ARE HEALTH STATES "TIMELESS"? A TEST OF THE UTILITY INDEPENDENCE ASSUMPTION- COMPARING A REPEATED MEASURES DESIGN AND LATENT GROWTH MODELING
Author(s)
Franic D1, Gafni A2, Vandenberg R11University of Georgia, Athens, GA, USA, 2McMaster University, Hamilton, ON, Canada
OBJECTIVES: Primary study objective was to test whether individuals’ responses to standard gamble (SG) questions do not depend on the duration of time spent in the health scenario presented (“timelessness”). Secondary objective of the study was to test the “timelessness” of VAS responses. METHODS: Face-to-face interviews were conducted in a convenience sample of healthy volunteers (n=59) aged 20 to 63. Individuals rated their preferences for three health states of varying post chemotherapy nausea and vomiting (PCNV) severity and current health, assuming six different time horizons. Repeated measures analysis of variance (RM-ANOVA) was conducted (SX6X4X2) to determine the affect of time (6 levels:3 days, 3 months, 1- , 5- and 20- year(s) and rest of life), health state (4 levels: mild, moderate and severe PCNV and current health), and method (2 levels: SG and VAS) on preference. RESULTS: Results were analyzed using RM-ANOVA and latent growth modeling (LGM). Both showed that preferences decreased over time for SG and VAS (p<0.05). For the RM-ANOVA, all main effects and interaction terms were significant (p<0.05). LGM showed acceptable fit and significant slope parameters for all PCNV. The slopes were decreasing over time. Significant latent variances for LGM showed that not all individuals change at the same rate over time (p<0.05) CONCLUSIONS: There is a clear advantage in the use of LGM over RM-ANOVA because LGM can evaluate group differences in addition to individual changes over time. For the majority of respondents the utility independence assumption for SG and VAS did not hold both at the group and the individual level. Similar to Bala et al (1999) and Franic et al (2003) the results of this study indicated preferences as measured by SG and VAS are not timeless. Regardless of the preference measure used: both SG and VAS yield higher preferences for shorter time horizons.
Conference/Value in Health Info
2010-05, ISPOR 2010, Atlanta, GA, USA
Value in Health, Vol. 13, No. 3 (May 2010)
Code
PR4
Topic
Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Oncology