这种死亡或那种死亡:对健康状况的评估中的框架效应
Michał Jakubczyk1, Paul Schneider2, Stefan A Lipman3
1Decision Analysis and Support Unit, SGH Warsaw School of Economics, Poland.
概括
健康状况评估对质疑框架很敏感. 评估状态为"比死亡更糟糕" (WTD) 在常规和领先时间时间权衡 (TTO) 任务之间以及当专注于结果与改进时存在显著差异.
科学领域:
- 卫生经济学 卫生经济学
- 决策分析 决策分析
- 心理测量 心理测量 心理测量
背景情况:
- 健康状况评估对于成本效益分析至关重要.
- 将状态分类为"比死亡更好"或"比死亡更糟" (WTD) 是一种标准的方法.
- 估值问题的框架可能会影响WTD分类.
研究的目的:
- 调查不同的问题框架如何影响健康状况的评估.
- 为了在各种框架中比较将健康状况归类为WTD的倾向.
主要方法:
- 对361名参与者进行了在线调查.
- 参与者使用3个不同的框架评估了9个EQ-5D-5L健康状况.
- 测试了六个框架,包括常规时间权衡 (TTO),领先时间TTO,以及专注于寿命或生活质量改善的框架.
主要成果:
- 将一个状态归类为WTD的几率增加了2.7倍,主要时间TTO (框架B) 和1.5倍,当专注于长寿 (框架E) 与普通TTO (框架A) 相比.
- 专注于改善生活质量 (框架F) 降低了WTD分类的5倍以上.
- 排除死亡即时性或死亡过程 (C和D) 的与常规TTO没有显著差异.
结论:
- 问题框架显著影响健康状况的评估,即使对于理论上相当的场景.
- 在常规的TTO和领先时间的TTO任务之间做出选择,会大大改变WTD分类.
- 评估结果取决于是否强调最终状态或随时间推移的改进.
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