Predicting utility for joint health states: a general framework and a new nonparametric estimator

Medical Decision Making : an International Journal of the Society for Medical Decision Making
Bo Hu, Alex Z Fu

Abstract

Measuring utility is important in clinical decision making and cost-effectiveness analysis because utilities are often used to compute quality-adjusted life expectancy, a metric used in measuring the effectiveness of health care programs and medical interventions. Predicting utility for joint health states has become an increasingly valuable research topic because of the aging of the population and the increasing prevalence of comorbidities. Although multiplicative, minimum, and additive estimators are commonly used in practice, research has shown that they are all biased. In this study, the authors propose a general framework for predicting utility for joint health states. This framework includes these 3 nonparametric estimators as special cases. A new simple nonparametric estimator, the adjusted decrement estimator, [U(ij) = U(min) - U(min) (1 - U(i) )(1 - U(j) )], is introduced under the proposed framework. When applied to 2 independent data sources, the new nonparametric estimator not only generated unbiased prediction of utilities for joint health states but also had the least root mean squared error and highest concordance when compared with other nonparametric and parametric estimators. Further research and validation of...Continue Reading

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Citations

Apr 12, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Benjamin P LinasKenneth A Freedberg
Nov 14, 2014·Health Expectations : an International Journal of Public Participation in Health Care and Health Policy·Katerina PapageorgiouMaya J Schroevers
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Sep 25, 2012·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Roberta Ara, Allan Wailoo
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Aug 29, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Roberta Ara, Allan J Wailoo
Oct 21, 2017·PharmacoEconomics·Roberta Ara, John Brazier
Jul 10, 2020·European Heart Journal. Cardiovascular Pharmacotherapy·Bin Wu, Lizheng Shi
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Feb 7, 2021·BMC Health Services Research·Matthew J GlasgowJane E Harding
Jul 22, 2021·Journal of Comparative Effectiveness Research·Xuanqian XieAndrei Volodin

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