Health State Valuation and Preference-Based Measures (QALYs, DALYs, MAUIs)

Vocabulary flashcards covering key terms and concepts from the lecture notes on measuring health outcomes, QALYs, DALYs, and MAUIs.

QALY

Quality Adjusted Life Year: a health outcome measure that combines length of life and health-related quality of life; 1 QALY = 1 year in full health; scale anchored 0 (dead) to 1 (full health), with possible values below 0 for states worse than dead.

DALY

Disability-Adjusted Life Year; a summary measure of population health: DALY = YLL (Years of Life Lost) + YLD (Years Lived with Disability); 1 DALY equals one year of full health lost.

YLL

Years of Life Lost; component of DALY representing premature mortality.

YLD

Years Lived with Disability; component of DALY representing time lived with less than full health.

HRQoL

Health-Related Quality of Life; aspects of quality of life affected by health condition or healthcare treatment.

MAUI

Multi-Attribute Utility Instrument; generic preference-based measures used to derive utility scores for health states.

EQ-5D

A MAUI with 5 dimensions (Mobility, Self-care, Usual Activities, Pain/Discomfort, Anxiety/Depression); available in 3L/5L versions; provides utility tariffs.

SF-36

36-item health survey covering 8 domains of health; can be mapped to utility measures like SF-6D.

SF-6D

A MAUI derived from SF-36, providing a 6-dimension utility scoring system.

HUI3

Health Utilities Index Mark 3; a MAUI with eight attributes (e.g., Vision, Hearing, Ambulation) producing utility scores.

AQOL-8D

Australian Quality of Life 8-Dimensions; a MAUI with eight health dimensions.

15D

A 15-dimension generic MAUI used for utility valuation across multiple health states.

EQ-5D-Y

Child/adolescent version of EQ-5D; values recently developed for youth populations (e.g., Australia).

TTO

Time Trade-Off; a direct elicitation method where respondents trade length of life for quality (full health) to derive utility values.

SG

Standard Gamble; an elicitation method based on expected utility under uncertainty, comparing a certain health state to a gamble with possible outcomes (full health or death).

VAS

Visual Analogue Scale; a rating scale (often 0–100) used to value health states, anchored by dead and full health in some applications.

DCE

Discrete Choice Experiment; respondents choose between pairs of health states with different attributes to infer preferences and utilities.

Best-Worst Scaling (BWS)

A stated-preference method where respondents identify the best and worst attributes within a health state set.

DCE with duration

A DCE variant that includes survival duration as an attribute to capture trade-offs between quality and length of life.

Tariff

The set of utility values assigned to health states within a MAUI, derived from valuation studies (e.g., TTO, SG, VAS).

Utility weight

A numeric score (0–1, sometimes including negatives) reflecting the desirability of a health state.

Preference elicitation

Methods used to directly or indirectly measure utilities by obtaining people’s valuations of health states.

Mapping

Transforming non-preference HRQoL measures into utility scores (e.g., SF-36 to SF-6D or EQ-5D).

Generic measures

MAUIs designed to be applicable across many conditions (e.g., EQ-5D, HUI3, SF-6D, AQOL-8D).

Direct elicitation

Utility assessment obtained from respondents via methods like TTO, SG, or DCE, as opposed to mapping from non-preference measures.

Vignette vs patient-based valuations

Valuation using hypothetical health state descriptions (vignettes) versus valuations based on patients’ own experiences.

General population vs patient values

Two perspectives in valuation: general population values (often used by policy bodies) versus patient-derived values.

Anchor 0-1 scale

Scale where 0 = dead and 1 = full health; some methods allow states worse than dead with negative values.

Tariffs across countries

Country-specific valuation sets (tariffs) for MAUIs reflecting local preferences, often derived from TTO or VAS.

Utility vs health state description

Utility combines quality and length of life; health state descriptions are profiles used to assign utilities.

QALY vs DALY use

QALYs measure years in full health gained; DALYs measure years of healthy life lost; they provide complementary perspectives on health outcomes.

Health state valuation

Process of assigning a numerical value to a health state, typically derived from elicitation methods or tariff scores.

Generic vs disease-specific measures

Generic measures apply across conditions (MAUIs); disease-specific measures focus on a particular condition or population.