title: Automated current health time-trade-off assessments in women's health.
abstract: 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.
authors.affiliation: Center for the Evaluative Clinical Sciences, Department of Community and Family Medicine, Dartmouth Medical School, Hanover, New Hampshire 03756, USA. anna.tosteson@dartmouth.edu
authors.forename: Anna N A
authors.initials: AN
authors.lastname: Tosteson
authors.forename: Terry S
authors.initials: TS
authors.lastname: Kneeland
authors.forename: Robert F
authors.initials: RF
authors.lastname: Nease
authors.forename: Walton
authors.initials: W
authors.lastname: Sumner
mesh_terms: 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