Abstract
The Health Utilities Index is a generic multiattribute preference-based system for assessing health-related quality of life and is widely used in economic evaluations in North America and in international multicentre studies. As the HUI3 consists of 8 attributes deliberately selected to be structurally independent and specifies 5 or 6 levels by attribute, the explicit approach of the multiattribute utility theory (MAUT) provides an efficient framework to determine the utility scores of the 972,000 health states of this system. After reviewing the theoretical foundations used to model the multiattribute utility function, this article describes the protocol for revealing individual preferences and the analysis of a study carried out on a French population in June 1999. Results obtained at the person-mean level will be presented and discussed. This research illustrates the contribution of the MAUT to develop a weighting function for a health-related quality of life instrument. The analysis showed the importance of accounting for an individual’s risk attitude when modelling preferences for health states.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Anderson, N. (1970). Functional measurement and psychophysical judgment, Psychological Review 77, 153–170.
Ardine de Wits, G., Busschbach, J. and de Charro, F. (2000). Sensitivity and perspective in the valuation of health status: whose values count? Health Economics 9, 109–126.
Buron, C. (1999). Utilities and Preferences under Risk and Uncertainty: An Application of Multiattribute Utility Theory to Health Economics (French). Doctoral thesis. Université Panthéon-Assas (Paris II).
Cadman, D. and Goldsmith, C. (1986). Construction of social value or utility-based health indices: the usefulness of factorial experimental design plans. Journal of Chronic Disease 39, 643–651.
Costet, N., Le Gales, C., Buron, C. Kinkor, F., Mesbah, M., Chwalow, J. and Slama, G. (1998). French cross-cultural adaptation of the Health Utilities Indexes Mark 2 (HUI2) and 3 (HUI3) classification systems. Clinical and Economic Working Groups. Quality of Life Research 7, 245–256.
Dolan, P., Gudex, C., Kind, P. and Williams, A. (1995). A social tariff for EuroQol: results from a UK general population survey. Discussion Paper 138, Center for Health Economics, University of York, York.
Dolan, P. and Sutton, M. (1997). Mapping visual analogue scale health state valuations onto standard gamble and time trade-off values. Social Science and Medicine 44, 1519–1530.
Dyer, J.S., Farrell, W. and Bradley, P. (1973). Utility functions for test performance. Management Sciences 20, 507–519.
Dyer, J.S. and Sarin, R.A. (1979). Measurable multiattribute value functions. Operations Research 24, 220–243.
Dyer, J.S. and Sarin, R.K. (1982). Relative risk aversion. Management Sciences 28, 875–886.
Fanshell, S. and Bush, J.W. (1970). A health status index and its application to health services outcomes. Operations Research 18, 1021–1066.
Farquhar, P.H. (1977). A survey of multi-attribute utility theory and application. TIMS Studies in the Management Sciences 6, 59–89.
Feeny, D.H., Torrance, G.W. and Furlong W.J. (1996). Health Utilities Index. In: Spilker, B. (ed.), Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd Edition. Philadelphia: Lippincott-Raven.
Fischer, G.W. (1979). Utility models for multiple objective decisions: do they accurately represent human preferences? Decision Sciences 10, 451–479.
Fishburn, P.C. (1965). Independence in utility theory with whole product sets. Operations Research 13, 28–45.
Fishburn, P.C. and Kochenberger G. (1979). Two-piece Von Neumann-Morgenstern utility functions. Decision Sciences 10, 503–518.
Furlong, W., Feeny D., Torrance G.W., Goldsmith, C.H., DePauw, S., Zhu, Z., Denton, M. and Boyle, M. (1998). Multiplicative multi-attribute utility function for the Health Utilities Index Mark 3 (HUI3) system: a technical report. Working paper series 98–11, CHEPA, McMaster University.
Gold, M.R., Siegel, J.E., Russel, L.B. and Weinstein, M.C., Eds. (1996). Cost-Effectiveness in Health and Medicine. New York: Oxford University Press.
Kaplan, R.M., Bush, J.W. and Berry, C.C. (1978). The reliability, stability and generalisability of a health status index. Proceedings of the Social Statistics Section of the American Statistical Association, 704–709.
Keeney, R.L. (1971). Utility independence and preferences for multiattributed consequences. Operations Research 19, 875–893.
Keeney, R.L. (1974). Multiplicative utility functions. Operations Research, 22, 22–34.
Keeney, R.L. and Raiffa, H. (1976). Decision with multiple objectives. New York: Wiley.
Keller, L.R. (1985). An empirical investigation of relative risk aversion. IEEE Transactions on Systems, Man and Cybernetics 15, 475–482.
Le Gales, C., Costet, N., Gentet, J.C., Kalifa, C., Prappaz, D., Edan, C., Sariban, E., Plantaz, D. and Doz, F. (1999). Cross-cultural adaptation of a health status classification system in children with cancer. First results of the French adaptation of the Health Utilities Index Marks 2 and 3. International Journal of Cancer — Supplement 12, 112–118.
Le Gales, C., Costet, N., Buron, C. et le groupe HUI (1997). Methodology of the trans-cultural adaptation of a preference-weighted health status classification system (French). Journal d’Economie Médicale 15, 529–548.
Le Galès, C., Costet, N., Buron, C. and Slama, G. (2000). Development of a preference-weighted health index (French). Working paper, CHEAR, INSERM U537, Le Kremlin-Bicêtre.
Le Gales, C., Buron, C., Costet, N., Rosman, S. and Slama, G. (forthcoming 1). Development of a preference-weighted health status classification system in France (French). Economie et Prévision.
Le Gales, C., Buron, C., Costet, N., Rosman, S. and Slama, G. (2002). Development of a preference-weighted health status classification system in France: the Health Utilities Index 3. Journal of Health Care and Management Science 5, 41–51.
Llewellyn-Thomas, H., Sutherland, H.J., Tibshirani, R., Ciampi, A., Till, J.E. and Boyd, N.F. (1984). Describing health states. Methodologic issues in obtaining values for health states. Medical Care 22, 543–552.
Mehrez, A. and Gafni, A. (1987). An Empirical evaluation of two assessment methods for utility measurement for life years. Socio-Economic Planification Science 21, 371–375.
O’Connor, A.M., Boyd, N.F., Warde, P., Stolbach, L. and Till, J.E. (1987). Eliciting preferences for alternative drug therapies in oncology: influence of treatment outcome description, elicitation technique and treatment experience on preferences. Journal of Chronic Diseases 40, 811–818.
Read, J.L., Quinn, R.J., Berwick, D.M., Fineberg, H.V. and Weinstein, M.C. (1984). Preferences for health outcomes. Comparison of assessment methods. Medical Decision Making 4, 315–329.
Torrance, G.W. (1976). Social preferences for health states: an empirical evaluation of three measurement techniques. Socio-Economic Planification Science 10, 129–136.
Torrance, G.W., Feeny, D., Furlong, W., Barr, R.D., Zhang, Y. and Wang, Q. (1996). Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Medical Care 34, 702–722.
Von Neumann, J. and Morgenstern, O. (1947). Theory of games and economic behaviour, 2nd Edition. Princeton: Princeton University Press.
Wolfson, A.D., Sinclair, A.J., Bombardier, C. and McGeer, A. (1982). Preference measurements for functional status in stroke patients: interrater and intertechnique comparaisons. In: Kane, R.L. and Kane, R.A. (eds.), Values and Long Term Care. Lexington: Lexington Books.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2002 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Galès, C.L. (2002). Application of the Multiattribute Utility Theory to the Development of a Preference-Based Health-Related Quality of Life Instrument. In: Mesbah, M., Cole, B.F., Lee, ML.T. (eds) Statistical Methods for Quality of Life Studies. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3625-0_4
Download citation
DOI: https://doi.org/10.1007/978-1-4757-3625-0_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-5207-3
Online ISBN: 978-1-4757-3625-0
eBook Packages: Springer Book Archive