title: Valuing SF-6D Health States Using a Discrete Choice Experiment.
abstract: SF-6D utility weights are conventionally produced using a standard gamble (SG). SG-derived weights consistently demonstrate a floor effect not observed with other elicitation techniques. Recent advances in discrete choice methods have allowed estimation of utility weights. The objective was to produce Australian utility weights for the SF-6D and to explore the application of discrete choice experiment (DCE) methods in this context. We hypothesized that weights derived using this method would reflect the largely monotonic construction of the SF-6D.
  
  
  
  We designed an online DCE and administered it to an Australia-representative online panel (n = 1017). A range of specifications investigating nonlinear preferences with respect to additional life expectancy were estimated using a random-effects probit model. The preferred model was then used to estimate a preference index such that full health and death were valued at 1 and 0, respectively, to provide an algorithm for Australian cost-utility analyses.
  
  
  
  Physical functioning, pain, mental health, and vitality were the largest drivers of utility weights. Combining levels to remove illogical orderings did not lead to a poorer model fit. Relative to international SG-derived weights, the range of utility weights was larger with 5% of health states valued below zero.
  
  
  
  s. DCEs can be used to investigate preferences for health profiles and to estimate utility weights for multi-attribute utility instruments. Australian cost-utility analyses can now use domestic SF-6D weights. The comparability of DCE results to those using other elicitation methods for estimating utility weights for quality-adjusted life-year calculations should be further investigated.
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia (RN, RV, PC)
authors.forename: Richard
authors.initials: R
authors.lastname: Norman
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia (RN, RV, PC)
authors.forename: Rosalie
authors.initials: R
authors.lastname: Viney
authors.affiliation: School of Health and Related Research, University of Sheffield, UK (JB)
authors.forename: John
authors.initials: J
authors.lastname: Brazier
authors.affiliation: Department of Mathematical Sciences, University of Technology, Sydney, Australia (LB, DS)
authors.forename: Leonie
authors.initials: L
authors.lastname: Burgess
authors.affiliation: Centre for Health Economics Research and Evaluation, University of Technology, Sydney, Australia (RN, RV, PC)
authors.forename: Paula
authors.initials: P
authors.lastname: Cronin
authors.affiliation: Psycho-oncology Co-operative Research Group, University of Sydney, Australia (MK)
authors.forename: Madeleine
authors.initials: M
authors.lastname: King
authors.affiliation: Flinders Health Economics Group, Flinders Clinical Effectiveness, Flinders University, Adelaide, Australia (JR).
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
authors.affiliation: Department of Mathematical Sciences, University of Technology, Sydney, Australia (LB, DS)
authors.forename: Deborah
authors.initials: D
authors.lastname: Street
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001315:Australia; D002755:Choice Behavior; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005260:Female; D006304:Health Status; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Australia; SF-6D; cost-utility analysis; discrete choice experiment; economic evaluation; quality of life valuation