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Medical Decision Making
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What Should Be Reported in a Methods Section on Utility Assessment?

Peep F. M. Stalmeier, PhD

Medical Psychology, Academic Medical Center, Amsterdam, and the Joint Center for Radiation Oncology Arnhem-Nijmegen (RADIAN), University Medical Center Nijmegen, and the Nijmegen Institute for Cognition and Information (NICI), Nijmegen, the Netherlands

M. K. Goldstein, MD

VA Palo Alto Health Care System and Department of Medicine, Stanford University School of Medicine, Stanford, California

A. M. Holmes, PhD

School of Public and Environmental Affairs, Indiana University-Purdue University, Indianapolis, Indiana

L. Lenert, MD, MS

Department of Medicine, Veterans Affairs Healthcare System and the University of California, San Diego

J. Miyamoto, PhD

Department of Psychology, University of Washington, Seattle

A. M. Stiggelbout, PhD

Department of Medical Decision Making, Leiden University Medical Center, the Netherlands

G. W. Torrance, PhD

Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada, Innovus Research, Inc., Burlington, Ontario, Canada, and Health Utilities, Inc., Dundas, Ontario, Canada

J. Tsevat, MD, MPH

Section of Outcomes Research, Division of General Internal Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio

Background. The measurement of utilities, or preferences, for health states may be affected by the technique used. Unfortunately, in papers reporting utilities, it is often difficult to infer how the utility measurement was carried out. Purpose. To present a list of components that, when described, provide sufficient detail of the utility assessment. Methods. An initial list was prepared by one of the authors. A panel of 8 experts was formed to add additional components. The components were drawn from 6 clusters that focus on the design of the study, the administration procedure, the health state descriptions, the description of the utility assessment method, the description of the indifference procedure, and the use of visual aids or software programs. The list was updated and redistributed among a total of 14 experts, and the components were judged for their importance of being mentioned in a Methods section. Results. More than 40 components were generated. Ten components were identified as necessary to include even in an article not focusing on utility measurement: how utility questions were administered, how health states were described, which utility assessment method(s) was used, the response and completion rates, specification of the duration of the health states, which software program (if any) was used, the description of the worst health state (lower anchor of the scale), whether a matching or choice indifference search procedure was used, when the assessment was conducted relative to treatment, and which (if any) visual aids were used. The interjudge reliability was satisfactory (Cronbach’s alpha = 0.85). Discussion. The list of components important for utility papers may be used in various ways, for instance, as a checklist while writing, reviewing, or reading a Methods section or while designing experiments. Guidelines are provided for a few components.

Key Words: utility assessment • cost-utility assessment

Medical Decision Making, Vol. 21, No. 3, 200-207 (2001)
DOI: 10.1177/0272989X0102100305


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