Developing a common outcome measure for priority setting in health: Validation of the 'Transfer to Utility' Technique

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The economic evaluation of health programs is a common requirement of funders and purchasers seeking to get the best value from the health dollar. But researchers employ a wide range of disease specific and generic health status instruments to describe trial outcomes, making comparison between diverse interventions difficult. In response to this problem a 'Transfer to Utility' or TTU technique was developed by Dr Segal and colleagues, to translate diverse outcomes reported in clinical trials, into a utility score, so the performance of diverse health interventions can be expressed in cost-QALY and compared. The technique establishes a statistical transformation between instruments commonly used in clinical trials and a utility value. While the technique appears highly useful, based on a priority setting exercise in osteoarthritis enabling 20 disparate interventions to be compared its validity and applicability in other contexts is not established. The purpose of the grant is to explore the TTU technique to i) establish the best method for estimating the regression equation between common health outcome measures and a utility score and validating that method; ii) test generalisability to other disease areas, for which quality of life is the primary objective of management (in stroke, drug dependence and depression), iii) develop and validate a method for translating the most commonly used measure of general health status, the SF-36, into a utility score and iv) illustrate the application of the TTU in comparing intervensions for the prevention and management of depression. The results of the research will be of value to i) decision makers who must compare the performance of medical-health care interventions across a range of diseases and modalities and ii) to clinicians who want to practice evidenced based health care. The potential health gains for the community are substantial, in supporting the redirection of resources to more effective and cost-effective