Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation

Marten, O; Mulhern, B; Bansback, N; Tsuchiya, A

Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation

Marten, O Mulhern, B

Bansback, N Tsuchiya, A

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Medical Decision Making, 2020, 40, (6), pp. 735-745
Issue Date:: 2020

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Field	Value	Language
dc.contributor.author	Marten, O
dc.contributor.author	Mulhern, B https://orcid.org/0000-0003-3656-8063
dc.contributor.author	Bansback, N
dc.contributor.author	Tsuchiya, A
dc.date.accessioned	2020-10-03T08:27:01Z
dc.date.available	2020-10-03T08:27:01Z
dc.date.issued	2020
dc.identifier.citation	Medical Decision Making, 2020, 40, (6), pp. 735-745
dc.identifier.issn	0272-989X
dc.identifier.issn	1552-681X
dc.identifier.uri	http://hdl.handle.net/10453/143048
dc.description.abstract	The EQ-5D is made up of health state dimensions and levels, in which some combinations seem less “plausible” than others. If “implausible” states are used in health state valuation exercises, then respondents may have difficulty imagining them, causing measurement error. There is currently no standard solution: some valuation studies exclude such states, whereas others leave them in. This study aims to address 2 gaps in the literature: 1) to propose an evidence-based set of the least prevalent two-way combinations of EQ-5D-5L dimension levels and 2) to quantify the impact of removing perceived implausible states from valuation designs. For the first aim, we use data from 2 waves of the English General Practitioner Patient Survey (n = 1,639,453). For the second aim, we remodel a secondary data set of a Discrete Choice Experiment (DCE) with duration that valued EQ-5D-5L and compare across models that drop observations involving different health states: 1) implausible states as defined in the literature, 2) the least prevalent states identified in stage 1, and 3) randomly select states, alongside 4) a model that does not drop any observations. The results indicate that two-way combinations previously thought to be implausible actually exist among the general population; there are other combinations that are rarer, and removing implausible states from an experimental design of a DCE with duration leads to value sets with potentially different characteristics depending on the criterion of implausible states. We advise against the routine removal of implausible states from health state valuation studies.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	SAGE Publications
dc.relation	EuroQol Research Foundation
dc.relation.ispartof	Medical Decision Making
dc.relation.isbasedon	10.1177/0272989X20940673
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.classification	Health Policy & Services
dc.title	Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation
dc.type	Journal Article
utslib.citation.volume	40
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney/Faculty of Business
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney
utslib.copyright.status	closed_access	*
pubs.consider-herdc	false
dc.date.updated	2020-10-03T08:26:34Z
pubs.issue	6
pubs.publication-status	Published
pubs.volume	40
utslib.start-page	735
utslib.citation.issue	6

Abstract:

The EQ-5D is made up of health state dimensions and levels, in which some combinations seem less “plausible” than others. If “implausible” states are used in health state valuation exercises, then respondents may have difficulty imagining them, causing measurement error. There is currently no standard solution: some valuation studies exclude such states, whereas others leave them in. This study aims to address 2 gaps in the literature: 1) to propose an evidence-based set of the least prevalent two-way combinations of EQ-5D-5L dimension levels and 2) to quantify the impact of removing perceived implausible states from valuation designs. For the first aim, we use data from 2 waves of the English General Practitioner Patient Survey (n = 1,639,453). For the second aim, we remodel a secondary data set of a Discrete Choice Experiment (DCE) with duration that valued EQ-5D-5L and compare across models that drop observations involving different health states: 1) implausible states as defined in the literature, 2) the least prevalent states identified in stage 1, and 3) randomly select states, alongside 4) a model that does not drop any observations. The results indicate that two-way combinations previously thought to be implausible actually exist among the general population; there are other combinations that are rarer, and removing implausible states from an experimental design of a DCE with duration leads to value sets with potentially different characteristics depending on the criterion of implausible states. We advise against the routine removal of implausible states from health state valuation studies.

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http://hdl.handle.net/10453/143048