UTILITIES, PREFERENCE MEASURES, AND QALYS
Course Level: Beginner
Background: This course introduces attendees to the use of preference-based measures in decision sciences. When assessing health outcomes, decision scientists often wish to capture information about quality of life. These have most frequently been captured as utilities, which are summary measures of that reflect how individuals feel about defined health states. Utilities form the basis for cost-utility analyses, in which benefits are usually quantified as quality adjusted life years, or QALYs (the amount of time in each health state is weighted by the utility of each health state to determine the expected overall quality adjusted life years). This course will explore several issues relevant to understanding utilities and QALYs, including what is being measured, how utilities should be measured, from which perspective, the relative merits of alternative approaches, and a brief overview of alternative approaches.
Format Requirements: This course will integrate “theory bursts” with interactive exercises. Mini-lectures will include audience participation and will be followed by brief (usually computer-based) exercise which participants can complete individually or in pairs. No prerequisites are required although some familiarity with decision theory is an advantage.
Description and Objectives: We will review four main topics: 1) The concept of preference measurement / utility and its role in decision sciences; 2) the most common direct preference-based measures, including the Standard Gamble, the Time Trade-Off, and the Visual Analog Scale; 3) Indirect measures of utility, including the EQ-5D, and alternatives; and 4) The QALY model, its strengths and limitations. By the end of the course, participants should be able to:
- Describe the main methods for measuring utilities and their relative strengths and weaknesses
- Recognize the main strengths and limitations of each method and of direct and indirect utility measurement
- Appreciate the main strengths and limitations of the QALY approach
Attendees are asked to bring a laptop loaded with Internet Explorer (version 9 or higher) or Google Chrome or Firefox or Safari to complete the exercises.
Ahmed Bayoumi, MD, MSc
University of Toronto
Health Policy, Management and Evaluation