Chained time trade-off and standard gamble methods. Applications in oesophageal cancer

It may be difficult to value palliative health states using health state valuation methods such as the time trade-off (TTO) and standard gamble (SG) where health states are traditionally valued relative to perfect/good health and death. Chained methods have been developed to help in this context. However, few studies have compared the values produced by chained TTO and SG methods. To address this issue, a study was conducted to measure the health state values associated with oesophageal cancer using chained TTO and SG techniques. The methods were found to be acceptable amongst the sample respondents, who had previously been treated for oesophageal cancer. There were no significant differences between the health state values produced by the TTO and the SG methods. Within each method, however, there were significant differences between the health states valued. It is concluded that the use of health state valuation techniques such as the TTO and SG is feasible amongst people with a history of oesophageal cancer.