Cargando…

Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?

BACKGROUND: Quality Adjusted Life Years (QALYs) are a key outcome measure widely used within health technology assessment and health service research studies. QALYs combine quantity and quality of life, with quality of life calculations relying on the value of distinct health states. Such health sta...

Descripción completa

Detalles Bibliográficos
Autores principales: Oliveira, Mónica Duarte, Agostinho, Andreia, Ferreira, Lara, Nicola, Paulo, Bana e Costa, Carlos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299594/
https://www.ncbi.nlm.nih.gov/pubmed/30563525
http://dx.doi.org/10.1186/s12955-018-1056-y
_version_ 1783381518455930880
author Oliveira, Mónica Duarte
Agostinho, Andreia
Ferreira, Lara
Nicola, Paulo
Bana e Costa, Carlos
author_facet Oliveira, Mónica Duarte
Agostinho, Andreia
Ferreira, Lara
Nicola, Paulo
Bana e Costa, Carlos
author_sort Oliveira, Mónica Duarte
collection PubMed
description BACKGROUND: Quality Adjusted Life Years (QALYs) are a key outcome measure widely used within health technology assessment and health service research studies. QALYs combine quantity and quality of life, with quality of life calculations relying on the value of distinct health states. Such health states’ values capture the preferences of a population and have been typically built through numerical elicitation methods. Evidence points to these value scores being influenced by methods in use and individuals reporting cognitive difficulties in eliciting their preferences. Evidence from other areas has further suggested that individuals may prefer using distinct elicitation techniques and that this preference can be influenced by their numeracy. In this study we explore the use of the MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) non-numerical preference elicitation approach for health states’ evaluation. METHODS: A new protocol for preference elicitation based on MACBETH (only requiring qualitative judgments) was developed and tested within a web survey format. A sample of the Portuguese general population (n=243) valued 25 EQ-5D-3L health states with the MACBETH protocol and with a variant of the time trade-off (TTO) protocol, for comparison purposes and for understanding respondents’ preference for distinct protocols and differences in inconsistent evaluations. Respondents answered to a short numeracy test, and basic socio-economic information collected. RESULTS: Results show that the mean values derived from MACBETH and the TTO variant are strongly correlated; however, there are substantial differences for several health states’ values. Large and similar numbers of logical inconsistencies were found in respondents’ answers with both methods. Participants with higher levels of numeracy according to the test preferred expressing value judgments with MACBETH, while participants with lower levels were mostly indifferent to both methods. Higher correlations between MACBETH and TTO variant evaluations were observed for individuals with higher numeracy. CONCLUSION: Results suggest that it is worth researching the use of non-numerical preference elicitation methods. Numeracy tests more appropriate for preference elicitation when no explicit considerations of uncertainty are made need to be explored and used. Further behavioural research is needed to fully understand the potential for using these methods in distinct settings (e.g. in different evaluation contexts and in face-to-face and non-face-to-face environments), as well as to explore the effect of literacy on assessments and on respondents’ preferences.
format Online
Article
Text
id pubmed-6299594
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-62995942018-12-20 Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states? Oliveira, Mónica Duarte Agostinho, Andreia Ferreira, Lara Nicola, Paulo Bana e Costa, Carlos Health Qual Life Outcomes Research BACKGROUND: Quality Adjusted Life Years (QALYs) are a key outcome measure widely used within health technology assessment and health service research studies. QALYs combine quantity and quality of life, with quality of life calculations relying on the value of distinct health states. Such health states’ values capture the preferences of a population and have been typically built through numerical elicitation methods. Evidence points to these value scores being influenced by methods in use and individuals reporting cognitive difficulties in eliciting their preferences. Evidence from other areas has further suggested that individuals may prefer using distinct elicitation techniques and that this preference can be influenced by their numeracy. In this study we explore the use of the MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) non-numerical preference elicitation approach for health states’ evaluation. METHODS: A new protocol for preference elicitation based on MACBETH (only requiring qualitative judgments) was developed and tested within a web survey format. A sample of the Portuguese general population (n=243) valued 25 EQ-5D-3L health states with the MACBETH protocol and with a variant of the time trade-off (TTO) protocol, for comparison purposes and for understanding respondents’ preference for distinct protocols and differences in inconsistent evaluations. Respondents answered to a short numeracy test, and basic socio-economic information collected. RESULTS: Results show that the mean values derived from MACBETH and the TTO variant are strongly correlated; however, there are substantial differences for several health states’ values. Large and similar numbers of logical inconsistencies were found in respondents’ answers with both methods. Participants with higher levels of numeracy according to the test preferred expressing value judgments with MACBETH, while participants with lower levels were mostly indifferent to both methods. Higher correlations between MACBETH and TTO variant evaluations were observed for individuals with higher numeracy. CONCLUSION: Results suggest that it is worth researching the use of non-numerical preference elicitation methods. Numeracy tests more appropriate for preference elicitation when no explicit considerations of uncertainty are made need to be explored and used. Further behavioural research is needed to fully understand the potential for using these methods in distinct settings (e.g. in different evaluation contexts and in face-to-face and non-face-to-face environments), as well as to explore the effect of literacy on assessments and on respondents’ preferences. BioMed Central 2018-12-18 /pmc/articles/PMC6299594/ /pubmed/30563525 http://dx.doi.org/10.1186/s12955-018-1056-y Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Oliveira, Mónica Duarte
Agostinho, Andreia
Ferreira, Lara
Nicola, Paulo
Bana e Costa, Carlos
Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title_full Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title_fullStr Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title_full_unstemmed Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title_short Valuing health states: is the MACBETH approach useful for valuing EQ-5D-3L health states?
title_sort valuing health states: is the macbeth approach useful for valuing eq-5d-3l health states?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6299594/
https://www.ncbi.nlm.nih.gov/pubmed/30563525
http://dx.doi.org/10.1186/s12955-018-1056-y
work_keys_str_mv AT oliveiramonicaduarte valuinghealthstatesisthemacbethapproachusefulforvaluingeq5d3lhealthstates
AT agostinhoandreia valuinghealthstatesisthemacbethapproachusefulforvaluingeq5d3lhealthstates
AT ferreiralara valuinghealthstatesisthemacbethapproachusefulforvaluingeq5d3lhealthstates
AT nicolapaulo valuinghealthstatesisthemacbethapproachusefulforvaluingeq5d3lhealthstates
AT banaecostacarlos valuinghealthstatesisthemacbethapproachusefulforvaluingeq5d3lhealthstates