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The Effect of Search Procedures on Utility Elicitations

Author

Listed:
  • Leslie A. Lenert
  • Daniel J. Cher
  • Mary K. Goldstein
  • Merlynn R. Bergen
  • Alan Garber

Abstract

Objective. Elicited preferences for health states vary among scaling methods, manners of describing health states, and other features of the elicitation process. The authors examined the effects of changing the search procedure for a subject's utility on mean utility values. Methods. A randomized controlled trial of two search procedures (titration and "ping-pong") using two otherwise identical computer programs that describe health states related to Gaucher's disease, then measuring subjects' preferences. Setting. Paid, healthy volunteers recruited from the community through advertisements. Re sults . The mean time tradeoff (TTO) and standard gamble (SG) utility values for life with severe anemia and splenomegaly and life with chronic bone pain from Gaucher's disease were between 0.10 and 0.15 higher with the titration search procedure than with the ping-pong procedure. Effects of the search procedure were additive with var iability due to scaling methods, resulting in mean differences in utility ratings for the same health state of as much as 0.28 among procedures and scaling methods. Effects of search procedures on utility values persisted on repeated testing at week 2 and week 3; there was no evidence of convergence to a single "true" utility value over time. Conclusions. The procedure used to search for subjects' utility values strongly influences the results of preference-assessment experiments. Effects of search pro cedures persist on repeated testing. The results suggest that utility values are heavily influenced by, if not created during, the process of elicitation. Thus, utility values elic ited using different search procedures may not be directly comparable. Key words: search procedures; utility elicitations; patient preferences; titration; ping-pong. (Med Decis Making 1998;18:76-83)

Suggested Citation

  • Leslie A. Lenert & Daniel J. Cher & Mary K. Goldstein & Merlynn R. Bergen & Alan Garber, 1998. "The Effect of Search Procedures on Utility Elicitations," Medical Decision Making, , vol. 18(1), pages 76-83, January.
    • Handle: RePEc:sae:medema:v:18:y:1998:i:1:p:76-83
    DOI: 10.1177/0272989X9801800115
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    References listed on IDEAS

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    1. Mary Kane Goldstein & Ann E. Clarke & David Michelson & Alan M. Garber & Merlynn R. Bergen & Leslie A. Lenert, 1994. "Developing and Testing a Multimedia Presentation of a Health-state Description," Medical Decision Making, , vol. 14(4), pages 336-344, October.
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    2. Jose-Luis Pinto-Prades & Jorge-Eduardo Martinez-Perez & Jose-Maria Abellan-Perpinan, 2006. "The influence of the ratio bias phenomenon on the elicitation of health states utilities," Judgment and Decision Making, Society for Judgment and Decision Making, vol. 1, pages 118-133, November.
    3. Michela Meregaglia & Elena Nicod & Michael Drummond, 2023. "The estimation of health state utility values in rare diseases: do the approaches in submissions for NICE technology appraisals reflect the existing literature? A scoping review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(7), pages 1151-1216, September.
    4. Jose Mª Abellán Perpiñán & Fernando Ignacio Sánchez Martínez & Jorge Eduardo Martínez Pérez & Ildefonso Méndez Martínez, 2009. "The QALY model wich came in from a general population survey: roughly multiplicative, broadly nonlinear and sometimes contex-dependt," Economic Working Papers at Centro de Estudios Andaluces E2009/04, Centro de Estudios Andaluces.
    5. José María Abellán Perpiñán & Fernando Ignacio Sánchez Martínez & Jorge Eduardo Martínez Pérez & Ildefonso Méndez, 2012. "Lowering The ‘Floor’ Of The Sf‐6d Scoring Algorithm Using A Lottery Equivalent Method," Health Economics, John Wiley & Sons, Ltd., vol. 21(11), pages 1271-1285, November.
    6. Koonal K. Shah & Juan Manuel Ramos-Goñi & Simone Kreimeier & Nancy J. Devlin, 2020. "An exploration of methods for obtaining 0 = dead anchors for latent scale EQ-5D-Y values," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(7), pages 1091-1103, September.
    7. Jeff Richardson & Angelo Iezzi & Kompal Sinha & Munir A. Khan & John Mckie, 2014. "An Instrument For Measuring The Social Willingness To Pay For Health State Improvement," Health Economics, John Wiley & Sons, Ltd., vol. 23(7), pages 792-805, July.
    8. Han Bleichrodt, 2002. "A new explanation for the difference between time trade‐off utilities and standard gamble utilities," Health Economics, John Wiley & Sons, Ltd., vol. 11(5), pages 447-456, July.
    9. Arthur Attema & Yvette Edelaar-Peeters & Matthijs Versteegh & Elly Stolk, 2013. "Time trade-off: one methodology, different methods," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(1), pages 53-64, July.
    10. Trude Arnesen & Mari Trommald, 2005. "Are QALYs based on time trade‐off comparable? – A systematic review of TTO methodologies," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 39-53, January.
    11. Hämäläinen, Raimo P. & Lahtinen, Tuomas J., 2016. "Path dependence in Operational Research—How the modeling process can influence the results," Operations Research Perspectives, Elsevier, vol. 3(C), pages 14-20.
    12. Scott B. Cantor, 2004. "Clinical Applications in the Decision Analysis Literature," Decision Analysis, INFORMS, vol. 1(1), pages 23-25, March.
    13. Ubel, Peter A. & Richardson, Jeff & Baron, Jonathan, 2002. "Exploring the role of order effects in person trade-off elicitations," Health Policy, Elsevier, vol. 61(2), pages 189-199, August.
    14. William Hollingworth & Richard A. Deyo & Sean D. Sullivan & Scott S. Emerson & Darryl T. Gray & Jeffrey G. Jarvik, 2002. "The practicality and validity of directly elicited and SF‐36 derived health state preferences in patients with low back pain," Health Economics, John Wiley & Sons, Ltd., vol. 11(1), pages 71-85, January.
    15. Nancy J. Devlin & Koonal K. Shah & Brendan J. Mulhern & Krystallia Pantiri & Ben van Hout, 2019. "A new method for valuing health: directly eliciting personal utility functions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(2), pages 257-270, March.
    16. Ruixuan Jiang & Thomas Kohlmann & Todd A. Lee & Axel Mühlbacher & James Shaw & Surrey Walton & A. Simon Pickard, 2021. "Increasing respondent engagement in composite time trade-off tasks by imposing three minimum trade-offs to improve data quality," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 17-33, February.

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