Measuring the value of program outcomes: a review of multiattribute utility measures.

Selection of a multiattribute utility instrument for economic evaluation is complex due to competition between developers and inflated claims for instrument properties. This review presents multiattribute utility theoretical requirements and assesses leading multiattribute utility instruments against these. Instruments reviewed are: the QWB, HUI3, 15D, EQ5D, AQoL and SF6D. The key finding is that no current instrument satisfies all the requirements for multiattribute utility measurement. We recommend that users should choose instruments most relevant to their circumstances and that studies should include two instruments. Rigorous sensitivity analyses should be conducted and both results reported. Subject to these caveats, preference should be given to instruments best meeting multiattribute utility theoretical requirements, viz., the AQoL or HUI3. However, we recognise that other instruments may perform as well, or even better, under certain circumstances.