Setting Dead at Zero: Applying Scale Properties to the QALY Model.
Med Decis Making
; 38(6): 627-634, 2018 08.
Article
em En
| MEDLINE
| ID: mdl-29629848
ABSTRACT
INTRODUCTION:
Scaling severe states can be a difficult task. First, the method of measurement affects whether a health state is considered better or worse than dead. Second, in discrete choice experiments, different models to anchor health states on 0 (dead) and 1 (perfect health) produce varying amounts of health states worse than dead. RESEARCH QUESTION Within the context of the quality-adjusted life year (QALY) model, this article provides insight into the value assigned to dead and its consequences for decision making. Our research questions are 1) what are the arguments set forth to assign dead the number 0 on the health-utility scale? And 2) what are the effects of the position of dead on the health-utility scale on decision making?METHODS:
A literature review was conducted to explore the arguments set forth to assign dead a value of 0 in the QALY model. In addition, scale properties and transformations were considered.RESULTS:
The review uncovered several practical and theoretical considerations for setting dead at 0. In the QALY model, indifference between 2 health episodes is not preserved under changes of the origin of the duration scale. Ratio scale properties are needed for the duration scale to preserve indifferences. In combination with preferences and zero conditions for duration and health, it follows that dead should have a value of 0.CONCLUSIONS:
The health-utility and duration scales have ratio scale properties, and dead should be assigned the number 0. Furthermore, the position of dead should be carefully established, because it determines how life-saving and life-improving values are weighed in cost-utility analysis.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Nível de Saúde
/
Técnicas de Apoio para a Decisão
/
Análise Custo-Benefício
/
Anos de Vida Ajustados por Qualidade de Vida
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article