Methodology for measuring health-state preferences--IV: Progress and a research agenda.

Remaining questions relative to the measurement of health-state preferences are outlined and applications discussed. We recommend more widespread use of functional measurement to better understand preference structures. Further research should be conducted on the reliability and validity of preference values produced by different scaling methods, including careful examination of the content validity of health-state descriptions. Construct validation studies using the multitrait-multimethod matrix would be useful as well as comparisons of stated preferences with revealed preferences. Despite the many unanswered measurement questions, preference values are currently being used in decision making at both the individual and societal levels. Several global health status measures incorporate preference values, and preferences are increasingly being used in cost-effectiveness studies. If preferences are to be used effectively, research on their measurement must accelerate to keep pace with the urgency for application.