使复合时间权衡对比死亡状况更糟的健康状况变得敏感
Michał Jakubczyk1, Bram Roudijk2, Stefan A Lipman3
1SGH Warsaw School of Economics, Warszawa, Poland. michal.jakubczyk@sgh.waw.pl.
PharmacoEconomics
|February 26, 2025
概括
修改复合时间权衡 (cTTO) 方法提高了对比死亡更糟糕 (WTD) 的健康状况的敏感性. 删除立即死亡比较问题增强了实用值和健康严重程度之间的相关性.
科学领域:
- 卫生经济学 卫生经济学
- 心理测量 心理测量 心理测量
- 决策分析 决策分析
背景情况:
- 复合时间权衡 (cTTO) 方法用于引出卫生状态公用事业.
- 标准的cTTO通常与严重程度指标的相关性很差,对于比死亡更糟糕的 (WTD) 状态.
- 这表明cTTO对健康状况严重下降的敏感性存在局限性.
研究的目的:
- 调查cTTO方法的修改,以提高其对WTD健康状况的敏感性.
- 了解为什么标准cTTO与其他严重性指标的相关性很差.
- 确定严重健康状况的公用事业诱导的潜在改进.
主要方法:
- 总共有480名受访者完成了在线时间权衡 (TTO) 面试,评估了12个EQ-5D-5L健康状况.
- 参与者被随机分配到四个组:标准cTTO,没有死亡比较问题的cTTO,允许负效用的领先时间TTO (LT-TTO) 和随机启动负效用的LT-TTO.
- 分析包括公用事业分布,与水平总和得分 (LSS) 的相关性以及状态不一致性.
主要成果:
- 标准cTTO (A臂) 复制了LSS和负效用之间的差相关性.
- 删除死亡比较问题 (B部分) 导致显著的负相关性.
- 与A臂相比,B臂的WTD状态比例更高,平均效用率较低.
结论:
- 标准cTTO的差相关性与排序问题中与即时死亡的比较有关.
- 领先时间TTO (LT-TTO) 可以引起对健康状况严重程度敏感的实用值.
- 建议修改cTTO的初始问题,以更好地识别好于死亡 (BTD) 与WTD状态.
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