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Tests of Preferential Independence in the QALY Model

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  • Jonathan R. Treadwell

Abstract

The author presents evidence for the descriptive adequacy of the quality-adjusted life years (QALY) model as applied to health profiles. One important assumption of the model is preferential independence: if two profiles have the same health state during year X, then preference between them does not switch if the level of health changes during year X. In experiment 1, 30-year health profiles were used to perform 27 em pirical tests of independence with 98 subjects. Independence was reliably satisfied in all 27 tests. In experiment 2, 15 additional tests were conducted. These tests had been specifically designed to be more sensitive to independence violations, but indepen dence was still mostly satisfied. In both experiments, the conclusions about indepen dence hold regardless of what discount rate is used. These results act as a "lower bound" on the validity of the QALY model for health profiles. Key words: quality-ad justed life years; QALY model; health profiles; preferential independence. (Med Decis Making 1998;18:418-428)

Suggested Citation

  • Jonathan R. Treadwell, 1998. "Tests of Preferential Independence in the QALY Model," Medical Decision Making, , vol. 18(4), pages 418-428, October.
    • Handle: RePEc:sae:medema:v:18:y:1998:i:4:p:418-428
    DOI: 10.1177/0272989X9801800410
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    References listed on IDEAS

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    Cited by:

    1. Bleichrodt, Han & Filko, Martin, 2008. "New tests of QALYs when health varies over time," Journal of Health Economics, Elsevier, vol. 27(5), pages 1237-1249, September.
    2. Spencer, Anne & Robinson, Angela, 2007. "Tests of utility independence when health varies over time," Journal of Health Economics, Elsevier, vol. 26(5), pages 1003-1013, September.
    3. Carmen Herrero Blanco, 2001. "Individual Evidence Of Independence In Health Profiles Evaluation," Working Papers. Serie AD 2001-20, Instituto Valenciano de Investigaciones Económicas, S.A. (Ivie).
    4. Anne Spencer & Angela Robinson, 2007. "Tests of Utility Independence When Health Varies over Time," Working Papers 596, Queen Mary University of London, School of Economics and Finance.
    5. Spencer, Anne & Rivero-Arias, Oliver & Wong, Ruth & Tsuchiya, Aki & Bleichrodt, Han & Edwards, Rhiannon Tudor & Norman, Richard & Lloyd, Andrew & Clarke, Philip, 2022. "The QALY at 50: One story many voices," Social Science & Medicine, Elsevier, vol. 296(C).
    6. Anne Spencer, 2000. "Testing the Additive Independence Assumption in the QALY Model," Working Papers 427, Queen Mary University of London, School of Economics and Finance.
    7. José‐María Abellán‐Perpiñán & José‐Luis Pinto‐Prades & Ildefonso Méndez‐Martínez & Xabier Badía‐Llach, 2006. "Towards a better QALY model," Health Economics, John Wiley & Sons, Ltd., vol. 15(7), pages 665-676, July.
    8. Anne Spencer, 2000. "Testing the Additive Independence Assumption in the QALY Model," Working Papers 427, Queen Mary University of London, School of Economics and Finance.
    9. Kristian Schultz Hansen & Lars Peter Østerdal, 2006. "Models of Quality‐Adjusted Life Years when Health Varies Over Time: Survey and Analysis," Journal of Economic Surveys, Wiley Blackwell, vol. 20(2), pages 229-255, April.
    10. Anne Spencer & Angelo Ranaldo, 2007. "Tests of Utility Independence When Health Varies over Time," Working Papers 596, Queen Mary University of London, School of Economics and Finance.

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