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      Experience-based utility and own health state valuation for a health state classification system: why and how to do it

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          Abstract

          In the estimation of population value sets for health state classification systems such as the EuroQOL five dimensions questionnaire (EQ-5D), there is increasing interest in asking respondents to value their own health state, sometimes referred to as “experience-based utility values” or, more correctly, own rather than hypothetical health states. Own health state values differ to hypothetical health state values, and this may be attributable to many reasons. This paper critically examines whose values matter; why there is a difference between own and hypothetical values; how to measure own health state values; and why to use own health state values. Finally, the paper examines other ways that own health state values can be taken into account, such as including the use of informed general population preferences that may better take into account experience-based values.

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          Most cited references40

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          A survey method for characterizing daily life experience: the day reconstruction method.

          The Day Reconstruction Method (DRM) assesses how people spend their time and how they experience the various activities and settings of their lives, combining features of time-budget measurement and experience sampling. Participants systematically reconstruct their activities and experiences of the preceding day with procedures designed to reduce recall biases. The DRM's utility is shown by documenting close correspondences between the DRM reports of 909 employed women and established results from experience sampling. An analysis of the hedonic treadmill shows the DRM's potential for well-being research.
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            Integrating response shift into health-related quality of life research: a theoretical model.

            Patients confronted with a life-threatening or chronic disease are faced with the necessity to accommodate to their illness. An important mediator of this adaptation process is 'response shift' which involves changing internal standards, values and the conceptualization of quality of life (QOL). Integrating response shift into QOL research would allow a better understanding of how QOL is affected by changes in health status and would direct the development of reliable and valid measures for assessing changes in QOL. A theoretical model is proposed to clarify and predict changes in QOL as a result of the interaction of: (a) a catalyst, referring to changes in the respondent's health status; (b) antecedents, pertaining to stable or dispositional characteristics of the individual (e.g. personality); (c) mechanisms, encompassing behavioral, cognitive, or affective processes to accommodate the changes in health status (e.g. initiating social comparisons, reordering goals); and (d) response shift, defined as changes in the meaning of one's self-evaluation of QOL resulting from changes in internal standards, values, or conceptualization. A dynamic feedback loop aimed at maintaining or improving the perception of QOL is also postulated. This model is illustrated and the underlying assumptions are discussed. Future research directions are outlined that may further the investigation of response shift, by testing specific hypotheses and predictions about the QOL domains and the clinical and psychosocial conditions that would potentiate or prevent response shift effects.
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              Swedish experience-based value sets for EQ-5D health states

              Purpose To estimate Swedish experience-based value sets for EQ-5D health states using general population health survey data. Methods Approximately 45,000 individuals valued their current health status by means of time trade off (TTO) and visual analogue scale (VAS) methods and answered the EQ-5D questionnaire, making it possible to model the association between the experience-based TTO and VAS values and the EQ-5D dimensions and severity levels. The association between TTO and VAS values and the different severity levels of respondents’ answers on a self-rated health (SRH) question was assessed. Results Almost all dimensions (except usual activity) and severity levels had less impact on TTO valuations compared with the UK study based on hypothetical values. Anxiety/depression had the greatest impact on both TTO and VAS values. TTO and VAS values were consistently related to SRH. The inclusion of age, sex, education and socioeconomic group affected the main effect coefficients and the explanatory power modestly. Conclusions A value set for EQ-5D health states based on Swedish valuations has been lacking. Several authors have recently advocated the normative standpoint of using experience-based values. Guidelines of economic evaluation for reimbursement decisions in Sweden recommend the use of experience-based values for QALY calculations. Our results that anxiety/depression had the greatest impact on both TTO and VAS values underline the importance of mental health for individuals’ overall HRQoL. Using population surveys is in line with recent thinking on valuing health states and could reduce some of the focusing effects potentially appearing in hypothetical valuation studies. Electronic supplementary material The online version of this article (doi:10.1007/s11136-013-0496-4) contains supplementary material, which is available to authorized users.
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                Author and article information

                Contributors
                d.rowen@sheffield.ac.uk
                Journal
                Eur J Health Econ
                Eur J Health Econ
                The European Journal of Health Economics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                1618-7598
                1618-7601
                11 October 2017
                11 October 2017
                2018
                : 19
                : 6
                : 881-891
                Affiliations
                [1 ]ISNI 0000 0004 1936 9262, GRID grid.11835.3e, School of Health and Related Research (ScHARR), , University of Sheffield, ; Sheffield, UK
                [2 ]ISNI 0000000092621349, GRID grid.6906.9, Erasmus School of Health Policy & Management, , Erasmus University Rotterdam, ; Rotterdam, The Netherlands
                [3 ]ISNI 0000 0004 1936 9262, GRID grid.11835.3e, Department of Economics, , University of Sheffield, ; Sheffield, UK
                [4 ]ISNI 0000 0000 8994 5086, GRID grid.1026.5, Institute for Choice, School of Business, , University of South Australia, ; Adelaide, Australia
                Article
                931
                10.1007/s10198-017-0931-5
                6008352
                29022120
                018cbf5d-b5ef-4910-8bf1-673d443ca0d8
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 8 February 2017
                : 19 September 2017
                Funding
                Funded by: NIHR CLAHRC Yorkshire and Humber
                Categories
                Original Paper
                Custom metadata
                © Springer-Verlag GmbH Germany, part of Springer Nature 2018

                Economics of health & social care
                experience-based utility,own health state valuation,hypothetical health state values,informed preferences,i10

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