchler
  • Bernard J. Cummings

Abstract

The goal of this study was to examine sources of variation in the utilities assigned to health states. The authors selected a common clinical problem, carcinoma of the rectum, and examined the utilities assigned to colostomy, a common outcome of treatment for that disease. After preparing and validating a description of colostomy and its effects on patients' lives, utilities for the state were obtained from five groups of individuals. These comprised two groups of patients who received treatment for rectal cancer, a group of physicians and surgeons specializing in the treatment of this disease, and two groups of healthy subjects, none of whom were health professionals. Of the patients who had been treated for rectal cancer, one group had been treated surgically with the formation of colostomies and the other had been treated with radiotherapy and none had a colostomy. Utilities for colostomy were elicited using the standard gamble, category rating, and a treatment choice question naire. The groups differed substantially in the utilities assigned to colostomy. In general, patients with colostomies and physicians assigned significantly higher utilities than did pa tients who did not themselves have a colostomy. The clinical significance of these differences was examined in a simplified clinical decision problem that compared surgery (with colostomy) and radiotherapy (without colostomy) as primary treatment. The expected clinical value of these treatment alternatives was substantially influenced by the differences observed in utilities for colostomy. These results emphasize the importance of patient utilities in clinical decision making and the need to gain greater understanding of the factors that influence the utilities that patients assign to health states. Key words : utilities; decision analysis; oncology. (Med Decis Making 1990;10:58-67)

Suggested Citation

  • Norman F. Boyd & Heather J. Sutherland & Karen Z. Heasman & David L. Tritchler & Bernard J. Cummings, 1990. "Whose Utilities for Decision Analysis?," Medical Decision Making, , vol. 10(1), pages 58-67, February.
    • Handle: RePEc:sae:medema:v:10:y:1990:i:1:p:58-67
    DOI: 10.1177/0272989X9001000109
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    References listed on IDEAS

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    1. Torrance, George W., 1976. "Social preferences for health states: An empirical evaluation of three measurement techniques," Socio-Economic Planning Sciences, Elsevier, vol. 10(3), pages 129-136.
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    1. Brazier, J, 2005. "Current state of the art in preference-based measures of health and avenues for further research," MPRA Paper 29762, University Library of Munich, Germany.
    2. Schünemann, Johannes & Strulik, Holger & Trimborn, Timo, 2017. "Going from bad to worse: Adaptation to poor health health spending, longevity, and the value of life," Journal of Economic Behavior & Organization, Elsevier, vol. 140(C), pages 130-146.
    3. Patricia Cubí‐Mollá & Mireia Jofre‐Bonet & Victoria Serra‐Sastre, 2017. "Adaptation to health states: Sick yet better off?," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1826-1843, December.
    4. Peter A. Ubel & Jeff Richardson & Paul Menzel, 2000. "Societal value, the person trade‐off, and the dilemma of whose values to measure for cost‐effectiveness analysis," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 127-136, March.
    5. A. Pickard & Rima Tawk & James Shaw, 2013. "The effect of chronic conditions on stated preferences for health," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(4), pages 697-702, August.
    6. Shiell, Alan, 1997. "Health outcomes are about choices and values: an economic perspective on the health outcomes movement," Health Policy, Elsevier, vol. 39(1), pages 5-15, January.
    7. Mary Steffel & Daniel Oppenheimer, 2009. "Happy by What Standard? The Role of Interpersonal and Intrapersonal Comparisons in Ratings of Happiness," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 92(1), pages 69-79, May.
    8. Ogorevc, Marko & Murovec, Nika & Fernandez, Natacha Bolanos & Rupel, Valentina Prevolnik, 2019. "Questioning the differences between general public vs. patient based preferences towards EQ-5D-5L defined hypothetical health states," Health Policy, Elsevier, vol. 123(2), pages 166-172.
    9. Damschroder, Laura J. & Zikmund-Fisher, Brian J. & Ubel, Peter A., 2005. "The impact of considering adaptation in health state valuation," Social Science & Medicine, Elsevier, vol. 61(2), pages 267-277, July.
    10. Björn Sossong & Stefan Felder & Malte Wolff & Klaus Krüger, 2017. "Evaluating the consequences of rheumatoid arthritis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(6), pages 685-696, July.
    11. Álvarez, Begoña & Rodríguez-Míguez, Eva, 2011. "Patients' self-interested preferences: Empirical evidence from a priority setting experiment," Social Science & Medicine, Elsevier, vol. 72(8), pages 1317-1324, April.
    12. repec:cup:judgdm:v:1:y:2006:i::p:146-152 is not listed on IDEAS
    13. Paul McNamee & Sharon Glendinning & Jonathan Shenfine & Nick Steen & S. Griffin & John Bond, 2004. "Chained time trade-off and standard gamble methods," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(1), pages 81-86, February.
    14. Cubi-Molla, P. & Jofre-Bonet, M. & Serra-Sastre, V., 2013. "Adaptation to Health States: A Micro-Econometric Approach," Working Papers 13/02, Department of Economics, City University London.
    15. Jiryoun Gong & Juhee Han & Donghwan Lee & Seungjin Bae, 2020. "A Meta-Regression Analysis of Utility Weights for Breast Cancer: The Power of Patients’ Experience," IJERPH, MDPI, vol. 17(24), pages 1-16, December.
    16. Hans-Helmut König & Oliver Günther & Matthias Angermeyer & Christiane Roick, 2009. "Utility Assessment in Patients with Mental Disorders," PharmacoEconomics, Springer, vol. 27(5), pages 405-419, May.
    17. Matthias Wrede, 2005. "Health Values, Preference Inconsistency, and Insurance Demand," CESifo Working Paper Series 1634, CESifo.
    18. Renate M. Houts & William D. Smucker & Jill A. Jacobson & Peter H. Ditto & Joseph H. Danks, 2002. "Predicting Elderly Outpatients’ Life-Sustaining Treatment Preferences over Time: The Majority Rules," Medical Decision Making, , vol. 22(1), pages 39-52, February.
    19. Valerie Seror, 2008. "Fitting observed and theoretical choices – women's choices about prenatal diagnosis of Down syndrome," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 557-577, May.
    20. Aliasghar A. Kiadaliri & Ulf-G Gerdtham & Björn Eliasson & Soffia Gudbjörnsdottir & Ann-Marie Svensson & Katarina Steen Carlsson, 2014. "Health Utilities of Type 2 Diabetes-Related Complications: A Cross-Sectional Study in Sweden," IJERPH, MDPI, vol. 11(5), pages 1-14, May.
    21. Heather P. Lacey & Angela Fagerlin & George Loewenstein & Dylan M. Smith & Jason Riis & Peter A. Ubel, 2006. "It must be awful for them: Healthy people overlook disease variability in quality of life judgments," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 146-152, November.
    22. Octave Jokung & Serge Macé, 2013. "Long-term health investment when people underestimate their adaptation to old age-related health problems," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 1003-1013, December.
    23. G. Ardine De Wit & Jan J.V. Busschbach & Frank Th. De Charro, 2000. "Sensitivity and perspective in the valuation of health status: whose values count?," Health Economics, John Wiley & Sons, Ltd., vol. 9(2), pages 109-126, March.
    24. de Wit, G.Ardine & Ramsteijn, Paul G & de Charro, Frank Th, 1998. "Economic evaluation of end stage renal disease treatment," Health Policy, Elsevier, vol. 44(3), pages 215-232, June.

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