A note on the expected biases in conventional iterative health state valuation protocols

Area of Science:

• Health Economics
• Decision Analysis
• Psychometrics

Background:

• Health state valuation exercises commonly use iterative tradeoff methods (e.g., time tradeoff, standard gamble).
• Potential biases inherent in these iterative processes have been under-researched in health state valuation literature.
• Contingent valuation (CV) literature extensively studies biases in eliciting monetary values for hypothetical outcomes.

Purpose of the Study:

• To revisit lessons from CV literature for health state valuation design and administration.
• To examine how known CV biases may impact conventional iterative health state valuation methods.
• To identify specific biases relevant to health state valuation.

Main Methods:

• Review and synthesis of biases identified in the contingent valuation (CV) literature.
• Application of CV bias concepts to iterative health state valuation methods.
• Qualitative analysis of potential bias impact based on existing literature.

Main Results:

• Starting point bias, range bias, and incentive incompatibility bias are identified as potentially relevant to health state valuations.
• The magnitude and direction of these biases are likely variable and dependent on the value range.
• This study is an overview, and empirical validation of findings is necessary.

Conclusions:

• Health state valuation studies share susceptibility to biases with CV studies.
• The impact of biases on health state values is likely non-uniform.
• Empirical research is crucial to identify and address these biases in health state valuation.