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Cost-Effectiveness in Health and Medicine$
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Peter J. Neumann, Theodore G. Ganiats, Louise B. Russell, Gillian D. Sanders, and Joanna E. Siegel

Print publication date: 2016

Print ISBN-13: 9780190492939

Published to Oxford Scholarship Online: November 2016

DOI: 10.1093/acprof:oso/9780190492939.001.0001

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PRINTED FROM OXFORD SCHOLARSHIP ONLINE (oxford.universitypressscholarship.com). (c) Copyright Oxford University Press, 2020. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in OSO for personal use. date: 26 October 2020

Valuing Health Outcomes

Valuing Health Outcomes

(p.167) 7 Valuing Health Outcomes
Cost-Effectiveness in Health and Medicine

David Feeny

Murray Krahn

Lisa A. Prosser

Joshua A. Salomon

Oxford University Press

This chapter examines preference-based measures of health-related quality of life that are used to estimate the health effects of interventions. The chapter focuses on quality-adjusted life years (QALYs), which combine effects on mortality and morbidity, and which are the Panel’s preferred unit for measuring health outcomes. Direct elicitation of preferences for health states (standard gamble; time trade-off; ordinal methods) and indirect approaches using multi-attribute measures such as EQ-5D, HUI, SF-6D, and QWB are discussed. Theory, practice, and measurement properties are reviewed, and the use and interpretation of utility scores from diverse sources are discussed. Special issues include states worse than dead, children, and spillover effects of the health of one family member on the health of others. We recommend generic preference-based multi-attribute measures based on community preferences for Reference Case analyses while encouraging other approaches when such measures are not ideal in the context of the study.

Keywords:   Community preferences, direct measures of preferences, health utility, multi-attribute measures, preferences, preference-based measures, quality-adjusted life years, utility measures

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