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Valuing health states : is the MACBETH approach useful for valuing EQ-5D-3L health states?

dc.contributor.authorOliveira, Mónica Duarte
dc.contributor.authorAgostinho, Andreia
dc.contributor.authorFerreira, Lara
dc.contributor.authorNicola, Paulo
dc.contributor.authorBana e Costa, Carlos
dc.date.accessioned2019-01-09T11:31:10Z
dc.date.available2019-01-09T11:31:10Z
dc.date.issued2018
dc.description© The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.pt_PT
dc.description.abstractBackground: Quality Adjusted Life Years (QALYs) are a key outcome measure widely used within health technology assessment and health service research studies. QALYs combine quantity and quality of life, with quality of life calculations relying on the value of distinct health states. Such health states’ values capture the preferences of a population and have been typically built through numerical elicitation methods. Evidence points to these value scores being influenced by methods in use and individuals reporting cognitive difficulties in eliciting their preferences. Evidence from other areas has further suggested that individuals may prefer using distinct elicitation techniques and that this preference can be influenced by their numeracy. In this study we explore the use of the MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) non-numerical preference elicitation approach for health states’ evaluation. Methods: A new protocol for preference elicitation based on MACBETH (only requiring qualitative judgments) was developed and tested within a web survey format. A sample of the Portuguese general population (n=243) valued 25 EQ-5D-3L health states with the MACBETH protocol and with a variant of the time trade-off (TTO) protocol, for comparison purposes and for understanding respondents’ preference for distinct protocols and differences in inconsistent evaluations. Respondents answered to a short numeracy test, and basic socio-economic information collected. Results: Results show that the mean values derived from MACBETH and the TTO variant are strongly correlated; however, there are substantial differences for several health states’ values. Large and similar numbers of logical inconsistencies were found in respondents’ answers with both methods. Participants with higher levels of numeracy according to the test preferred expressing value judgments with MACBETH, while participants with lower levels were mostly indifferent to both methods. Higher correlations between MACBETH and TTO variant evaluations were observed for individuals with higher numeracy. Conclusion: Results suggest that it is worth researching the use of non-numerical preference elicitation methods. Numeracy tests more appropriate for preference elicitation when no explicit considerations of uncertainty are made need to be explored and used. Further behavioural research is needed to fully understand the potential for using these methods in distinct settings (e.g. in different evaluation contexts and in face-to-face and non-face-to-face environments), as well as to explore the effect of literacy on assessments and on respondents’ preferences.pt_PT
dc.description.sponsorshipThe authors are thankful for support from the Centre for Management Studies of Instituto Superior Técnico (CEG-IST) [FCT- Foundation for Science and Technology grant number UID/GES/00097/2013] and from the Centre for Health Studies & Research-University of Coimbra (CEISUC) [FCT grant number UID/MULTI/4066/2016].pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHealth and Quality of Life Outcomes (2018) 16:235pt_PT
dc.identifier.doi10.1186/s12955-018-1056-ypt_PT
dc.identifier.issn1477-7525
dc.identifier.urihttp://hdl.handle.net/10451/36292
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherBMCpt_PT
dc.relationCentro de Estudos e Investigação em Saúde da Universidade de Coimbra
dc.relation.publisherversionhttps://hqlo.biomedcentral.com/pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectQALYpt_PT
dc.subjectPreference-based instrumentspt_PT
dc.subjectHealth states valuationpt_PT
dc.subjectMACBETHpt_PT
dc.subjectTTOpt_PT
dc.titleValuing health states : is the MACBETH approach useful for valuing EQ-5D-3L health states?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleCentro de Estudos e Investigação em Saúde da Universidade de Coimbra
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/5876/UID%2FGES%2F00097%2F2013/PT
oaire.awardURIinfo:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID%2FMULTI%2F4066%2F2016/PT
oaire.citation.issue1pt_PT
oaire.citation.startPage235pt_PT
oaire.citation.titleHealth and Quality of Life Outcomespt_PT
oaire.citation.volume16pt_PT
oaire.fundingStream5876
oaire.fundingStream6817 - DCRRNI ID
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isProjectOfPublication648616f3-f38e-4600-b3ad-1db9a9570d21
relation.isProjectOfPublicatione79acf59-6fef-42c6-a95c-75f8362b84bc
relation.isProjectOfPublication.latestForDiscoverye79acf59-6fef-42c6-a95c-75f8362b84bc

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