title: Dealing with the health state 'dead' when using discrete choice experiments to obtain values for EQ-5D-5L heath states.
abstract: OBJECTIVE
  To evaluate two different methods to obtain a dead (0)--full health (1) scale for EQ-5D-5L valuation studies when using discrete choice (DC) modeling.
  
  
  METHODS
  The study was carried out among 400 respondents from Barcelona who were representative of the Spanish population in terms of age, sex, and level of education. The DC design included 50 pairs of health states in five blocks. Participants were forced to choose between two EQ-5D-5L states (A and B). Two extra questions concerned whether A and B were considered worse than dead. Each participant performed ten choice exercises. In addition, values were collected using lead-time trade-off (lead-time TTO), for which 100 states in ten blocks were selected. Each participant performed five lead-time TTO exercises. These consisted of DC models offering the health state 'dead' as one of the choices--for which all participants' responses were used (DCdead)--and a model that included only the responses of participants who chose at least one state as worse than dead (WTD) (DCWTD). The study also estimated DC models rescaled with lead-time TTO data and a lead-time TTO linear model.
  
  
  RESULTS
  The DC(dead) and DCWTD models produced relatively similar results, although the coefficients in the DCdead model were slightly lower. The DC model rescaled with lead-time TTO data produced higher utility decrements. Lead-time TTO produced the highest utility decrements.
  
  
  CONCLUSIONS
  The incorporation of the state 'dead' in the DC models produces results in concordance with DC models that do not include 'dead'.
authors.affiliation: HTA Unit of Canary Islands Health Service, Servicio Canario de la Salud, C/Calvario, 271-B, 1 IQZ, 38350, Tacoronte, Santa Cruz de Tenerife, Canary Islands, Spain. juanmanuel.ramosgoni@gmail.com
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Ramos-Goñi
authors.forename: Oliver
authors.initials: O
authors.lastname: Rivero-Arias
authors.forename: María
authors.initials: M
authors.lastname: Errea
authors.forename: Elly A
authors.initials: EA
authors.lastname: Stolk
authors.forename: Michael
authors.initials: M
authors.lastname: Herdman
authors.forename: Juan Manuel
authors.initials: JM
authors.lastname: Cabasés
mesh_terms: D000328:Adult; D001293:Attitude to Death; D003643:Death; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D013030:Spain; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors; D026712:Value of Life
references.citation: Health Econ. 2007 Jun;16(6):645-7; discussion 649-51
references.pmid: 17535007
references.citation: J Health Econ. 2006 May;25(3):418-31
references.pmid: 16499981
references.citation: Qual Life Res. 2011 Dec;20(10):1727-36
references.pmid: 21479777
references.citation: Value Health. 2010 Dec;13(8):1005-13
references.pmid: 20825618
references.citation: Med Care. 2005 Mar;43(3):203-20
references.pmid: 15725977
references.citation: Health Econ. 2009 Nov;18(11):1261-76
references.pmid: 19142985
references.citation: Med Decis Making. 2001 Jan-Feb;21(1):7-16
references.pmid: 11206949
references.citation: Soc Sci Med. 2008 Sep;67(5):874-82
references.pmid: 18572295
references.citation: Popul Health Metr. 2008 Oct 22;6:6
references.pmid: 18945358
references.citation: Popul Health Metr. 2003 Dec 19;1(1):12
references.pmid: 14687419
references.citation: Health Econ. 1999 Mar;8(2):103-16
references.pmid: 10342724
references.citation: Health Econ. 2013 May;22(5):517-32
references.pmid: 22715069
references.citation: Health Econ. 2011 Jul;20(7):864-75
references.pmid: 20677328
references.citation: Health Econ. 2006 Oct;15(10):1121-32
references.pmid: 16786549
references.citation: Med Care. 1997 Nov;35(11):1095-108
references.pmid: 9366889
references.citation: Biometrics. 1989 Mar;45(1):255-68
references.pmid: 2720055