[Common effect measures in medical and health economics studies? Results of an exploratory survey of physicians].
BACKGROUND
In economic evaluation studies quality-adjusted life years (QALYs) are often used as measure of effects. QALYs are calculated by weighting survival time with a valuation of health-related quality of life (HRQoL). The results may support clinical decisions for patient groups provided that physicians consider QALYs acceptable and clinically relevant. This study investigates whether physicians accept the various methodological steps of the calculation of QALYs and whether effect measures that result from these steps are useful in clinical studies, too.


METHODS
In summer 1998, 41 physicians (21 principal investigators of clinical studies in oncology, 12 surgeons, 8 primary care physicians) completed a questionnaire.


RESULTS
90% of the physicians considered HRQoL a relevant measure of clinical effectiveness but only 54% were familiar with the concept of HRQoL. 80% accepted the creation of an index of HRQoL, 68% accepted the integration of HRQoL and survival time into a single effect measure, but only 44% accepted the multiplicative way of calculating QALYs. According to most physicians, HRQoL should be valued either by study patients or health care professionals rather than general population samples. 92% of the physicians considered identical effect measures in clinical and economic studies necessary or desirable.


CONCLUSIONS
QALYs are not generally rejected by the responding physicians. The integration of HRQoL is largely accepted. The multiplicative way of combining survival time and HRQoL values is rejected by many physicians. The findings can be used to define a starting point for the development of common effect measures in medicine and health economics.
König
H H
HH
Abteilung Gesundheitsökonomie, Universität Ulm. hans-helmut.koenig@mathematik.uni-ulm.de
Hoffmann
C
C
Graf von der Schulenburg
J M
JM
Leidl
R
R
D001291:Attitude of Health Personnel; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005858:Germany; D006302:Health Services Research; D006304:Health Status; D006801:Humans; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012107:Research Design; D012494:Sampling Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis