title: Lead versus lag-time trade-off variants: does it make any difference?
abstract: OBJECTIVE
  The traditional time trade-off (TTO) method has some problems in the valuation of health states considered worse than dead. The aim of our study is to compare two TTO variants that address this issue: lead-time and lag-time TTO.
  
  
  METHODS
  Quota sampling was undertaken in June 2011 in Buenos Aires as part of the EQ-5D-5L Multinational Pilot Study. Respondents were randomly assigned to one of the TTO variants with two blocks of five EQ-5D-5L health states. Tasks were administered using a web-based digital aid (EQ-VT) administered in a group interview.
  
  
  RESULTS
  A total of 387 participants were included [mean age 38.85 (SD: 13.97); 53.14 % females]. The mean observed values ranged from 0.44 (0.59) for state 21111 to 0.02 (0.76) for state 53555 in the lead-time group and between 0.53 (0.52) and 0.08 (0.76) in the lag-time group. There were no statistically significant differences in the values between TTO variants, except for a significant difference of 0.19 for state 33133. In both variants, marked peaks were observed around the value 0 across all states, with a higher percentage of 0 responses in the last state valued, suggesting ordering effects.
  
  
  CONCLUSIONS
  No important differences were found between TTO variants regarding values for EQ-5D-5L health states, suggesting that they could be equivalent variants. However, differences between the two methods may have been obscured by other aspects of the study design affecting the characteristics of the data.
authors.affiliation: Institute of Clinical Effectiveness and Health Policy, IECS, Dr Emilio Ravignani 2024, C1414CPV Buenos Aires, Argentina. faugustovski@iecs.org.ar
authors.forename: Federico
authors.initials: F
authors.lastname: Augustovski
authors.forename: Lucila
authors.initials: L
authors.lastname: Rey-Ares
authors.forename: Vilma
authors.initials: V
authors.lastname: Irazola
authors.forename: Mark
authors.initials: M
authors.lastname: Oppe
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Devlin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors; D055815:Young Adult
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