Are QALYs based on time trade‐off comparable? – A systematic review of TTO methodologies
Trude Arnesen and
Mari Trommald
Health Economics, 2005, vol. 14, issue 1, 39-53
Abstract:
A wide range of methods is used to elicit quality‐of‐life weights of different health states to generate ‘Quality‐adjusted life years’ (QALYs). The comparability between different types of health outcomes at a numerical level is the main advantage of using a ‘common currency for health’ such as the QALY. It has been warned that results of different methods and perspectives should not be directly compared in QALY league tables. But do we know that QALYs are comparable if they are based on the same method and perspective? The Time trade‐off (TTO) consists in a hypothetical trade‐off between living shorter and living healthier. We performed a literature review of the TTO methodology used to elicit quality‐of‐life weights for own, current health. Fifty‐six journal articles, with quality‐of‐life weights assigned to 102 diagnostic groups were included. We found extensive differences in how the TTO question was asked. The time frame varied from 1 month to 30 years, and was not reported for one‐fourth of the weights. The samples in which the quality‐of‐life weights were elicited were generally small with a median size of 53 respondents. Comprehensive inclusion criteria were given for half the diagnostic groups. Co‐morbidity was described in less than one‐tenth of the groups of respondents. For two‐thirds of the quality‐of‐life weights, there was no discussion of the influence of other factors, such as age, sex, employment and children. The different methodological approaches did not influence the TTO weights in a predictable or clear pattern. Whether or not it is possible to standardise the TTO method and the sampling procedure, and whether or not the TTO will then give valid quality‐of‐life weights, remains an open question. This review of the TTO elicited on own behalf, shows that limiting cost–utility analysis to include only quality life weights from one method and one perspective is not enough to ensure that QALYs are comparable. Copyright © 2004 John Wiley & Sons, Ltd.
Date: 2005
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (15)
Downloads: (external link)
https://doi.org/10.1002/hec.895
Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
HTML/Text
Persistent link: https://EconPapers.repec.org/RePEc:wly:hlthec:v:14:y:2005:i:1:p:39-53
Access Statistics for this article
Health Economics is currently edited by Alan Maynard, John Hutton and Andrew Jones
More articles in Health Economics from John Wiley & Sons, Ltd.
Bibliographic data for series maintained by Wiley Content Delivery ().