This Dead or That Dead: Framing Effects in the Evaluation of Health States.
Value Health
; 27(1): 95-103, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37913922
ABSTRACT
OBJECTIVES:
Current approaches to health state valuation rely on credible classification of states as either "better than dead" or "worse than dead" (WTD). We investigate how such evaluations of health states are affected by the framing in pairwise comparison tasks.METHODS:
We conducted an online survey with 361 participants to compare the propensity to evaluate a state as WTD under 6 frames (A) using a regular time trade-off (TTO) choice task, (B) using a lead-time TTO choice task, (C) excluding the immediacy of death, (D) avoiding reference to the process of dying, (E) focusing on longevity, and (F) focusing on improvements in quality of life. Each participant evaluated 9 EQ-5D-5L health states using 3 frames. The frames were compared using several statistical approaches to confirm robustness to indirect comparisons or respondent heterogeneity and inattentiveness.RESULTS:
The odds of a state being evaluated as WTD, compared with frame A, increase 2.7-fold and 1.5-fold in frame B and E, respectively, and decrease >5-fold in frame F. Frames C and D do not differ significantly from frame A.CONCLUSIONS:
Different framings for questions about whether a state is WTD or better than dead, even if theoretically equivalent, yield substantially different results. Notably, whether a state is evaluated as WTD differs greatly between the regular TTO and lead-time TTO choice tasks and when either final outcomes or improvements over time are considered.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Transtornos Cognitivos
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article