Parameter Estimates for a QALY Utility Model
This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a pa...
Gespeichert in:
Veröffentlicht in: | Medical decision making 1985, Vol.5 (2), p.191-213 |
---|---|
Hauptverfasser: | , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 213 |
---|---|
container_issue | 2 |
container_start_page | 191 |
container_title | Medical decision making |
container_volume | 5 |
creator | Miyamoto, John M. Eraker, Stephen A. |
description | This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a patient's risk attitude with respect to survival duration. The parameter H(Q) represents the proportionate reduction in the utility of survival when health state Q prevails. Methods are described for estimating these parameters from the results of an individual patient utility assessment. Results are then reported for empirical estimation of parameters r and H(Q) from the preference judgments of a sample of 46 coronary artery disease patients. In this empirical study, health state Q takes on two values--survival with angina pectoris and survival free from angina pectoris. Estimated values of parameters r and H(Q) are discussed in relation to the decision analysis of coronary artery bypass graft surgery. Finally, it is argued that the model deserves consideration as a medical utility model, despite some preliminary evidence that assumptions of the model are descriptively false, because it provides a simple representation of the utility of survival duration and health quality. These aspects of health outcomes are known to be critically important in the expected utility analysis of health decisions. |
doi_str_mv | 10.1177/0272989X8500500208 |
format | Article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_76612370</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0272989X8500500208</sage_id><sourcerecordid>76612370</sourcerecordid><originalsourceid>FETCH-LOGICAL-c302t-f0fb717051ad722a56b95b81c250f16669a08ce7a5aaa9dad12bde7f2dbf6103</originalsourceid><addsrcrecordid>eNp9kEtLw0AUhQdRaq3-AUHIypWx9046jyxLqQ-oqFChrsJNMiMpSVNnkkX_vQkNbgThwl2c7xw4h7FrhHtEpabAFY91vNECoDsO-oSNUQgeSo2bUzbugbAnztmF91sAnMV6NmKjSEcoZzBmd2_kqDKNccHSN0VFjfGBrV1Awft89Rl8NEVZNIfgpc5NecnOLJXeXA1_wtYPy_XiKVy9Pj4v5qswi4A3oQWbKlQgkHLFOQmZxiLVmHEBFqWUMYHOjCJBRHFOOfI0N8ryPLUSIZqw22Ps3tXfrfFNUhU-M2VJO1O3PlFSIo9UD_IjmLnae2dssnddBXdIEJJ-oeTvQp3pZkhv08rkv5Zhkk6fHnVPXybZ1q3bdV3_S_wBkYltBw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76612370</pqid></control><display><type>article</type><title>Parameter Estimates for a QALY Utility Model</title><source>Access via SAGE</source><source>MEDLINE</source><creator>Miyamoto, John M. ; Eraker, Stephen A.</creator><creatorcontrib>Miyamoto, John M. ; Eraker, Stephen A.</creatorcontrib><description>This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a patient's risk attitude with respect to survival duration. The parameter H(Q) represents the proportionate reduction in the utility of survival when health state Q prevails. Methods are described for estimating these parameters from the results of an individual patient utility assessment. Results are then reported for empirical estimation of parameters r and H(Q) from the preference judgments of a sample of 46 coronary artery disease patients. In this empirical study, health state Q takes on two values--survival with angina pectoris and survival free from angina pectoris. Estimated values of parameters r and H(Q) are discussed in relation to the decision analysis of coronary artery bypass graft surgery. Finally, it is argued that the model deserves consideration as a medical utility model, despite some preliminary evidence that assumptions of the model are descriptively false, because it provides a simple representation of the utility of survival duration and health quality. These aspects of health outcomes are known to be critically important in the expected utility analysis of health decisions.</description><identifier>ISSN: 0272-989X</identifier><identifier>EISSN: 1552-681X</identifier><identifier>DOI: 10.1177/0272989X8500500208</identifier><identifier>PMID: 3831640</identifier><language>eng</language><publisher>Thousand Oaks, CA: Sage Publications</publisher><subject>Angina Pectoris - mortality ; Angina Pectoris - psychology ; Humans ; Mathematics ; Models, Biological ; Models, Psychological ; Quality of Life ; Risk</subject><ispartof>Medical decision making, 1985, Vol.5 (2), p.191-213</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c302t-f0fb717051ad722a56b95b81c250f16669a08ce7a5aaa9dad12bde7f2dbf6103</citedby><cites>FETCH-LOGICAL-c302t-f0fb717051ad722a56b95b81c250f16669a08ce7a5aaa9dad12bde7f2dbf6103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0272989X8500500208$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0272989X8500500208$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,4024,21819,27923,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3831640$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Miyamoto, John M.</creatorcontrib><creatorcontrib>Eraker, Stephen A.</creatorcontrib><title>Parameter Estimates for a QALY Utility Model</title><title>Medical decision making</title><addtitle>Med Decis Making</addtitle><description>This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a patient's risk attitude with respect to survival duration. The parameter H(Q) represents the proportionate reduction in the utility of survival when health state Q prevails. Methods are described for estimating these parameters from the results of an individual patient utility assessment. Results are then reported for empirical estimation of parameters r and H(Q) from the preference judgments of a sample of 46 coronary artery disease patients. In this empirical study, health state Q takes on two values--survival with angina pectoris and survival free from angina pectoris. Estimated values of parameters r and H(Q) are discussed in relation to the decision analysis of coronary artery bypass graft surgery. Finally, it is argued that the model deserves consideration as a medical utility model, despite some preliminary evidence that assumptions of the model are descriptively false, because it provides a simple representation of the utility of survival duration and health quality. These aspects of health outcomes are known to be critically important in the expected utility analysis of health decisions.</description><subject>Angina Pectoris - mortality</subject><subject>Angina Pectoris - psychology</subject><subject>Humans</subject><subject>Mathematics</subject><subject>Models, Biological</subject><subject>Models, Psychological</subject><subject>Quality of Life</subject><subject>Risk</subject><issn>0272-989X</issn><issn>1552-681X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1985</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtLw0AUhQdRaq3-AUHIypWx9046jyxLqQ-oqFChrsJNMiMpSVNnkkX_vQkNbgThwl2c7xw4h7FrhHtEpabAFY91vNECoDsO-oSNUQgeSo2bUzbugbAnztmF91sAnMV6NmKjSEcoZzBmd2_kqDKNccHSN0VFjfGBrV1Awft89Rl8NEVZNIfgpc5NecnOLJXeXA1_wtYPy_XiKVy9Pj4v5qswi4A3oQWbKlQgkHLFOQmZxiLVmHEBFqWUMYHOjCJBRHFOOfI0N8ryPLUSIZqw22Ps3tXfrfFNUhU-M2VJO1O3PlFSIo9UD_IjmLnae2dssnddBXdIEJJ-oeTvQp3pZkhv08rkv5Zhkk6fHnVPXybZ1q3bdV3_S_wBkYltBw</recordid><startdate>1985</startdate><enddate>1985</enddate><creator>Miyamoto, John M.</creator><creator>Eraker, Stephen A.</creator><general>Sage Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1985</creationdate><title>Parameter Estimates for a QALY Utility Model</title><author>Miyamoto, John M. ; Eraker, Stephen A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c302t-f0fb717051ad722a56b95b81c250f16669a08ce7a5aaa9dad12bde7f2dbf6103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1985</creationdate><topic>Angina Pectoris - mortality</topic><topic>Angina Pectoris - psychology</topic><topic>Humans</topic><topic>Mathematics</topic><topic>Models, Biological</topic><topic>Models, Psychological</topic><topic>Quality of Life</topic><topic>Risk</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Miyamoto, John M.</creatorcontrib><creatorcontrib>Eraker, Stephen A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical decision making</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Miyamoto, John M.</au><au>Eraker, Stephen A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Parameter Estimates for a QALY Utility Model</atitle><jtitle>Medical decision making</jtitle><addtitle>Med Decis Making</addtitle><date>1985</date><risdate>1985</risdate><volume>5</volume><issue>2</issue><spage>191</spage><epage>213</epage><pages>191-213</pages><issn>0272-989X</issn><eissn>1552-681X</eissn><abstract>This paper discusses a utility model for quality adjusted life years (QALY). According to this model, the utility of Y years of survival in health state Q is bYrH(Q), where b is a scaling constant and r and H(Q) are parameters. The parameter r is shown to be interpretable as a representation of a patient's risk attitude with respect to survival duration. The parameter H(Q) represents the proportionate reduction in the utility of survival when health state Q prevails. Methods are described for estimating these parameters from the results of an individual patient utility assessment. Results are then reported for empirical estimation of parameters r and H(Q) from the preference judgments of a sample of 46 coronary artery disease patients. In this empirical study, health state Q takes on two values--survival with angina pectoris and survival free from angina pectoris. Estimated values of parameters r and H(Q) are discussed in relation to the decision analysis of coronary artery bypass graft surgery. Finally, it is argued that the model deserves consideration as a medical utility model, despite some preliminary evidence that assumptions of the model are descriptively false, because it provides a simple representation of the utility of survival duration and health quality. These aspects of health outcomes are known to be critically important in the expected utility analysis of health decisions.</abstract><cop>Thousand Oaks, CA</cop><pub>Sage Publications</pub><pmid>3831640</pmid><doi>10.1177/0272989X8500500208</doi><tpages>23</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0272-989X |
ispartof | Medical decision making, 1985, Vol.5 (2), p.191-213 |
issn | 0272-989X 1552-681X |
language | eng |
recordid | cdi_proquest_miscellaneous_76612370 |
source | Access via SAGE; MEDLINE |
subjects | Angina Pectoris - mortality Angina Pectoris - psychology Humans Mathematics Models, Biological Models, Psychological Quality of Life Risk |
title | Parameter Estimates for a QALY Utility Model |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T18%3A28%3A54IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Parameter%20Estimates%20for%20a%20QALY%20Utility%20Model&rft.jtitle=Medical%20decision%20making&rft.au=Miyamoto,%20John%20M.&rft.date=1985&rft.volume=5&rft.issue=2&rft.spage=191&rft.epage=213&rft.pages=191-213&rft.issn=0272-989X&rft.eissn=1552-681X&rft_id=info:doi/10.1177/0272989X8500500208&rft_dat=%3Cproquest_cross%3E76612370%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=76612370&rft_id=info:pmid/3831640&rft_sage_id=10.1177_0272989X8500500208&rfr_iscdi=true |