The effect of time of onset on community preferences for health states: an exploratory study.
The effect of time of onset on community preferences for health states: an exploratory study.
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DOI：
10.1186/1477-7525-9-6
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发表时间：
2011-01-20
影响因子：
3.6
通讯作者：
Wittenberg E
中科院分区：
文献类型：
--
作者：
Wittenberg E
在社区视角效用调查中，用于描述假设情景的健康状态描述通常省略了疾病发生时间的细节，尽管我们知道，在有疾病的患者中，经验会影响分配给该疾病的值。关于在成本效用分析中使用谁的价值的争论，部分是基于这种观察到的价值之间的差异，这取决于衡量它们的角度。本研究探讨在健康状态描述中包含健康状况的发病时间对社区对假设健康状况偏好的影响，以调查这一信息是否会促使社区受访者提供与有健康状况经历的患者更接近的值。这项研究的目标是弥合患者和社区偏好之间的差距。一项从社区角度对假设健康状态的偏好进行的调查是从一个医院联盟的研究志愿者池中招募的健康成年人的便利样本中进行的。对三种不同严重程度的假设健康状态的标准赌注在描述发病时间的三个框架内进行了比较：发病前六个月、当前发病和描述中指定的没有发病。结果在不同发病时间的健康状态下进行了比较，控制了已知的影响效用得分的受访者特征。进行了分分析，以确认符合纳入标准的价值的结果，表明对评估任务的了解和遵守程度最低。来自368项已完成调查的标准赌博分数在健康状况描述中描述的发病时间之间没有显着差异，与健康状况严重程度和受试者特征控制无关。在排除了不合逻辑和不变的回答的292个回答的子集中也发现了类似的结果。在社区视角效用调查中包括关于健康状况发生时间的信息，健康状况描述可能不会突出或不会诱导受访者表达与疾病发病相关的偏好。需要进一步的研究来了解社区对疾病发病的偏好，以及如何将这些信息整合到健康状态描述中，以优化效用数据的有效性。更好地理解健康状况描述的设计和呈现如何影响反应，将有助于得出有效的偏好，以便纳入决策。
Health state descriptions used to describe hypothetical scenarios in community-perspective utility surveys commonly omit detail on the time of onset of a condition, despite our knowledge that among patients who have a condition, experience affects the value assigned to that condition. The debate regarding whose values to use in cost utility analysis is based in part on this observed difference between values depending on the perspective from which they are measured. This research explores the effect on community preferences for hypothetical health states of including the time of onset of a health condition in the health state description, to investigate whether this information induces community respondents to provide values closer to those of patients with experience with a condition. The goal of the research is to bridge the gap between patient and community preferences. A survey of community-perspective preferences for hypothetical health states was conducted among a convenience sample of healthy adults recruited from a hospital consortium's research volunteer pool. Standard gambles for three hypothetical health states of varying severity were compared across three frames describing time of onset: six months prior onset, current onset, and no onset specified in the description. Results were compared within health state across times of onset, controlling for respondent characteristics known to affect utility scores. Sub-analyses were conducted to confirm results on values meeting inclusion criteria indicating a minimum level of understanding and compliance with the valuation task. Standard gamble scores from 368 completed surveys were not significantly different across times of onset described in the health state descriptions regardless of health condition severity and controlling for respondent characteristics. Similar results were found in the subset of 292 responses that excluded illogical and invariant responses. The inclusion of information on the time of onset of a health condition in community-perspective utility survey health state descriptions may not be salient to or may not induce expression of preferences related to disease onset among respondents. Further research is required to understand community preferences regarding condition onset, and how such information might be integrated into health state descriptions to optimize the validity of utility data. Improved understanding of how the design and presentation of health state descriptions affect responses will be useful to eliciting valid preferences for incorporation into decision making.
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