Tsuchiya Aki, Dolan Paul
Centre for Well-being in Public Policy, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Med Decis Making. 2005 Jul-Aug;25(4):460-7. doi: 10.1177/0272989X05276854.
The numbers of quality-adjusted life years (QALYs) gained are increasingly being used to represent the gains in individual utility from treatment. This requires that the value of a health improvement to an individual is a simple product of gains in quality of life and length of life. The article reports on a systematic review of the literature on 2 issues: whether the value of a state is affected by how long the state lasts, and by states that come before or after it. It was found that individual preferences over health are influenced by the duration of health states and their sequence. However, although there is much variation across individual respondents, the assumptions tend to hold much better when valuations are aggregated across respondents, which is encouraging for economic evaluations that rely on using average (mean or median) values.
获得的质量调整生命年（QALY）数量越来越多地被用于表示治疗给个体带来的效用增益。这要求健康改善对个体的价值是生活质量增益和生命长度的简单乘积。本文报道了对关于两个问题的文献的系统综述：一种状态的价值是否受该状态持续时间的影响，以及受其之前或之后状态的影响。研究发现，个体对健康的偏好受健康状态的持续时间及其顺序的影响。然而，尽管个体受访者之间存在很大差异，但当对受访者的估值进行汇总时，这些假设往往更能成立，这对于依赖使用平均（均值或中位数）值的经济评估来说是令人鼓舞的。
