Gerard K, Dobson M, Hall J
Centre for Health Economics Research and Evaluation (CHERE), Westmead Hospital, NSW, Australia.
J Clin Epidemiol. 1993 Jan;46(1):77-84. doi: 10.1016/0895-4356(93)90011-o.
At present there is a growing interest in the use of cost-utility analysis (CUA) to a point where it merits serious consideration by health care decision makers. However, there remain a number of theoretical and practical issues to be resolved including the way in which quality of life information is presented and described to subjects. Two potential sources of influence in the construction of the quality adjusted life year (QALY) values elicited for a recent Australian CUA of mammography screening have been investigated. 180 subjects were randomly allocated to nine different presentations of two breast cancer health descriptions to investigate the impact of some framing and labelling effects. No statistically significant differences were found in the valuations placed on these descriptions when framing and labelling effects were taken into account, either as separate framing and labelling factors or as interactions with one another. A significant difference was found in the particular values of descriptions that were written in the third person that differed in terms of whether the word "cancer" was used. The main contribution of these data is to the robustness of the health descriptions used in the cost-utility analysis of mammography screening.
目前，人们对成本效用分析（CUA）的应用兴趣日益浓厚，已到了值得医疗保健决策者认真考虑的程度。然而，仍有一些理论和实际问题有待解决，包括向受试者呈现和描述生活质量信息的方式。针对最近澳大利亚乳腺钼靶筛查成本效用分析中得出的质量调整生命年（QALY）值构建过程中的两个潜在影响源进行了调查。180名受试者被随机分配到两种乳腺癌健康描述的九种不同呈现方式中，以研究某些框架和标签效应的影响。当将框架和标签效应作为单独的框架和标签因素或相互作用因素考虑时，对这些描述的估值未发现统计学上的显著差异。在用第三人称撰写的描述中，是否使用“癌症”一词会导致特定值存在显著差异。这些数据的主要贡献在于乳腺钼靶筛查成本效用分析中所使用健康描述的稳健性。
