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Marker states and a health state prompt provide modest improvements in the reliability and validity of the standard gamble and rating scale in prostate cancer patients

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Abstract

Purpose

To evaluate the combined effect of marker states and a prompt on the reliability and validity of direct utility assessment.

Methods

In a structured interview, 141 prostate cancer (PC) patients provided rating scale (RS) and standard gamble (SG) utilities for their “own health” (RS−/SG−). Following self-completion of comparison instruments (two generic utility and one disease-specific psychometric), they answered a checklist of PC-related items (a prompt to consider self-health) and provided utilities for self-health and mild and severe PC marker states (RS+/SG+). The interview was repeated 5 weeks later, but without comparison instruments. Using Bayesian modeling, we computed and compared correlation coefficients to assess RS and SG test–retest reliability and validity and the effects of the prompt and marker states.

Results

RS and SG had acceptable test–retest reliability (intraclass correlation coefficients = 0.57–0.63). The prompt and marker states decreased the reliability of the RS by 0.01 (from 0.58 to 0.57) but increased the reliability of the SG by 0.05 (from 0.58 to 0.63). The probability that the reliability of the SG+ was greater than that of the SG− was very high (0.96). Correlations with comparison instruments were higher by 0.01–0.06 for RS+ vs RS−, and higher by 0.03–0.06 for SG+ vs SG−. The probabilities that the prompt and marker states improved validity ranged from 0.55 to 0.74 (RS), and from 0.61 to 0.70 (SG).

Conclusions

A self-health description prompt and marker states modestly improved the reliability and validity of direct utility elicitation.

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Abbreviations

RS:

Rating scale

SG:

Standard gamble

RS−:

Rating scale administered without prompt and marker states

RS+:

Rating scale administered with prompt and marker states

SG−:

Standard gamble administered without prompt and marker states

SG+:

Standard gamble administered with prompt and marker states

HUI:

Health Utilities Index

HUI3:

Health Utilities Index, Mark 3

QWB:

Quality of Well-Being Scale

PORPUS-U:

Patient-oriented prostate utility scale—utility

PORPUS-P:

Patient-oriented prostate utility scale—profile

FACT-P:

Functional Assessment of Cancer Therapy—Prostate

T1:

First interview (time 1)

T2:

Second interview (time 2)

ICC:

Intraclass correlation coefficient

SD:

Standard deviation

CrI:

Credible interval

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Acknowledgements

The authors wish to acknowledge Dr. Gary Naglie, Dr. Jane Irvine and Dr. Paul Ritvo for their contributions to the development of the PORPUS-P and PORPUS-U. Financial support: This work was supported by grants from the National Cancer Institute of Canada, and the Canadian Institutes for Health Research. Dr. Krahn is supported by an Investigator Award from the Canadian Institutes for Health Research, and the F. Norman Hughes Chair in Pharmacoeconomics, Faculty of Pharmacy, University of Toronto.

Author information

Authors and Affiliations

  1. Toronto General Hospital, University Health Network, EN13-241, 200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4

    Karen E. Bremner

  2. Department of Medicine, University of Toronto, Toronto, Ontario, Canada

    George Tomlinson & Murray D. Krahn

  3. Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada

    George Tomlinson & Murray D. Krahn

  4. Toronto General Hospital, University Health Network, EN13-238, 200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4

    George Tomlinson

  5. Department of Biostatistics, University of Toronto, Toronto, Ontario, Canada

    George Tomlinson

  6. Toronto General Hospital, University Health Network, EN14-207, 200 Elizabeth Street, Toronto, Ontario, Canada, M5G 2C4

    Murray D. Krahn

  7. Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada

    Murray D. Krahn

Authors
  1. Karen E. Bremner
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  2. George Tomlinson
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  3. Murray D. Krahn
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Corresponding author

Correspondence to Karen E. Bremner.

Additional information

Preliminary results of this study were presented at the 25th Annual Meeting of the Society for Medical Decision Making, Chicago, Illinois, October 18–22, 2003.

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Bremner, K.E., Tomlinson, G. & Krahn, M.D. Marker states and a health state prompt provide modest improvements in the reliability and validity of the standard gamble and rating scale in prostate cancer patients. Qual Life Res 16, 1665–1675 (2007). https://doi.org/10.1007/s11136-007-9264-7

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  • DOI: https://doi.org/10.1007/s11136-007-9264-7

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