Peruvian Valuation of the EQ-5D-5L: A Direct Comparison of Time Trade-Off and Discrete Choice Experiments

Jul 1, 2020, 00:00
10.1016/j.jval.2020.05.004
https://www.valueinhealthjournal.com/article/S1098-3015(20)32099-4/fulltext
Title : Peruvian Valuation of the EQ-5D-5L: A Direct Comparison of Time Trade-Off and Discrete Choice Experiments
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(20)32099-4&doi=10.1016/j.jval.2020.05.004
First page : 880
Section Title : THEMED SECTION: APPLICATIONS OF HEALTH PREFERENCES RESEARCH
Open access? : No
Section Order : 880

Objectives

(1) To produce Peruvian general population EQ-5D-5L value sets on a quality-adjusted life-year scale, (2) to investigate the feasibility of a “Lite” protocol less reliant on the composite time trade-off (cTTO), and (3) to compare cTTO and discrete choice experiment (DCE) value sets.

Methods

A random sample of adults (N = 1000) in Lima, Arequipa, and Iquitos did a home interview; 300 were randomly selected to complete 11 cTTOs first. All respondents completed a DCE, including 10 latent-scale pairs (A/B) with 5 EQ-5D-5L attributes, and 12 matched pairs (A/B and B/C) with 5 EQ-5D-5L and one lifespan attributes. We estimated a cTTO heteroscedastic tobit (N = 300) model and 3 DCE Zermelo-Bradley-Terry models (N = 300, 700, and 1000).

Results

Each model produced a consistent value set (20 positive incremental parameters). Nevertheless, their lowest quality-adjusted life-year values differed greatly (cTTO: –1.076 [N = 300]; DCE: –0.984 [300], 0.048 [700], –0.213 [1000]). Compared with the cTTO, the DCE (N = 300) produced different parameters (Pearson’s correlation = 0.541), fewer insignificant parameters (0 vs 8), and fewer values less than 0 (26% vs 44%). Compared with the DCE (N = 300), the DCE (N = 700) produced higher values but similar parameters (Pearson’s correlation = 0.800).

Conclusions

Besides producing EQ-5D-5L value sets for Peru, the results casts doubt about the feasibility of a Lite protocol like the one in this study. Additionally, fundamental differences between cTTO and DCE—without the existence of a gold standard—need further clarification. The choice between the two rational value sets produced in the current study is a matter of judgment and may have substantial policy implications.

Categories :
  • Health Care Research
  • Health Policy & Regulatory
  • Health Service Delivery & Process of Care
  • Health State Utilities
  • Patient-Centered Research
Tags :
  • discrete choice experiment
  • EuroQoL
  • preference elicitation methods
  • time trade off
  • utility assessment
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