Evaluating Utility Measures: Biases and Alternatives

描述（由申请人提供）：成本效益和成本效用分析（CEA/CUA）越来越多地用于健康和医学的临床和政策决策。公用事业是经济分析的关键投入，为共同成果衡量标准“质量调整生命年”提供加权因子。“计量的准确性和有效性以及公用事业措施的应用对于从这种分析中产生有意义和信息丰富的结果至关重要。拟议的研究将提供洞察力，以了解现有的效用测量方法的适当使用和应用，并指导改进和替代方案的开发。它将侧重于癌症，这种疾病的生活质量的影响是特别重要的临床决策和政策。本研究提出一系列的研究，以探讨效用的测量，探讨效用的应用，并制定改进效用评估方法的指导方针。第一项研究将采用调查研究和过程跟踪方法，以确定在效用评估方法中产生偏见的认知因素，并开发和测试修改以避免此类偏见。第二项研究将使用Meta分析技术确定效用是否因个人的年龄、种族和性别而系统地变化。研究将最终建议使用现有的效用测量方法和价值观，并建立一个框架，开发新的方法来评估健康。这项研究的一个有用的副产品将是CEA/CUA和其他应用研究人员使用的癌症健康状态的实用价值估计。 候选人在她的论文、博士后研究和目前在马萨诸塞州总医院和哈佛医学院担任讲师的职位中研究了偏好和效用评估方法及其应用。她开始了作为生活质量方法学家的职业生涯，专注于癌症干预。这一职业发展奖将有助于启动她的独立研究议程。她将在她的部门，MGH技术评估研究所主任，以及在这一领域的高级研究人员谁建立了与候选人（包括她的论文和博士后顾问）的工作关系，她的职业发展的指导。她有强大的机构支持和教师指导，以保证她在拟议的研究成功。

DESCRIPTION (provided by the applicant): Cost-effectiveness and cost-utility analysis (CEA/CUA) is increasingly used for clinical and policy decision making in health and medicine. Utilities are critical inputs to economic analyses, providing the weighting factor for the common outcome measure "quality adjusted life years." The accuracy and validity of measurement and application of utility measures are essential to producing meaningful and informative results from such analyses. The proposed research will provide insight to understanding the appropriate use and application of existing utility measurement methods, and to guide the development of improvements and alternatives. It will focus on cancer, a disease for which quality of life effects are of particular importance in clinical decision making and policy. The research proposes a series of studies to investigate the measurement of utilities, to explore the application of utilities, and to develop guidelines for improvements in utility assessment methodology. The first study will employ survey research and process tracing methods to identify cognitive factors that create biases in utility assessment methods, and develop and test modifications to avoid such biases. The second study will determine whether utilities vary systematically by individuals' age, race and gender using meta analytic techniques. The research will culminate in recommendations for the use of existing utility measurement methods and values, and the construction of a framework for the development of new methods to value health. A useful by-product of the research will be estimates of utility values for cancer health states for use by CEA/CUA and other applied researchers. The candidate has studied preference and utility assessment methods and their application in her dissertation, post-doctoral research, and current position as Instructor at Massachusetts General Hospital and Harvard Medical School. She is beginning a career as a quality of life methodologist, focusing on cancer interventions. This career development award would contribute to the initiation of her independent research agenda. She will be guided in her career development by the Director of her department, the MGH Institute for Technology Assessment, as well as senior researchers in this field who have established working relationships with the candidate (including her dissertation and post-doctoral advisors). She has strong institutional support and faculty mentorship to guarantee her success in the proposed research.