Evidence map›Paper›PMID 22128393›Full record

ReviewBMJ (Clinical research ed.)2009

Comparison of direct and indirect methods of estimating health state utilities for resource allocation: review and empirical analysis.

David Arnold, Alan Girling, Andrew Stevens, Richard Lilford

Abstract readComparative StudyReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ (Clinical research ed.), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
83citing papers in PubMed, 19 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

83 citing papers in PubMed, 19 syntheses or guidelines pooled it.

  1. Quality-of-life measures in pharmacogenomic studies: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. The impact of acute pneumococcal disease on health state utility values: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022
    Pooled it
  10. Health state utility values by cancer stage: a systematic literature review.The European journal of health economics : HEPAC : health economics in prevention and care · 2021
    Pooled it
  11. Pooled it
  12. Pooled it
  13. A systematic review of utility values in children with cerebral palsy.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2019
    Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Health State Preference Weights for the Glasgow Outcome Scale Following Traumatic Brain Injury: A Systematic Review and Mapping Study.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2017
    Pooled it
  18. Pooled it
  19. Pooled it
  20. Trial

23 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

David ArnoldCardiff University Medical School,Cardiff.
Alan Girling
Andrew Stevens
Richard Lilford

Funding

Medical Research Council G0800808
6 · The paper itself

Abstract

BACKGROUND AND

objectiveUtilities (values representing preferences) for healthcare priority setting are typically obtained indirectly by asking patients to fill in a quality of life questionnaire and then converting the results to a utility using population values. We compared such utilities with those obtained directly from patients or the public.

designReview of studies providing both a direct and indirect utility estimate. SELECTION CRITERIA: Papers reporting comparisons of utilities obtained directly (standard gamble or time tradeoff) or indirectly (European quality of life 5D [EQ-5D], short form 6D [SF-6D], or health utilities index [HUI]) from the same patient. DATA SOURCES: PubMed and Tufts database of utilities. STATISTICAL

methodsSign test for paired comparisons between direct and indirect utilities; least squares regression to describe average relations between the different methods.

main outcome measuresMean utility scores (or median if means unavailable) for each method, and differences in mean (median) scores between direct and indirect methods.

resultsWe found 32 studies yielding 83 instances where direct and indirect methods could be compared for health states experienced by adults. The direct methods used were standard gamble in 57 cases and time trade off in 60(34 used both); the indirect methods were EQ-5D (67 cases), SF-6D (13), HUI-2 (5), and HUI-3 (37). Mean utility values were 0.81 (standard gamble) and 0.77 (time tradeoff) for the direct methods; for the indirect methods: 0.59(EQ-5D), 0.63 (SF-6D), 0.75 (HUI-2) and 0.68 (HUI-3). DISCUSSION: Direct methods of estimating utilities tend to result in higher health ratings than the more widely used indirect methods, and the difference can be substantial.Use of indirect methods could have important implications for decisions about resource allocation: for example, non-lifesaving treatments are relatively more favoured in comparison with lifesaving interventions than when using direct methods.

Indexed as

Cost-Benefit AnalysisHealth Status IndicatorsQuality of LifeResource AllocationAdultData CollectionData Interpretation, StatisticalHealth Care CostsHumansRisk

Identifiers

PMID22128393
PMCPMC2714630

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.