Societal & Patient Utilities for Drug Problems

描述（由申请人提供）： 成本效用分析（CUA）是一种以质量调整生命年（QHLS）为度量标准衡量健康影响的经济评价方法，是评估医疗保健计划相对效率的重要工具。然而，CUA在药物滥用治疗计划中的应用受到缺乏基于社会和患者偏好的药物相关健康状态和后果的效用权重的限制，这是计算QOLS所必需的。该提案的主要目标是通过实现以下两个具体目标来推进CUA在药物滥用项目评估中的应用：1）。制定方法，直接测量的效用权重的频谱药物相关的健康状况和后果;和2）测试和比较的重测信度，一致性，和歧视的直接效用测量方法在三个关键的“利益相关者”群体：吸毒者，吸毒者的重要他人，和一般人群。为了实现这些目标，我们将使用利益相关者的焦点小组和一个研究人员/临床医生小组来定义，开发和验证一系列药物相关疾病和后果的健康状态描述。50名接受治疗的药物滥用者、50名其他重要药物滥用者和50名来自一般人群的受试者将使用既定效用指标（时间权衡和标准赌博）为药物相关健康状态分配效用权重。虽然本项目的主要重点是方法的开发和测试，但我们将测试以下探索性假设：1）效用评级随着药物相关健康状态严重程度的增加而降低; 2）特定药物相关健康状态的效用评级在三个利益相关者群体中存在显著差异。本研究结果将用于未来药物滥用治疗项目CUA中的QALY计算。此外，制定与毒品有关的健康状况描述的重点小组和专门小组进程将对利益攸关方群体之间的偏好/价值观差异产生重要的见解，并将指导今后的研究。

DESCRIPTION (provided by applicant): Cost-utility analysis (CUA), a type of economic evaluation in which health effects are measured in the metric of Quality-Adjusted Life-Years (QALYs), is a valuable tool for assessing the relative efficiency of health care programs. However, the application of CUA to drug abuse treatment programs is limited by the absence of societal and patient preference-based utility weights for drug-related health states and consequences, which are needed to calculate QALYs. The main goal of this proposal is to advance the application of CUA to drug abuse program evaluation by achieving 2 specific aims: 1). Develop methods for the direct measurement of utility weights for a spectrum of drug-related health states and consequences; and 2) Test and compare the test-retest reliability, consistency, and discrimination of the direct utility measurement methods in three key "stakeholder" groups: persons with drug abuse, significant others of persons with drug abuse, and the general population. To accomplish these aims, we will use focus groups of stakeholders and a panel of researchers/clinicians to define, develop, and validate health state descriptions for a spectrum of drug-related conditions and consequences. Fifty drug abusers in treatment, 50 significant others of drug abusers, and 50 subjects from the general population will assign utility weights to the drug-related health states using established utility measures (Time Trade-Off and Standard Gamble). Although the main focus of this project is the development and testing of the methods, we will test exploratory hypotheses that: 1) utility ratings decrease as the severity of the drug-related health states increase; and 2) utility ratings for specific drug-related related health states will differ significantly among the three stakeholder groups. The results of this project will be used for QALY calculation in future CUA of drug abuse treatment programs. In addition, the focus group and panel process for developing the drug-related health state descriptions will yield important insights into differences in preferences/values among the stakeholder groups and will guide future research.