Skip to Content
Interactive Textbook on Clinical Symptom Research Logo


Home Button

Assessing Desirability of Outcome States
Author Biographies
Introduction
Common Health Status Measures
Preference-Based Measures
Currently selected section: Direct Utility Elicitation
Issues with Utiliy Assessment
How are Utilities Used?
Utility and Health Status
Utility and Sociodemographic Factors
Computerized Utility Assessment
Catalogs of Utilities
Case Studies
Conclusions


Chapter 24: Assessing Desirability of Outcome States: Direct Utility Elicitation
        

Direct Preference Elicitation/Direct Utility Assessment

Direct preference measurement methods include:

  • Standard Gamble (SG)
  • Time Trade-Off (TTO)
  • Willingness-To-Pay (WTP) (also known as "contingent valuation"), and
  • Person Trade-Off (PTO)

SG flows directly from VNM theory. Values obtained using the TTO often approximate those obtained with the SG. WTP and PTO have different theoretical foundations and are not VNM utility methods.

In the SG, the respondent considers what probability of (usually) painless and immediate death she would risk in order to be restored to perfect health, or better health than the health state under consideration. Techniques for TTO and SG are described by Torrance (Torrance, 1986).

The TTO measures one's willingness to live a shorter but healthier life. The respondent considers how much of remaining life expectancy he or she would be willing to trade off in order to live in perfect health.

In WTP (willingness-to-pay), the respondent considers how much she would be willing to pay, either as a lump sum or as continuing payments analogous to insurance payments, to avoid an undesirable health state. (Kenkel, Berger et al., 1994; O'Brien and Gafni, 1996; Diener, O'Brien et al., 1998).

The PTO method seeks to equate a certain number of persons with a given health state with an equivalent number of persons with normal health or a different health state. It asks people to say how many outcomes of one kind they consider equivalent in social value to x outcomes of another kind (Nord, 1995).

It is worth noting that the rating scale (RS) is sometime listed as a method for collecting data on utilities; however, rating scales lack validity for utility assessment.

Standard Gamble

SG is the name by which the method described by von Neumann and Morgenstern is now known in health applications.

Page 5 of 14
Previous Section