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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

Summary

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.

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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.
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.