Searching for a common currency: critical appraisal of the scientific basis underlying European harmonization of the measurement of health related quality of life (EuroQol)
The EuroQol has recently been proposed as a measure of health-related quality of life based on individuals' valuations of health states. The derived values would be used in assessing cost-effectiveness and establishing priorities across a wide range of health-care activities. In this paper we identify some of the limitations of the EuroQol in its role as a particular method for deriving the more generic QALYs. More specifically we explore the implications of using the EuroQol as a measure of individuals' and communities' valuation of health outcomes. We show that the EuroQol suffers from several major limitations and thus cannot be relied upon to provide a valid measure to be used in economic appraisals or studies concerned with establishing priorities as proposed by its proponents. An alternative approach is identified and discussed.
Gafni
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Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Ontario.
Birch
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D005060:Europe; D005069:Evaluation Studies as Topic; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research / Q000379:methods; D006305:Health Status Indicators; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D015203:Reproducibility of Results; D026712:Value of Life