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Toward Quality Assurance in QALY Calculations

Published online by Cambridge University Press:  10 March 2009

Erik Nord
Affiliation:
Norwegian National Institute of Public Health

Abstract

The utility weights that are used in published scientific articles for assessing benefits in terms of quality adjusted life-years gained often have a weak theoretical and empirical basis. To a large extent, the weights seem to be used without critical thought and sensible discussion. In a majority of cases, the sensitivity of the results to the weights that have been chosen is not demonstrated, and readers are not provided with information in a way that facilitates independent calculations. This paper calls for a standard for future publications.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

1.Allen, D., Lee, R. H., & Lowson, K.The use of QALYs in health service planning. International Journal of Health Planning and Management, 1989, 4, 261–73.Google ScholarPubMed
2.Barry, M. J., Mulley, A. G., Fowler, F. J., & Wennberg, J. W.Watchful waiting vs. immediate transurethral resection for symptomatic prostatism. The importance of patients’ preferences. Journal of the American Medical Association, 1988, 259, 3010–17.CrossRefGoogle ScholarPubMed
3.Binkin, N. J., & Koplan, J. P.The high cost and low efficacy of weekly viral cultures for pregnant women with recurrent genital herpes: A reappraisal. Medical Decision Making, 1989, 9, 225–30.CrossRefGoogle ScholarPubMed
4.Carr-Hill, R. A.Assumptions of the QALY procedure. Social Science and Medicine, 1989, 29, 469–77.CrossRefGoogle ScholarPubMed
5.Dixon, J., & Welch, H. G.Priority setting: Lessons from Oregon. Lancet, 1991, 337, 891–93.CrossRefGoogle ScholarPubMed
6.Drummond, M. F.Output measurement for resource allocation decisions in health care. Oxford Review of Economic Policy, 1991, 5, 5974.CrossRefGoogle Scholar
7.Eckman, M. H., Beshansky, J. R., Durand-Zaleski, I., et al. Anticoagulation for noncardiac procedures in patients with prosthetic heart valves. Journal of the American Medical Association, 1990, 263, 15131521.CrossRefGoogle ScholarPubMed
8.Fanshel, S., & Bush, J. W.A health status index and its application to health service outcomes. Operations Research, 1970, 18, 1021–66.CrossRefGoogle Scholar
9.Froberg, D. G., & Kane, R. L.Methodology for measuring health-state preferences-II: Scaling methods. Journal of Clinical Epidemiology, 1989, 42, 459–71.CrossRefGoogle ScholarPubMed
10.Gafni, A., & Zylak, C. J. Ionic vs. non-ionic contrast media: A burden or a bargain. Working paper no. 90–8. Hamilton, Ontario: McMaster University, Centre for Health Economics and Policy Analysis, 1990.Google Scholar
11.Goel, V., Deber, R B., & Detsky, A. S.Nonionic contrast media: Economic analysis and health policy development. Canadian Medical Association Journal, 1989, 140, 389–95.Google ScholarPubMed
12.Hadorn, D. C.Setting health care priorities in Oregon. Journal of the American Medical Association, 1991, 265, 2218–25.CrossRefGoogle ScholarPubMed
13.Hatziandreu, E., Koplan, J. P., Weinstein, M. C., et al. A cost-effectiveness analysis of exercise as a health promotion activity. American Journal of Public Health, 1988, 78,1417–21.CrossRefGoogle ScholarPubMed
14.Hurley, S.A review of cost-effectiveness analyses. The Medical Journal of Australia, 1990, 153(suppl.), S20–S23.CrossRefGoogle ScholarPubMed
15.Jønsson, B., Horisberger, B., Bruguera, M., & Matter, L.Cost-benefit analysis of hepatitis-B vaccination. A computerized decision model for Spain. International Journal of Technology Assessment in Health Care, 1991, 7, 379402.CrossRefGoogle ScholarPubMed
16.Kaplan, R. M., & Anderson, J. P.A general health policy model: Update and applications. Health Services Research, 1988, 23, 203–35.Google ScholarPubMed
17.Kawachi, I., & Malcolm, L. A.The benefits of treating mild to moderate hypertension. Journal of Clinical Epidemiology, 1989, 42, 905–12.CrossRefGoogle ScholarPubMed
18.Kievit, J., & van de Velde, C. J. H.Utility and cost of carcinoembryonic antigen monitoring in colon cancer follow-up evaluation. Cancer, 1990, 65, 2580-87.3.0.CO;2-I>CrossRefGoogle ScholarPubMed
19.Loomes, G., & McKenzie, L.The use of QALYs in health care decision making. Social Science and Medicine, 1989, 28, 299308.CrossRefGoogle ScholarPubMed
20.Mulkay, M., Ashmore, M., & Pinch, T.Measuring the quality of life: A sociological invention concerning the application of economics to health care. Sociology, 1987, 21, 541–64.CrossRefGoogle Scholar
21.Nord, E.Methods for quality adjustment of life years. Social Science & Medicine, 1992, 34, 559–69.CrossRefGoogle ScholarPubMed
22.Nord, E.The validity of a visual analogue scale in determining social utility weights for health states. International Journal ofHealth Planning and Management, 1991,6,234–42.Google ScholarPubMed
23.Nord, E. The use of EuroQol values in QALY calculations. In Björk, (ed), EuroQol Conference Proceedings. IHE Working Paper, 1992:2. Lund, 1992.Google Scholar
24.Nord, E. Unjustified use of the Quality of Well-being Scale in priority setting in Oregon. Health Policy (in press).Google Scholar
25.O'Kelly, T. J., & Westaby, S.Trauma centres and the efficient use of financial resources. British Journal of Surgery, 1990, 77, 1142–44.CrossRefGoogle ScholarPubMed
26.Pliskin, J. S., Shephard, D. S., & Weinstein, M. C.Utility functions for life years and health status. Operations Research, 1980, 28, 206–22.CrossRefGoogle Scholar
27.Rawls, J.A theory of justice. Cambridge, MA: Harvard University Press, 1971.CrossRefGoogle Scholar
28.Read, J. L., Quinn, R. J., Berwick, D. M., et al. Preferences for health outcomes. Comparison of assessment methods. Medical Decision Making, 1984, 4, 315–29.CrossRefGoogle ScholarPubMed
29.Russel, J. G. B.Is screening for abdominal aortic aneurism worthwhile? Clinical Radiology, 1990, 41, 182–84.CrossRefGoogle Scholar
30.Schechter, C. B., Rose, D. N., Fahs, M. C, & Silver, A. L.Tuberculin screening: Costeffectiveness analysis of various testing schedules. American Journal of Preventive Medicine, 1990, 6, 167–75.CrossRefGoogle ScholarPubMed
31.Shephard, R. J.The economics of fitness. Champaign, IL: Human Kinetics, 1986.Google ScholarPubMed
32.Shephard, R. J., & Montelpare, W.Geriatric benefits of exercise as an adult. Journal of Gerontology, 1988, 43, M8690.CrossRefGoogle ScholarPubMed
33.Smith, A.Qualms about QALYs. Lancet, 1987, i 1134–36.CrossRefGoogle Scholar
34.Smith, G. T.The economics of hypertension and stroke. American Heart Journal, 1990, 119, 725–28.CrossRefGoogle ScholarPubMed
35.Torrance, G. W.Measurement of health state utilities for economic appraisal. Journal of Health Economics, 1986, 5, 130.CrossRefGoogle ScholarPubMed
36.Torrance, G. W.Utility approach to measuring health-related quality of life. Journal of Chronic Diseases, 1987, 40, 593600.CrossRefGoogle ScholarPubMed
37.Tsevat, J., Durand-Zalesky, I., & Pauker, S. G.Cost-effectiveness of antibiotic prophylaxis for dental procedures in patients with artificial joints. American Journal of Public Health, 1989, 79, 739–43.CrossRefGoogle ScholarPubMed
38.Vermeer, F., et al. Cost benefit analysis of early thrombolytic treatment with intracoronary streptokinase. British Heart Journal, 1988, 59, 527–34.CrossRefGoogle ScholarPubMed
39.Weinstein, M. C.Economic assessments of medical practices and technologies. Medical Decision Making, 1981, 1, 309–30.CrossRefGoogle ScholarPubMed
40.Weinstein, M. C., Coley, C. M., & Richter, J. M.Medical management of gallstones: A cost effectiveness analysis. Journal of General Internal Medicine, 1990, 5, 277–84.CrossRefGoogle ScholarPubMed
41.Weinstein, M. C., & Stason, W. B.Foundations of cost-effectiveness analysis for health and medical practices. New England Journal of Medicine, 1976, 296, 716–21.CrossRefGoogle Scholar
42.Weinstein, M. C., & Stason, W. B.Cost-effectiveness of coronary artery bypass surgery. Circulation, 1982, 66(suppl. Ill), III–56–III–67.Google ScholarPubMed
43.Weinstein, M. C., & Stason, W. B.Cost-effectiveness of interventions to prevent or treat coronary heart disease. Annual Review of Public Health, 1985, 6, 4163.CrossRefGoogle ScholarPubMed
44.Williams, A.Economics of coronary artery bypass grafting. British Medical Journal, 1985, 291, 326–29.CrossRefGoogle ScholarPubMed
45.Williams, A.Who is to live? A question for the economist or the doctor? World Hospitals, 1987, 13, 3436.Google Scholar
46.Williams, A.The measurement and valuation of improvements in health. In Centre for Health Economics, Newsletter 3. York: University of York, 1988.Google Scholar
47.Wong, J. B., Sonnenberg, F. A., Salem, D. N., & Pauker, S. G.Myocardial revascularization for chronic stable angina. Annals of Internal Medicine, 1990, 113, 852–71.CrossRefGoogle ScholarPubMed
48.Yates, J. W., Chalmer, B., & McKegney, E. P.Evaluation of patients with advanced cancer using the Karnofsky performance status. Cancer, 1980, 45, 2220–24.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed