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Preference Weighting of Health State Values: What Difference Does It Make, and Why?
Admassu N Lamu1, Thor Gamst-Klaussen1, Jan Abel Olsen2
1Department of Community Medicine, University of Tromsø, Tromsø, Norway.
Summary
Preference weighting minimally impacts health quality of life scores when using the EuroQol 5-dimension (EQ-5D) and 15D instruments. Unweighted values show strong agreement with preference-weighted values at the group level.
Area of Science:
- Health Economics
- Patient-Reported Outcomes
- Quality of Life Measurement
Background:
- Patient-reported outcome measures (PROMs) often use simple summary scores for health-related quality of life (HRQoL).
- Generic preference-based instruments require utility weighting for health state valuation, using preference elicitation and algorithms.
Purpose of the Study:
- To compare preference-weighted and unweighted values for the EQ-5D and 15D instruments.
- To assess differences using a large dataset from six OECD countries with diverse samples.
Main Methods:
- Examined construct validities of preference-weighted and unweighted values.
- Assessed agreement using intraclass correlation coefficient (ICC), Bland-Altman plots, and reduced major axis regression.
Main Results:
- Convergent and known-group validities were comparable for both instruments.
- EQ-5D: Individual-level differences were considerable, but group-level mean difference was minimal (0.023) with strong agreement (ICC=0.96).
- 15D: Almost perfect agreement (ICC=0.99) with negligible mean difference (-0.001).
Conclusions:
- Preference weighting has minimal effect on EQ-5D and 15D scores when unweighted values are scaled comparably.
- Findings support the use of unweighted values in specific contexts, provided appropriate scaling.
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