Invariance and Inconsistency in Utility Ratings

Dena M. Bravata, Lorene M. Nelson, Alan M. Garber and Mary K. Goldstein
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Dena M. Bravata: Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, dbravata@stanford.edu
Lorene M. Nelson: Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
Alan M. Garber: Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, VA Palo Alto Healthcare System, Palo Alto, California
Mary K. Goldstein: Center for Primary Care and Outcomes Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, VA Palo Alto Healthcare System, Palo Alto, California, Division of Health Services Research, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California

Medical Decision Making, 2005, vol. 25, issue 2, 158-167

Abstract: Purpose . To assess utilities of composite health states for dependence in activities of daily living (ADLs) for invariance ( i.e., when subjects provide a utility of 1 for all health states) and order inconsistency ( i.e., when subjects order their utilities such that their utility for a combination of ADL dependencies is greater than their utility for any subset of the combination). Methods . Each of the 400 subjects, age 65 y and older, enrolled in one of several regional medical centers of the Kaiser Permanente Medical Care Program of Northern California and provided standard-gamble utilities for single ADL dependencies (e.g., bathing, dressing, continence) and for dependence in 8 other combinations of ADL dependencies. For order-inconsistent responses, the authors calculated the maximum magnitude of inconsistency as the maximum difference between the utility for the combined ADL dependence health state and that of its inconsistent subset. Results . A total of 76 subjects (19%) gave a utility of 1.0 for all health states presented to them; 19 (5%) gave the same utility other than 1.0 for all health states; 130 (33%) gave at least 1 utility

Keywords: activities of daily living; quality of life; utility theory (search for similar items in EconPapers)
Date: 2005
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:25:y:2005:i:2:p:158-167

DOI: 10.1177/0272989X05275399

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