IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v38y2018i6p627-634.html
   My bibliography  Save this article

Setting Dead at Zero: Applying Scale Properties to the QALY Model

Author

Listed:
  • Bram Roudijk

    (Department for Health Evidence, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

  • A. Rogier T. Donders

    (Department for Health Evidence, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

  • Peep F.M. Stalmeier

    (Department for Health Evidence, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, Gelderland, the Netherlands)

Abstract

Introduction. Scaling severe states can be a difficult task. First, the method of measurement affects whether a health state is considered better or worse than dead. Second, in discrete choice experiments, different models to anchor health states on 0 (dead) and 1 (perfect health) produce varying amounts of health states worse than dead. Research Question. Within the context of the quality-adjusted life year (QALY) model, this article provides insight into the value assigned to dead and its consequences for decision making. Our research questions are 1) what are the arguments set forth to assign dead the number 0 on the health–utility scale? And 2) what are the effects of the position of dead on the health–utility scale on decision making? Methods. A literature review was conducted to explore the arguments set forth to assign dead a value of 0 in the QALY model. In addition, scale properties and transformations were considered. Results. The review uncovered several practical and theoretical considerations for setting dead at 0. In the QALY model, indifference between 2 health episodes is not preserved under changes of the origin of the duration scale. Ratio scale properties are needed for the duration scale to preserve indifferences. In combination with preferences and zero conditions for duration and health, it follows that dead should have a value of 0. Conclusions. The health–utility and duration scales have ratio scale properties, and dead should be assigned the number 0. Furthermore, the position of dead should be carefully established, because it determines how life-saving and life-improving values are weighed in cost–utility analysis.

Suggested Citation

  • Bram Roudijk & A. Rogier T. Donders & Peep F.M. Stalmeier, 2018. "Setting Dead at Zero: Applying Scale Properties to the QALY Model," Medical Decision Making, , vol. 38(6), pages 627-634, August.
  • Handle: RePEc:sae:medema:v:38:y:2018:i:6:p:627-634
    DOI: 10.1177/0272989X18765184
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X18765184
    Download Restriction: no

    File URL: https://libkey.io/10.1177/0272989X18765184?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Joseph S. Pliskin & Donald S. Shepard & Milton C. Weinstein, 1980. "Utility Functions for Life Years and Health Status," Operations Research, INFORMS, vol. 28(1), pages 206-224, February.
    2. Robinson, Angela & Dolan, Paul & Williams, Alan, 1997. "Valuing health status using VAS and TTO: What lies behind the numbers?," Social Science & Medicine, Elsevier, vol. 45(8), pages 1289-1297, October.
    3. Louviere, Jordan J. & Lancsar, Emily, 2009. "Choice experiments in health: the good, the bad, the ugly and toward a brighter future," Health Economics, Policy and Law, Cambridge University Press, vol. 4(4), pages 527-546, October.
    4. Richard Norman & Paula Cronin & Rosalie Viney, 2013. "A Pilot Discrete Choice Experiment to Explore Preferences for EQ-5D-5L Health States," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 287-298, June.
    5. John M. Miyamoto & Peter P. Wakker & Han Bleichrodt & Hans J. M. Peters, 1998. "The Zero-Condition: A Simplifying Assumption in QALY Measurement and Multiattribute Utility," Management Science, INFORMS, vol. 44(6), pages 839-849, June.
    6. 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.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hougaard, Jens Leth & Moreno-Ternero, Juan D. & Østerdal, Lars Peter, 2013. "A new axiomatic approach to the evaluation of population health," Journal of Health Economics, Elsevier, vol. 32(3), pages 515-523.
    2. Attema, Arthur E. & Brouwer, Werner B.F., 2012. "A test of independence of discounting from quality of life," Journal of Health Economics, Elsevier, vol. 31(1), pages 22-34.
    3. Arthur E. Attema & Marieke Krol & Job Exel & Werner B. F. Brouwer, 2018. "New findings from the time trade-off for income approach to elicit willingness to pay for a quality adjusted life year," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 277-291, March.
    4. Attema, Arthur E. & Brouwer, Werner B.F., 2009. "The correction of TTO-scores for utility curvature using a risk-free utility elicitation method," Journal of Health Economics, Elsevier, vol. 28(1), pages 234-243, January.
    5. Anne Spencer, 2003. "The TTO method and procedural invariance," Health Economics, John Wiley & Sons, Ltd., vol. 12(8), pages 655-668, August.
    6. MORENO-TERNERO, Juan & OSTERDAL, Lars P., 2014. "Normative foundations for equity-sensitive population health evaluation functions," LIDAM Discussion Papers CORE 2014031, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    7. Paul F M Krabbe, 2013. "A Generalized Measurement Model to Quantify Health: The Multi-Attribute Preference Response Model," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-12, November.
    8. Hansen, Kristian S. & Moreno-Ternero, Juan D. & Østerdal, Lars P., 2024. "Quality- and productivity-adjusted life years: From QALYs to PALYs and beyond," Journal of Health Economics, Elsevier, vol. 95(C).
    9. Arthur E. Attema & Han Bleichrodt & Olivier l’Haridon & Stefan A. Lipman, 2020. "A comparison of individual and collective decision making for standard gamble and time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 465-473, April.
    10. Dolan, Paul & Stalmeier, Peep, 2003. "The validity of time trade-off values in calculating QALYs: constant proportional time trade-off versus the proportional heuristic," Journal of Health Economics, Elsevier, vol. 22(3), pages 445-458, May.
    11. Hansen, Kristian S. & Moreno-Ternero, Juan D. & Østerdal, Lars P., 2023. "Productivity and quality-adjusted life years: QALYs, PALYs and beyond," Working Papers 11-2023, Copenhagen Business School, Department of Economics.
    12. James K. Hammitt, 2017. "Valuing Non-Fatal Health Risks: Monetary and Health-Utility Measures," Revue économique, Presses de Sciences-Po, vol. 68(3), pages 335-356.
    13. Arthur Attema & Werner Brouwer, 2012. "The way that you do it? An elaborate test of procedural invariance of TTO, using a choice-based design," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(4), pages 491-500, August.
    14. F. E. van Nooten & X. Koolman & W. B. F. Brouwer, 2009. "The influence of subjective life expectancy on health state valuations using a 10 year TTO," Health Economics, John Wiley & Sons, Ltd., vol. 18(5), pages 549-558, May.
    15. Arthur E. Attema & Werner B.F. Brouwer, 2014. "Deriving Time Discounting Correction Factors For Tto Tariffs," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 410-425, April.
    16. Marjon Pol & Larissa Roux, 2005. "Time preference bias in time trade-off," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(2), pages 107-111, June.
    17. José Mª Abellán & José Luis Pinto & Ildefonso Méndez & Xabier Badía, 2004. "A test of the predictive validity of non-linear QALY models using time trade-off utilities," Economics Working Papers 741, Department of Economics and Business, Universitat Pompeu Fabra.
    18. Charles M. Harvey & Lars Peter Østerdal, 2010. "Cardinal Scales for Health Evaluation," Decision Analysis, INFORMS, vol. 7(3), pages 256-281, September.
    19. 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.
    20. Kenneth C. Lichtendahl & Samuel E. Bodily, 2012. "Multiplicative Utilities for Health and Consumption," Decision Analysis, INFORMS, vol. 9(4), pages 314-328, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:38:y:2018:i:6:p:627-634. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.