title: Valuing the Child Health Utility 9D: Using profile case best worst scaling methods to develop a new adolescent specific scoring algorithm.
abstract: In contrast to the recent proliferation of studies incorporating ordinal methods to generate health state values from adults, to date relatively few studies have utilised ordinal methods to generate health state values from adolescents. This paper reports upon a study to apply profile case best worst scaling methods to derive a new adolescent specific scoring algorithm for the Child Health Utility 9D (CHU9D), a generic preference based instrument that has been specifically designed for the estimation of quality adjusted life years for the economic evaluation of health care treatment and preventive programs targeted at young people. A survey was developed for administration in an on-line format in which consenting community based Australian adolescents aged 11-17 years (N = 1982) indicated the best and worst features of a series of 10 health states derived from the CHU9D descriptive system. The data were analyzed using latent class conditional logit models to estimate values (part worth utilities) for each level of the nine attributes relating to the CHU9D. A marginal utility matrix was then estimated to generate an adolescent-specific scoring algorithm on the full health = 1 and dead = 0 scale required for the calculation of QALYs. It was evident that different decision processes were being used in the best and worst choices. Whilst respondents appeared readily able to choose 'best' attribute levels for the CHU9D health states, a large amount of random variability and indeed different decision rules were evident for the choice of 'worst' attribute levels, to the extent that the best and worst data should not be pooled from the statistical perspective. The optimal adolescent-specific scoring algorithm was therefore derived using data obtained from the best choices only. The study provides important insights into the use of profile case best worst scaling methods to generate health state values with adolescent populations.
authors.affiliation: Flinders Health Economics Group, Flinders University, South Australia, Australia. Electronic address: julie.ratcliffe@flinders.edu.au.
authors.forename: Julie
authors.initials: J
authors.lastname: Ratcliffe
authors.affiliation: Institute for Choice, University of South Australia, South Australia, Australia.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Huynh
authors.affiliation: Flinders Health Economics Group, Flinders University, South Australia, Australia.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Health Economics and Decision Science, ScHARR, University of Sheffield, United Kingdom.
authors.forename: Katherine
authors.initials: K
authors.lastname: Stevens
authors.affiliation: Institute for Choice, University of South Australia, South Australia, Australia.
authors.forename: Joffre
authors.initials: J
authors.lastname: Swait
authors.affiliation: Health Economics and Decision Science, ScHARR, University of Sheffield, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Brazier
authors.affiliation: Discipline of Paediatrics, University of Adelaide, South Australia, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Sawyer
authors.affiliation: Department of Psychology, University of Adelaide, Australia.
authors.forename: Rachel
authors.initials: R
authors.lastname: Roberts
authors.affiliation: TF Choices LTD and University of Western Sydney, Sydney, Australia.
authors.forename: Terry
authors.initials: T
authors.lastname: Flynn
mesh_terms: D000293:Adolescent; D000465:Algorithms; D001315:Australia; D002648:Child; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D057566:Self Report; D011795:Surveys and Questionnaires
keywords: Adolescents; Australia; Best worst scaling; Economic evaluation; Health; Quality adjusted life years; Valuation