Loading…
Utility Assessment in Cancer Patients: Adjustment of Time Tradeoff Scores for the Utility of Life Years and Comparison with Standard Gamble Scores
The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated...
Saved in:
Published in: | Medical decision making 1994, Vol.14 (1), p.82-90 |
---|---|
Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | |
---|---|
cites | cdi_FETCH-LOGICAL-c233t-ceb4df5ba9effe5e11bfdda9358b423c3e67231bedb931efb1b7b58530713a603 |
container_end_page | 90 |
container_issue | 1 |
container_start_page | 82 |
container_title | Medical decision making |
container_volume | 14 |
creator | Stiggelbout, A.M. Kiebert, G.M. Kievit, J. Leer, J.W.H. Stoter, G. De Haes, J.C.J.M. |
description | The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated this difference. In addition, the association between risk attitude and sociodemographic and medical variables was studied. In 30 disease-free testicular cancer patients, SG and TTO were used to assess the utilities of four health profiles relevant to testicular cancer. Utility of life years was estimated from certainty equivalents (CEs). SG scores were significantly higher than unadjusted TTO scores for all profiles. As the majority of patients (85%) were risk-averse, CE-adjusted TTO scores were higher than unadjusted scores, and were not significantly different from those obtained from the SG for three of the four profiles. However, adjusted scores were still slightly but consistently lower than SG scores. Possible explanations for this discrepancy are discussed. An association was found between risk aversion and medical treatment: patients who had received chemotherapy for their cancers were more risk-averse than were patients who had been in a surveillance protocol only. As risk aversion can have an impact on treatment decisions, it is important to assess the risk posture of the patient to whom the decision pertains. Key words: utility assessment; QALY; risk aversion; oncology; treatment preferences. (Med Decis Making 1994;14:82-90) |
doi_str_mv | 10.1177/0272989X9401400110 |
format | article |
fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_76436878</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0272989X9401400110</sage_id><sourcerecordid>76436878</sourcerecordid><originalsourceid>FETCH-LOGICAL-c233t-ceb4df5ba9effe5e11bfdda9358b423c3e67231bedb931efb1b7b58530713a603</originalsourceid><addsrcrecordid>eNp9kEtLAzEUhYMotVb_gCDMRndjc_OYZJal-IKCLix0F5KZG5kyj5rMLPrvndLiRnB14ZzvHLiHkFugjwBKzSlTLNf5JhcUBKUA9IxMQUqWZho252R6ANIDcUmuYtyOiMi1mJCJBsl4Rqfkft1XddXvk0WMGGODbZ9UbbK0bYEh-bB9NSrxmlx4W0e8Od0ZWT8_fS5f09X7y9tysUoLxnmfFuhE6aWzOXqPEgGcL0ubc6mdYLzgmCnGwWHpcg7oHTjlpJacKuA2o3xGHo69u9B9Dxh701SxwLq2LXZDNCoTPNNKjyA7gkXoYgzozS5UjQ17A9QctjF_txlDd6f2wTVY_kZOY4z-_OhH-4Vm2w2hHZ_9r_EH4Pxr_Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>76436878</pqid></control><display><type>article</type><title>Utility Assessment in Cancer Patients: Adjustment of Time Tradeoff Scores for the Utility of Life Years and Comparison with Standard Gamble Scores</title><source>SAGE Complete Deep Backfile Purchase 2012</source><creator>Stiggelbout, A.M. ; Kiebert, G.M. ; Kievit, J. ; Leer, J.W.H. ; Stoter, G. ; De Haes, J.C.J.M.</creator><creatorcontrib>Stiggelbout, A.M. ; Kiebert, G.M. ; Kievit, J. ; Leer, J.W.H. ; Stoter, G. ; De Haes, J.C.J.M.</creatorcontrib><description>The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated this difference. In addition, the association between risk attitude and sociodemographic and medical variables was studied. In 30 disease-free testicular cancer patients, SG and TTO were used to assess the utilities of four health profiles relevant to testicular cancer. Utility of life years was estimated from certainty equivalents (CEs). SG scores were significantly higher than unadjusted TTO scores for all profiles. As the majority of patients (85%) were risk-averse, CE-adjusted TTO scores were higher than unadjusted scores, and were not significantly different from those obtained from the SG for three of the four profiles. However, adjusted scores were still slightly but consistently lower than SG scores. Possible explanations for this discrepancy are discussed. An association was found between risk aversion and medical treatment: patients who had received chemotherapy for their cancers were more risk-averse than were patients who had been in a surveillance protocol only. As risk aversion can have an impact on treatment decisions, it is important to assess the risk posture of the patient to whom the decision pertains. Key words: utility assessment; QALY; risk aversion; oncology; treatment preferences. (Med Decis Making 1994;14:82-90)</description><identifier>ISSN: 0272-989X</identifier><identifier>EISSN: 1552-681X</identifier><identifier>DOI: 10.1177/0272989X9401400110</identifier><identifier>PMID: 8152360</identifier><language>eng</language><publisher>Thousand Oaks, CA: Sage Publications</publisher><subject>Adult ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Decision Support Techniques ; Humans ; Male ; Middle Aged ; Neoplasms - mortality ; Neoplasms - therapy ; Neoplasms, Germ Cell and Embryonal - mortality ; Neoplasms, Germ Cell and Embryonal - therapy ; Orchiectomy ; Prognosis ; Quality of Life ; Risk ; Survival Analysis ; Testicular Neoplasms - mortality ; Testicular Neoplasms - therapy</subject><ispartof>Medical decision making, 1994, Vol.14 (1), p.82-90</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c233t-ceb4df5ba9effe5e11bfdda9358b423c3e67231bedb931efb1b7b58530713a603</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0272989X9401400110$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0272989X9401400110$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>315,786,790,4043,21873,27956,27957,27958,45117,45505</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8152360$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stiggelbout, A.M.</creatorcontrib><creatorcontrib>Kiebert, G.M.</creatorcontrib><creatorcontrib>Kievit, J.</creatorcontrib><creatorcontrib>Leer, J.W.H.</creatorcontrib><creatorcontrib>Stoter, G.</creatorcontrib><creatorcontrib>De Haes, J.C.J.M.</creatorcontrib><title>Utility Assessment in Cancer Patients: Adjustment of Time Tradeoff Scores for the Utility of Life Years and Comparison with Standard Gamble Scores</title><title>Medical decision making</title><addtitle>Med Decis Making</addtitle><description>The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated this difference. In addition, the association between risk attitude and sociodemographic and medical variables was studied. In 30 disease-free testicular cancer patients, SG and TTO were used to assess the utilities of four health profiles relevant to testicular cancer. Utility of life years was estimated from certainty equivalents (CEs). SG scores were significantly higher than unadjusted TTO scores for all profiles. As the majority of patients (85%) were risk-averse, CE-adjusted TTO scores were higher than unadjusted scores, and were not significantly different from those obtained from the SG for three of the four profiles. However, adjusted scores were still slightly but consistently lower than SG scores. Possible explanations for this discrepancy are discussed. An association was found between risk aversion and medical treatment: patients who had received chemotherapy for their cancers were more risk-averse than were patients who had been in a surveillance protocol only. As risk aversion can have an impact on treatment decisions, it is important to assess the risk posture of the patient to whom the decision pertains. Key words: utility assessment; QALY; risk aversion; oncology; treatment preferences. (Med Decis Making 1994;14:82-90)</description><subject>Adult</subject><subject>Chemotherapy, Adjuvant</subject><subject>Combined Modality Therapy</subject><subject>Decision Support Techniques</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms - mortality</subject><subject>Neoplasms - therapy</subject><subject>Neoplasms, Germ Cell and Embryonal - mortality</subject><subject>Neoplasms, Germ Cell and Embryonal - therapy</subject><subject>Orchiectomy</subject><subject>Prognosis</subject><subject>Quality of Life</subject><subject>Risk</subject><subject>Survival Analysis</subject><subject>Testicular Neoplasms - mortality</subject><subject>Testicular Neoplasms - therapy</subject><issn>0272-989X</issn><issn>1552-681X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><recordid>eNp9kEtLAzEUhYMotVb_gCDMRndjc_OYZJal-IKCLix0F5KZG5kyj5rMLPrvndLiRnB14ZzvHLiHkFugjwBKzSlTLNf5JhcUBKUA9IxMQUqWZho252R6ANIDcUmuYtyOiMi1mJCJBsl4Rqfkft1XddXvk0WMGGODbZ9UbbK0bYEh-bB9NSrxmlx4W0e8Od0ZWT8_fS5f09X7y9tysUoLxnmfFuhE6aWzOXqPEgGcL0ubc6mdYLzgmCnGwWHpcg7oHTjlpJacKuA2o3xGHo69u9B9Dxh701SxwLq2LXZDNCoTPNNKjyA7gkXoYgzozS5UjQ17A9QctjF_txlDd6f2wTVY_kZOY4z-_OhH-4Vm2w2hHZ_9r_EH4Pxr_Q</recordid><startdate>1994</startdate><enddate>1994</enddate><creator>Stiggelbout, A.M.</creator><creator>Kiebert, G.M.</creator><creator>Kievit, J.</creator><creator>Leer, J.W.H.</creator><creator>Stoter, G.</creator><creator>De Haes, J.C.J.M.</creator><general>Sage Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1994</creationdate><title>Utility Assessment in Cancer Patients</title><author>Stiggelbout, A.M. ; Kiebert, G.M. ; Kievit, J. ; Leer, J.W.H. ; Stoter, G. ; De Haes, J.C.J.M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c233t-ceb4df5ba9effe5e11bfdda9358b423c3e67231bedb931efb1b7b58530713a603</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Adult</topic><topic>Chemotherapy, Adjuvant</topic><topic>Combined Modality Therapy</topic><topic>Decision Support Techniques</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms - mortality</topic><topic>Neoplasms - therapy</topic><topic>Neoplasms, Germ Cell and Embryonal - mortality</topic><topic>Neoplasms, Germ Cell and Embryonal - therapy</topic><topic>Orchiectomy</topic><topic>Prognosis</topic><topic>Quality of Life</topic><topic>Risk</topic><topic>Survival Analysis</topic><topic>Testicular Neoplasms - mortality</topic><topic>Testicular Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stiggelbout, A.M.</creatorcontrib><creatorcontrib>Kiebert, G.M.</creatorcontrib><creatorcontrib>Kievit, J.</creatorcontrib><creatorcontrib>Leer, J.W.H.</creatorcontrib><creatorcontrib>Stoter, G.</creatorcontrib><creatorcontrib>De Haes, J.C.J.M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Medical decision making</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stiggelbout, A.M.</au><au>Kiebert, G.M.</au><au>Kievit, J.</au><au>Leer, J.W.H.</au><au>Stoter, G.</au><au>De Haes, J.C.J.M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility Assessment in Cancer Patients: Adjustment of Time Tradeoff Scores for the Utility of Life Years and Comparison with Standard Gamble Scores</atitle><jtitle>Medical decision making</jtitle><addtitle>Med Decis Making</addtitle><date>1994</date><risdate>1994</risdate><volume>14</volume><issue>1</issue><spage>82</spage><epage>90</epage><pages>82-90</pages><issn>0272-989X</issn><eissn>1552-681X</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>The standard gamble (SG) and the time tradeoff (TTO), two frequently used methods of utility assessment, have often been found to lead to different utilities for the same health state. The authors investigated whether adjustment of TTO scores for the utility of life years (risk attitude) eliminated this difference. In addition, the association between risk attitude and sociodemographic and medical variables was studied. In 30 disease-free testicular cancer patients, SG and TTO were used to assess the utilities of four health profiles relevant to testicular cancer. Utility of life years was estimated from certainty equivalents (CEs). SG scores were significantly higher than unadjusted TTO scores for all profiles. As the majority of patients (85%) were risk-averse, CE-adjusted TTO scores were higher than unadjusted scores, and were not significantly different from those obtained from the SG for three of the four profiles. However, adjusted scores were still slightly but consistently lower than SG scores. Possible explanations for this discrepancy are discussed. An association was found between risk aversion and medical treatment: patients who had received chemotherapy for their cancers were more risk-averse than were patients who had been in a surveillance protocol only. As risk aversion can have an impact on treatment decisions, it is important to assess the risk posture of the patient to whom the decision pertains. Key words: utility assessment; QALY; risk aversion; oncology; treatment preferences. (Med Decis Making 1994;14:82-90)</abstract><cop>Thousand Oaks, CA</cop><pub>Sage Publications</pub><pmid>8152360</pmid><doi>10.1177/0272989X9401400110</doi><tpages>9</tpages></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0272-989X |
ispartof | Medical decision making, 1994, Vol.14 (1), p.82-90 |
issn | 0272-989X 1552-681X |
language | eng |
recordid | cdi_proquest_miscellaneous_76436878 |
source | SAGE Complete Deep Backfile Purchase 2012 |
subjects | Adult Chemotherapy, Adjuvant Combined Modality Therapy Decision Support Techniques Humans Male Middle Aged Neoplasms - mortality Neoplasms - therapy Neoplasms, Germ Cell and Embryonal - mortality Neoplasms, Germ Cell and Embryonal - therapy Orchiectomy Prognosis Quality of Life Risk Survival Analysis Testicular Neoplasms - mortality Testicular Neoplasms - therapy |
title | Utility Assessment in Cancer Patients: Adjustment of Time Tradeoff Scores for the Utility of Life Years and Comparison with Standard Gamble Scores |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-21T17%3A14%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Utility%20Assessment%20in%20Cancer%20Patients:%20Adjustment%20of%20Time%20Tradeoff%20Scores%20for%20the%20Utility%20of%20Life%20Years%20and%20Comparison%20with%20Standard%20Gamble%20Scores&rft.jtitle=Medical%20decision%20making&rft.au=Stiggelbout,%20A.M.&rft.date=1994&rft.volume=14&rft.issue=1&rft.spage=82&rft.epage=90&rft.pages=82-90&rft.issn=0272-989X&rft.eissn=1552-681X&rft_id=info:doi/10.1177/0272989X9401400110&rft_dat=%3Cproquest_cross%3E76436878%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c233t-ceb4df5ba9effe5e11bfdda9358b423c3e67231bedb931efb1b7b58530713a603%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=76436878&rft_id=info:pmid/8152360&rft_sage_id=10.1177_0272989X9401400110&rfr_iscdi=true |