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A time-tradeoff method for cost-effectiveness models applied to radiology.

J S Swan1, D G Fryback, W F Lawrence

  • 1Department of Radiology, Indiana University, Indianapolis 46202, USA. jsswan@iupui.edu

Medical Decision Making : an International Journal of the Society for Medical Decision Making
|January 19, 2000
PubMed
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The wait tradeoff (WTO) method shows patients prefer magnetic resonance angiography (MRA) over x-ray angiography (XRA). Patients were willing to wait significantly longer for MRA results, indicating a clear preference for this imaging technique.

Area of Science:

  • Radiology
  • Health Economics
  • Decision Analysis

Background:

  • Assessing patient preferences for medical tests is crucial for cost-effectiveness and resource allocation.
  • Traditional time-tradeoff methods may use artificial health states, potentially affecting preference validity.
  • Magnetic resonance angiography (MRA) and x-ray angiography (XRA) are common diagnostic tools for peripheral vascular disease.

Purpose of the Study:

  • To evaluate the utility of the wait tradeoff (WTO) method in assessing patient preferences for temporary health states.
  • To compare patient preferences between MRA and XRA using the WTO method.
  • To determine if the WTO method provides intuitive and realistic preference assessments.

Main Methods:

  • The wait tradeoff (WTO) method was employed via telephone interviews with 38 patients who had undergone both MRA and XRA.

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  • Patients reached an indifference point where they were ambivalent between immediate treatment or waiting for results after a hypothetical ideal test.
  • Waiting times for results and treatment were recorded for both MRA and XRA.

    • Main Results:

    • Patients indicated a willingness to wait a mean of 16.1 days for MRA results and treatment.
    • Patients were willing to wait a mean of 42.1 days for XRA results and treatment.
    • The significant difference in waiting times (p = 0.0001) demonstrated a clear patient preference for MRA over XRA.

    Conclusions:

    • The WTO method effectively assesses patient preferences for radiologic tests in a realistic manner.
    • The WTO approach avoids artificial health states, enhancing the validity of preference elicitation.
    • This method shows promise for evaluating other testing scenarios and short-term treatments for cost-effectiveness.