Mehrez A, Gafni A
Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva, Israel.
Med Decis Making. 1993 Oct-Dec;13(4):287-92. doi: 10.1177/0272989X9301300404.
The authors respond to the contention that healthy-years equivalents (HYEs) do not fulfil claims they previously made. They refute the argument for the equivalence of the two-stage lottery and the time tradeoff and show that it fails to recognize the difference between choice problems under uncertainty versus certainty. They also dismiss the claim that HYEs assume risk neutrality with respect to healthy years of life, and show that HYEs are superior to the "general" (risk-averse) form of QALYs because HYEs employ fewer assumptions; in particular, they do not assume a specific form of the individual's utility function. The examples they used earlier are demonstrated to be conclusive, and the authors respond to arguments about the practical aspects of using HYEs vs QALYs. Finally, they take issue with the assumption that the roots of the QALY model are all attributable to utility theory.
作者们回应了关于健康年当量（HYEs）未能实现其先前主张的论点。他们驳斥了两阶段彩票与时间权衡等价的观点，并表明该观点未能认识到不确定性与确定性下选择问题之间的差异。他们还驳回了关于HYEs在健康寿命年方面假定风险中性的说法，并表明HYEs优于QALYs的“一般”（风险厌恶）形式，因为HYEs采用的假设更少；特别是，它们不假定个体效用函数的特定形式。他们早期使用的例子被证明是有说服力的，作者们回应了关于使用HYEs与QALYs的实际方面的论点。最后，他们对QALY模型的根源都可归因于效用理论这一假设提出了质疑。
