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Journal of Public Health Medicine 25:8-12 (2003)
© 2003 Faculty of Public Health Medicine of the Royal Colleges of Physicians of the United Kingdom

For Debate

Putting the quality into quality-adjusted life years


Adam Oliver

LSE Health and Social Care, London School of Economics and Political Science, Houghton Street, London WC2A 2AE. a.j.oliver{at}lse.ac.uk

Over recent decades, a great deal of effort has been devoted towards developing instruments that can be used to elicit health state values. All of these instruments are conceptually very different from one another and all suffer from serious inherent biases. In this paper I outline the conceptual foundations and empirical limitations of the three principal health state value elicitation instruments. Given that the conceptual parameters internalized within an instrument influence the elicited health state values, I argue that it is necessary to attain a broad agreement on what the appropriate parameters ought to be. When the appropriate conceptual parameters have been identified we will be in a position to develop the methodology of a single standardized instrument.

Keywords: QALYs, rating scale, time trade-off, standard gamble


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[Abstract] [PDF]


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