Kohlmann T, Behrens M, Schipp B; International Society of Technology Assessment in Health Care. Meeting.
Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1999; 15: 38.
Medical University of Lubeck, Lubeck, Germany.
BACKGROUND: Preference-based measurement of health-related quality of life has become increasingly popular in studies of medical outcomes. Widely used instruments in this area are the "Quality of Well-being Index (QWB), the "Health Utilities Index" (HUI), or the EuroQol questionnaire (EQ-5D). To derive scoring systems for these instruments different approaches have been adopted and various mathematical scoring functions have been developed to aggregate data into a single utility summary score. These summary scores are an essential component in economic evaluation (cost-utility analysis) of health technologies. OBJECTIVE/PURPOSE: To review the main instruments for measuring health utilities (QWB, HUI, EQ-5D), the methods used to derive their scoring systems, and aspects of their feasibility in medical outcome studies. METHODS: In a critical appraisal of methods used in published cost-utility analyses mainly from the field of migraine therapy (for example: Evans et al. Pharmacoeconomics 1997, 12:565-577) relevant problems were identified. RESULTS: Three major methodological difficulties were found: A) Scoring systems are based on a model of rtional decision making which aggregates various aspects of health status in a single summary score. Yet, relevant psychometric concepts for testing unidimensionality have been seldomly addressed in the construction and application of preference-based measures. B) Different methods of deriving scoring algorithms often result in poorly correlated utility scores. It has also been shown in cross-national comparisons that utility weights may differ considerably across countries so that international equivalence of measures may not be warranted. C) Some scoring algorithms have substantial complexity. Users of preference-based measures may therefore face relevant difficulties in obtaining correct scores for the subjects included in their studies. CONCLUSIONS: More efforts are needed to solve the problems still inherent in preference-based quality of life measurement. Recent developments of psychometric and "cognitive" testing of instruments for measuring subjective health could be useful tools in this area.
Publication Types:
Keywords:
- Evaluation Studies
- Health Status
- Health Status Indicators
- Life
- Outcome Assessment (Health Care)
- Quality of Life
- Quality-Adjusted Life Years
- Questionnaires
- Research Design
- methods
- hsrmtgs
Other ID:
UI: 102193639
From Meeting Abstracts