The Prevalence, Correlates, and Impact of Logically Inconsistent Preferences in Utility Assessments for Joint Health States in Prostate Cancer
The Prevalence, Correlates, and Impact of Logically Inconsistent Preferences in Utility Assessments for Joint Health States in Prostate Cancer
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DOI：
10.1097/mlr.0b013e3181f37bf2
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发表时间：
2011-01-01
期刊：
影响因子：
3
通讯作者：
Meltzer, David
中科院分区：
文献类型：
--
作者：
Dale, William;Bilir, S. Pinar;Meltzer, David
背景：健康状态效用的变化会影响成本效益分析。一个潜在的错误来源是联合健康状态（JS）实用程序的评级高于嵌入式单一状态（SS）实用程序。了解何时和在谁发生这种情况可以提高成本效益analysis.Methods：男性（n = 323）进行了调查，在前列腺活检的时间。收集流行前列腺癌（PCa）健康状态的时间权衡SS和JS效用。评估的JS实用程序包括最常见的PCa。“不一致性”以以下3种方式定义：（1）任何尺寸等级顺序违背;（2）违背总数;和（3）差异大于1个标准差（SD）。回归分析评估与不一致的respons.Results：聚合JS效用是一致的独立的患者特征。在个体水平上，36%至41%的回答违反了等级顺序，12%至14%的回答大于1 SD。总的来说，69%的受访者至少有1个JS不一致，24%的受访者有>1个SD不一致。已婚和感到焦虑与给出所有类型的不一致评级独立相关，教育程度较低与犯>SD错误相关。SS实用程序，而不是JS实用程序，显着较低的不一致组。“纠正”JS的不一致性减少了总效用1至9 units.Conclusions：不一致的JS公用事业PCa是普遍存在于男性活检。已婚、更焦虑、受教育程度较低与不一致性相关。在一致和不一致的评分者之间存在差异的是SS实用程序，而不是JS实用程序。需要更好地了解这些不一致的根源。
Background: Variations in health state utilities can impact cost-effectiveness analyses. One potential source of error is when joint health state (JS) utilities are rated higher than the embedded single state (SS) utilities. Knowing when and in whom this occurs can improve cost-effectiveness analyses.Methods: Men (n = 323) were surveyed at the time of prostate biopsy. Time tradeoff SS and JS utilities for prevalent prostate cancer (PCa) health states were collected. JS utilities assessed included those most prevalent for PCa. "Inconsistency" was defined in the following 3 ways: (1) any size rank order violation; (2) total number of violations; and (3) differences greater than 1 standard deviation (SD). Regression analysis assessed independent patient characteristics associated with inconsistent responses.Results: Aggregate JS utilities were consistent. At the individual level, 36% to 41% of responses violated rank order and 12% to 14% were larger than 1 SD. In all, 69% of respondents had at least 1 JS inconsistency, and 24% had >1 SD inconsistencies. Being married and feeling anxious were independently correlated with giving all types of inconsistent ratings, and lower education correlated with making >SD errors. SS utilities, and not JS utilities, were significantly lower for the inconsistent group. "Correcting" JS inconsistencies decreased aggregate utilities 1 to 9 units.Conclusions: Inconsistent JS utilities for PCa are prevalent in men at biopsy. Being married, more anxious, and having less education are correlated with inconsistencies. It is the SS utilities, rather than the JS utilities, that differ between consistent and inconsistent raters. Better understanding of the source of these inconsistencies is needed.