Healthy Clinical Trial
Official title:
The Q in the QALY: Exploring New Methods
Aim: The aim of this proposal is to investigate the potential use and value of experienced
utility, as measured by the Experience Sampling Method and the Day Reconstruction Method, in
the economic evaluation of health care.
Methods: Three samples of 46 patients with different conditions one sample of 46 healthy
controls will be included in the study. The Experience Sampling Method (ESM) and the Day
Reconstruction Method (DRM) will be adapted and subsequently used to measure experienced
utility. Decision utilities will be elicited by traditional preference based methods.
Expected results: The expected results of this study are threefold. First, unified versions
of the ESM and DRM for use in the economic evaluation of health care will be developed and
applied. Second, a rich dataset will allow us to investigate the differences between the
results of experienced utilities derived from these methods, with the traditional preference
based measures. Third, the normative implications of the use of QALYs based on either
decision utilities, experienced utilities, or a combination of the two, for health care
resource allocation decisions, will be examined.
Keywords: experienced utility, decision utility, subjective well-being, experience sampling
method, day reconstruction method
This study explores new methodology regarding the measurement of health state utilities. A
new pharmaceutical is nowadays only reimbursed if there is evidence of cost-effectiveness.
This can be determined by different types of economic evaluations, of which cost-utility
analysis (CUA) is preferred in most guidelines. In CUA the health outcome of a technology is
measured in quality adjusted life years (QALY). Utilities to calculate QALYs should be based
on decisions under uncertainty (decision utilities). However, the health care literature
describes several problems that lead to bias in the measurement of decision utilities. These
biases lead to an inaccurate estimation of the value of a health state and can therefore
cause policy makers to allocate resources inefficiently. To solve some of these problems, it
was suggested to determine experiences associated with different health states by measuring
well-being moment-to-moment (experienced utility) by the Experience Sampling Method or the
Day Reconstruction Method.
Differences between the utilities measured using traditional preference based measures
(decision utility), and using the new state-of-art methods ESM and DRM (experienced utility)
in a range of populations with differing conditions and severity of health state will be
investigated. Since somatic, psychosomatic and psychological conditions are likely to differ
in the way they experience and affect well-being, we will involve patient groups from each
category in this study as well as healthy controls.
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