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Sunday, October 19, 2008
Columbus A-C (Hyatt Regency Penns Landing)
Objectives Different groups of individuals, such as patients or the general public, can value health states to be used in utility analysis. Whose preferences are used might have influence on the valuation and consequently on the cost-utility analysis. In spite of several studies analyzing this difference and an earlier limited meta-analysis it remains unclear if the type of individual has influence on such valuation of a health state. We investigate the influence of respondent group on health state valuations through meta-analyses.
Methods A literature search was performed using computerized databases and the references and citation index of retrieved studies. Only studies reporting directly elicited health state valuations were included, studies reporting utility weights from classification studies were excluded. In total 33 studies were found of which 5 were excluded due to differences in the elicitation method for patients and the general public, insufficient data, or because the data had already been included in another study. One overall meta-analysis and three sub-analyses by elicitation method (VAS, TTO, SG), were preformed. To make sure that each participant was only included once, data within studies were combined when necessary.
Results Since all samples appeared to be heterogeneous, random effects models were used in all analyses. From the 28 eligible studies 37 estimators were retrieved which taken together, revealed a small difference between valuations of patients and the general public (Cohens d = 0.19, p < 0.01). When each elicitation method was analysed separately, we found that patients gave higher valuations than the general public on the VAS (N = 20, Cohens d = 0.31, p < 0.01) and the TTO (N = 23, Cohens d = 0.17, p < 0.05). In contrast, when the SG was used as elicitation method no difference was seen between patients and the general public (N = 23, Cohens d = 0.07, p = 0.21). Conclusion In contrast with Dolders (2006), our results show that patients give slightly higher health state valuations than the general public, with a moderate difference when using the VAS and no difference when using the SG.
Methods A literature search was performed using computerized databases and the references and citation index of retrieved studies. Only studies reporting directly elicited health state valuations were included, studies reporting utility weights from classification studies were excluded. In total 33 studies were found of which 5 were excluded due to differences in the elicitation method for patients and the general public, insufficient data, or because the data had already been included in another study. One overall meta-analysis and three sub-analyses by elicitation method (VAS, TTO, SG), were preformed. To make sure that each participant was only included once, data within studies were combined when necessary.
Results Since all samples appeared to be heterogeneous, random effects models were used in all analyses. From the 28 eligible studies 37 estimators were retrieved which taken together, revealed a small difference between valuations of patients and the general public (Cohens d = 0.19, p < 0.01). When each elicitation method was analysed separately, we found that patients gave higher valuations than the general public on the VAS (N = 20, Cohens d = 0.31, p < 0.01) and the TTO (N = 23, Cohens d = 0.17, p < 0.05). In contrast, when the SG was used as elicitation method no difference was seen between patients and the general public (N = 23, Cohens d = 0.07, p = 0.21). Conclusion In contrast with Dolders (2006), our results show that patients give slightly higher health state valuations than the general public, with a moderate difference when using the VAS and no difference when using the SG.
See more of: Poster Session I
See more of: 30th Annual Meeting of the Society for Medical Decision Making (October 19-22, 2008)