Logical inconsistencies in survey respondents' health state valuations - a methodological challenge for estimating social tariffs

被引:84
作者
Devlin, NJ
Hansen, P
Kind, P
Williams, A
机构
[1] Kings Fund Inst, London W1G 0AN, England
[2] Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England
关键词
EQ-5D; EuroQol; logical inconsistency; CUA; New Zealand;
D O I
10.1002/hec.741
中图分类号
F [经济];
学科分类号
02 ;
摘要
Logical inconsistencies in survey respondents' valuations of hypothetical health states - represented by the EQ-5D, for example - present a conundrum as to whether or not their responses ought to be included for estimating social 'tariffs'. A 'logical inconsistency' occurs when a state that 'in logical terms' is unambiguously less severe than another is assigned a lower value. Excluding such responses is defensible on data quality grounds but puts at risk the representativeness of the estimated tariff, given it is meant to represent the preferences of 'society'. This paper explores the rationale for and effect of excluding, to varying degrees, responses distinguished by the number of pairwise inconsistencies they contain, and reports equations for two tariffs that arise from contrasting approaches. The data are from a random sample of adult New Zealanders whose visual analogue scale valuations for a selection of EQ-5D states were collected in 1999 via a postal survey to which 1360 people responded (a 50% response rate). We conclude that there is no simple, generalisable 'rule' to guide exclusions and therefore researchers ought to explore the sensitivity of their estimated tariffs (and ultimately QALY estimates) to alternative treatments of logically inconsistent responses. Copyright (C) 2002 John Wiley Sons, Ltd.
引用
收藏
页码:529 / 544
页数:16
相关论文
共 24 条
[1]  
[Anonymous], EUR J PUBLIC HLTH, DOI DOI 10.1093/EURPUB/5.2.87
[2]  
ASHTON T, 1999, PRIORITISING HLTH DI
[3]   Feasibility, validity and test-retest reliability of scaling methods for health states: The visual analogue scale and the time trade-off [J].
Badia, X ;
Monserrat, S ;
Roset, M ;
Herdman, M .
QUALITY OF LIFE RESEARCH, 1999, 8 (04) :303-310
[4]   Inconsistent responses in three preference-elicitation methods for health states [J].
Badia, X ;
Roset, M ;
Herdman, M .
SOCIAL SCIENCE & MEDICINE, 1999, 49 (07) :943-950
[5]  
Björk S, 1999, HEALTH ECON, V8, P117
[6]   EuroQol: The current state of play [J].
Brooks, R .
HEALTH POLICY, 1996, 37 (01) :53-72
[7]  
Devlin N, 1999, NEW ZEAL MED J, V112, P369
[8]  
Devlin N, 1999, NEW ZEAL MED J, V112, P68
[9]   Modeling valuations for EuroQol health states [J].
Dolan, P .
MEDICAL CARE, 1997, 35 (11) :1095-1108
[10]   Whose preferences count? [J].
Dolan, P .
MEDICAL DECISION MAKING, 1999, 19 (04) :482-486