This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Johannesson, M. Articles by Weinstein, M. C. Search for Related Content PubMed PubMed Citation Articles by Johannesson, M. Articles by Weinstein, M. C. Social Bookmarking                   What's this?

Are Healthy-years Equivalents an Improvement over Quality-adjusted Life Years?

Joseph S. Pliskin, PhD

Milton C. Weinstein, PhD

The construct of the healthy-years equivalent (HYE) has been proposed as an alternative to the quality-adjusted life year (QALY) on the grounds that it avoids certain restrictive assumptions about preferences and also incorporates attitudes toward risk. The authors review the construct of the QALY, including both the commonly used risk-neutral formulation and the more general formulation that permits risk aversion (or risk preference) with respect to remaining life years. They show that the HYE adds flexibility to the risk-neutral form of the QALY by permitting the rate of tradeoff between life years and quality of life to depend on the life span, albeit at the cost of eliciting numerous additional time-tradeoff assessments. However, the claim that the HYE incorporates attitudes toward risk is incorrect, and the proposed two-stage procedure to measure HYEs is neither necessary nor sufficient to in corporate attitudes toward risk. In fact, the HYE assumes risk neutrality with respect to healthy years of life and, therefore, is less suitable for decisions under uncertainty than is the general (risk-averse) form of the QALY. Key words: quality-adjusted life years; healthy- years equivalents; economic evaluation; medical decision making; individual preferences; time-tradeoff; standard gamble; utility theory. (Med Decis Making 1993;13:281-286)

Medical Decision Making, Vol. 13, No. 4, 281-286 (1993)
DOI: 10.1177/0272989X9301300403


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				P. P. Wakker Lessons Learned by (from?) an Economist Working in Medical Decision Making Med Decis Making, September 1, 2008; 28(5): 690 - 698. [Abstract] [PDF]

				L. D. Mackeigan, B. J. O'Brien, and P. I. Oh Holistic versus Composite Preferences for Lifetime Treatment Sequences for Type 2 Diabetes Med Decis Making, April 1, 1999; 19(2): 113 - 120. [Abstract] [PDF]

				J. R. Treadwell Tests of Preferential Independence in the QALY Model Med Decis Making, October 1, 1998; 18(4): 418 - 428. [Abstract] [PDF]

				M. Kuppermann, S. Shiboski, D. Feeny, E. P. Elkin, and A. E. Washington Can Preference Scores for Discrete States Be Used to Derive Preference Scores for an Entire Path of Events?: An Application to Prenatal Diagnosis Med Decis Making, February 1, 1997; 17(1): 42 - 55. [Abstract] [PDF]

				M. C. Weinstein and J. S. Pliskin Perspectives on Healthy-years Equivalents: HYEs: What Are the Issues? Med Decis Making, August 1, 1996; 16(3): 205 - 206. [PDF]

				P. Wakker A Criticism of Healthy-years Equivalents Med Decis Making, August 1, 1996; 16(3): 207 - 214. [Abstract] [PDF]

				B. J. Barrett, P. S. Parfrey, R. N. Foley, and A. S. Detsky An Economic Analysis of Strategies for the Use of Contrast Media for Diagnostic Cardiac Catheterization Med Decis Making, October 1, 1994; 14(4): 325 - 335. [Abstract] [PDF]

				M. Johannesson, J. S. Pliskin, and M. C. Weinstein A Note on QALYs, Time Tradeoff, and Discounting Med Decis Making, April 1, 1994; 14(2): 188 - 193. [Abstract] [PDF]

				D. G. Fryback QALYs, HYEs, and the Loss of Innocence Med Decis Making, December 1, 1993; 13(4): 271 - 272. [PDF]

				A. Mehrez and A. Gafni Healthy-years Equivalents versus Quality-adjusted Life Years: In Pursuit of Progress Med Decis Making, December 1, 1993; 13(4): 287 - 292. [Abstract] [PDF]