Original Article
Improving Decision Analyses: Parent Preferences (Utility Values) for Pediatric Health Outcomes

https://doi.org/10.1016/j.jpeds.2009.01.040Get rights and content

Objective

To gather and calculate utilities for a wide range of health states in the pediatric population.

Study design

The study subjects, parents or guardians at least 18 years of age with at least 1 child under age 18 years, were recruited through our Pediatric Research Network (PResNet). Recruitment locations included pediatric clinics, the Indiana State Fair, and public and private conventions. Each subject's utilities were assessed on 3 random health states out of 29 chosen for the study. Both the time trade-off and standard gamble methods were used to measure utilities.

Results

Utilities were assessed in a total of 4016 participants (a recruitment rate of 88%). Utility values ranged from a high for acute otitis media (0.96 by standard gamble; 0.97 by time trade-off) to a low for severe mental retardation (0.59 by standard gamble; 0.51 by time trade-off).

Conclusions

Our extensive data set of utility assessments for a wide range of disease states can aid future economic evaluations of pediatric health care.

Section snippets

Utility Assessment Methods

The 2 most widely accepted methods for assessing utility states are the standard gamble and time trade-off methods. In both of these methods, participants are presented with descriptions of health states and then asked what they would be willing to sacrifice or risk to achieve a better health state.1, 13 The standard gamble, considered the “gold standard” method for measuring preferences, is based on the fundamental axioms of expected utility theory as first formalized by Von Neumann and

Results

Over the 2- year study period, 4561 potential participants were approached; of these, 4016 agreed to participate, for a recruitment rate of 88%. Demographic data on the participants are given in Table II. Most of the study participants were mothers (85%) and fathers (13%), with a few other relations rounding out the group. The children referred to in the scenarios were split approximately evenly between boys and girls. There was reasonable diversity in the group in terms of race and ethnicity,

Discussion

This study has provided utility values for 29 disease states likely to be of value in future economic analyses involving child health. Utility values were assessed using 2 widely accepted methodologies, and utility values are presented along with SEMs, SDs, and confidence intervals that are necessary for sensitivity analyses. These data explicitly meet the call for an “off-the shelf reference catalog of utility values” put forth by the US Public Health Service Panel on Cost-Effectiveness in

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    The views expressed in this article are those of the authors and do not necessarily represent those of Indiana University. The authors declare no conflicts of interest related to this work.

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