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The effect of search procedures on utility elicitations
L A Lenert1, D J Cher, M K Goldstein
1Department of Medicine, Stanford University School of Medicine, CA 94305-5463, USA. lenert@stanford.edu
Summary
The method used to assess health state utility values significantly impacts results. Different search procedures yield varying utility scores, indicating these values are influenced by the elicitation process itself.
Area of Science:
- Health economics
- Decision analysis
- Psychometrics
Background:
- Health state preferences vary based on elicitation methods.
- Understanding these variations is crucial for accurate health economic evaluations.
- Previous research highlighted differences due to scaling and description methods.
Purpose of the Study:
- To investigate the impact of different search procedures on health state utility values.
- To compare the 'titration' and 'ping-pong' search methods in utility elicitation.
- To determine if search procedure effects on utility values persist over time.
Main Methods:
- A randomized controlled trial comparing two search procedures: titration and ping-pong.
- Utilized identical computer programs describing Gaucher's disease health states.
- Recruited paid, healthy volunteers from the community.
Main Results:
- The titration procedure yielded higher mean utility values (0.10-0.15 higher) than the ping-pong procedure.
- Combined effects of search procedures and scaling methods resulted in utility differences up to 0.28.
- Observed persistent effects of search procedures on utility values across repeated testing at weeks 2 and 3.
Conclusions:
- The choice of search procedure significantly influences elicited health state utility values.
- Observed effects of search procedures were persistent and did not converge over time.
- Elicited utility values may be context-dependent, questioning direct comparability across different procedures.