Automated current health time-trade-off assessments in women's health.
OBJECTIVE
To motivate the role for preference assessment in women's health and to report pilot data addressing the performance of automated time-trade-off (TTO) valuations of current health, which were developed to estimate quality-adjusted life years (QALYs) in the women's health setting.


METHODS
Values for current health relative to perfect health and death were assessed using an annual time trade-off (1-year horizon and sleep as the trading metaphor), a lifetime time trade-off, and a visual analog scale (VAS). All instruments were administered twice within a 12- to 14-day window among a convenience sample of 27 women.


RESULTS
Valuation of health was similar for both time trade-offs (mean of 0.95 for both), but was significantly lower for the VAS (mean of 0.84, Wilcoxon signed-rank p-value < 0.001). Reliability using the intraclass correlation coefficient was 0.67 +/- 0.09 and 0.75 +/- 0.07 for the annual and lifetime time trade-offs, respectively, and 0.89 +/- 0.03 for the VAS. Construct validity was supported by consistent trends in time-trade-off utilities across tertiles of the Short Form 36 (SF-36) general health subscale (trend test p-value < 0.001).


CONCLUSIONS
Automated time trade-offs for current health provide a promising approach for use in women's health studies where impact on QALYs must be measured. Natural areas of application include the economic evaluation of preventive interventions in postmenopausal women.
Tosteson
Anna N A
AN
Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire 03756, USA. anna.tosteson@dartmouth.edu
Kneeland
Terry S
TS
Nease
Robert F
RF
Sumner
Walton
W
D000328:Adult; D003199:Computer Systems; D003362:Cost-Benefit Analysis; D005260:Female; D006302:Health Services Research / Q000379:methods*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic / Q000379:methods*; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods*; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D016387:Women's Health