Health years equivalents as a measurement of preferences for dental interventions.
OBJECTIVE
To test the feasibility and importance of measuring preferences among treatment choices using Healthy Years Equivalents (HYE).


METHODS
Development of scenarios for alternative approaches to caries treatment. Completion of category rating and standard gamble questions elicited in personal interviews.


METHODS
The provision of dental care to children in a public-funded dental health clinic.


METHODS
Random sample of the adult population of Hamilton, Ontario.


METHODS
The percentage of the sample unable to complete the interviews, time taken to perform interviews, ease of understanding of interviews, correlation between rank ordering and HYE scores.


RESULTS
Ninety-six per cent of the sample were able to complete the HYE exercise. Inconsistencies between HYE scores and rank orders implying preference reversal occurred in 6% of those completing HYE scores for the two scenarios. The additional time taken by the HYE was of the order of 17 minutes but increased with the age of the subject. Where problems occurred, they were related to the method of measurement or the sensitivity of the chosen scale as opposed to additional requirements of the HYE. There was some evidence that HYEs and QALYs produced different scores even in the context of chronic constant health states.


CONCLUSIONS
HYEs are a feasible and important practical method of measuring preferences among interventions. Alternative utility-based approaches, such as willingness to pay, may be required to detect differences in modest improvements in temporary health states.
Birch
S
S
Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario, Canada.
Gafni
A
A
Markham
B
B
Marriott
M
M
Lewis
D
D
Main
P
P
D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002648:Child; D002755:Choice Behavior; D003188:Composite Resins; D003723:Dental Amalgam; D019140:Dental Care for Children; D003731:Dental Caries / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000191:economics / Q000379:methods*; D005240:Feasibility Studies; D005382:Financing, Personal; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D011636:Public Health Dentistry; D019057:Quality-Adjusted Life Years; D012390:Root Canal Therapy; D018401:Sample Size; D012680:Sensitivity and Specificity; D013997:Time Factors; D014081:Tooth Extraction