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Statistical Alchemy: Conceptual Validity and Mapping to Generate Health State Utility Values.
Jeff Round1, Annie Hawton2,3
1School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. jeff.round@bristol.ac.uk.
Pharmacoeconomics - Open
|February 15, 2018
Summary
Mapping health instruments is common but lacks justification. This study questions if mapped utility values truly reflect health preferences, highlighting the need for conceptual validity in economic evaluations.
Area of Science:
- Health economics
- Health outcomes research
- Psychometrics
Background:
- Mapping between non-preference- and preference-based health-related quality-of-life (HRQoL) instruments is widely used to estimate utility values for economic evaluations.
- Despite widespread use in health technology assessment, the methodological justification for these mapping techniques remains insufficient.
- Current guidelines standardize reporting but overlook fundamental conceptual issues in extrapolating between unrelated measures.
Purpose of the Study:
- To elucidate the concept of conceptual validity in the context of mapping HRQoL instruments.
- To examine the implications of poor conceptual validity on healthcare resource allocation decisions.
- To propose initial strategies for enhancing conceptual validity in mapping methodologies.
Main Methods:
- Conceptual analysis of validity in cross-instrument mapping.
- Exploration of the theoretical underpinnings of health state utility measurement.
- Literature review of current mapping practices and guidelines.
Main Results:
- Mapping methods often fail to ensure that the same health preference is measured by both the source and target instruments.
- The assumption of shared conceptual space between instruments is critical but frequently unaddressed.
- Poor conceptual validity can lead to flawed economic evaluations and suboptimal healthcare resource allocation.
Conclusions:
- Conceptual validity is a critical, yet often overlooked, aspect of mapping HRQoL instruments.
- Further research and methodological development are needed to ensure the validity of mapped utility values.
- Addressing conceptual validity is essential for reliable economic evaluations in healthcare.
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