Tracy A Comans1,2, Kim-Huong Nguyen3,4, Julie Ratcliffe5, Donna Rowen6, Brendan Mulhern7. 1. The Centre for Health Services Research, University of Queensland, St. Lucia, Brisbane, QLD, Australia. t.comans@uq.edu.au. 2. NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People, Sydney, NSW, Australia. t.comans@uq.edu.au. 3. The Centre for Health Services Research, University of Queensland, St. Lucia, Brisbane, QLD, Australia. 4. NHMRC Partnership Centre on Dealing with Cognitive and Related Functional Decline in Older People, Sydney, NSW, Australia. 5. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia. 6. Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK. 7. Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia.
Abstract
OBJECTIVE: This paper reports on the valuation of quality-of-life states in the Alzheimer's Disease Five Dimensions (AD-5D) instrument in a representative sample of the general population in Australia using the discrete-choice experiment with duration (DCETTO) elicitation technique. METHOD: A DCE with 200 choice sets of two quality-of-life (QoL) state-duration combinations blocked into 20 survey versions, with ten choice sets in each version, was designed and administered online to a sample representative of the Australian population. Two additional choice sets comprising internal consistency and dominance checks were included in each survey version. A range of model specifications investigating preferences with respect to duration and interactions between AD-5D dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale, suitable for the calculation of quality-adjusted life-year (QALY) weights for use in economic evaluation. RESULTS: In total, 1999 respondents completed the choice experiment. Overall, respondents were slightly better educated and had higher annual incomes than the Australian general population. The estimation results from different specifications and models were broadly consistent with the monotonic nature of the AD-5D: utility increased with increased life expectancy and decreased as the severity level for each dimension worsened. A utility value set was generated for the calculation of utilities for all QoL states defined by the AD-5D descriptive system. CONCLUSION: The DCE-based utility value set is now available to use to generate QALYs for the economic evaluation of treatments and interventions targeting people with dementia and/or their family caregivers.
OBJECTIVE: This paper reports on the valuation of quality-of-life states in the Alzheimer's Disease Five Dimensions (AD-5D) instrument in a representative sample of the general population in Australia using the discrete-choice experiment with duration (DCETTO) elicitation technique. METHOD: A DCE with 200 choice sets of two quality-of-life (QoL) state-duration combinations blocked into 20 survey versions, with ten choice sets in each version, was designed and administered online to a sample representative of the Australian population. Two additional choice sets comprising internal consistency and dominance checks were included in each survey version. A range of model specifications investigating preferences with respect to duration and interactions between AD-5D dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale, suitable for the calculation of quality-adjusted life-year (QALY) weights for use in economic evaluation. RESULTS: In total, 1999 respondents completed the choice experiment. Overall, respondents were slightly better educated and had higher annual incomes than the Australian general population. The estimation results from different specifications and models were broadly consistent with the monotonic nature of the AD-5D: utility increased with increased life expectancy and decreased as the severity level for each dimension worsened. A utility value set was generated for the calculation of utilities for all QoL states defined by the AD-5D descriptive system. CONCLUSION: The DCE-based utility value set is now available to use to generate QALYs for the economic evaluation of treatments and interventions targeting people with dementia and/or their family caregivers.
Authors: Sanjeewa Kularatna; Donna Rowen; Clara Mukuria; Steven McPhail; Gang Chen; Brendan Mulhern; Jennifer A Whitty; Joshua Byrnes; Paul Scuffham; John Atherton; Stefan Höfer; William Parsonage Journal: Qual Life Res Date: 2021-05-26 Impact factor: 4.147