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Medical Decision Making
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Can Preference Scores for Discrete States Be Used to Derive Preference Scores for an Entire Path of Events?

An Application to Prenatal Diagnosis

Miriam Kuppermann

Stephen Shiboski

David Feeny

Eric P. Elkin

A. Eugene Washington

The authors conducted a study exploring whether preferences for sequences of events can be approximated by preferences for component discrete states. Visual-analog- scale (VAS) and standard-gamble (SG) scores for a subset of the possible sequences of events (path states) and component temporary and chronic outcomes (discrete states) that can follow prenatal diagnostic decisions were elicited from 121 pregnant women facing a choice between chorionic villus sampling and amniocentesis. For in dividuals, preference scores for path states could not be predicted easily from discrete- state scores. Mean path-state VAS scores, however, were predicted reasonably ac curately by multiple regression models (R2 = 0.85 and 0.82 for two different anchoring schemes), with most measured scores lying within the 95% confidence intervals of the derived scores. It is concluded that, for individual patient decision making, preferences for path states should be elicited. When mean preference values for a population are sought, however, it may be reasonable to derive regression weights from a subset of respondents and then to apply those weights to preferences for discrete states elicited from a larger group. Key words: utility measurement; patient preferences; multiple re gression ; standard gamble; visual analog scaling; prenatal diagnosis. (Med Decis Mak ing 1997;17:42-55))

Medical Decision Making, Vol. 17, No. 1, 42-55 (1997)
DOI: 10.1177/0272989X9701700105


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