Visual Analogue Scales: do they have a role in the measurement of preferences for health states?

Abstract

Health state preference data are increasingly used to inform national health care resource allocation decisions. In such circumstances it is important to be confident that the data we provide to decision makers is fit for purpose. Whilst there are many unresolved issues in health state preference measurement, there are some areas of agreement on procedures that are inappropriate. The past ten years have seen the publication of a number of papers reporting substantive problems with the use of visual analogue scales to value health states. In this journal Torrance and colleagues reviewed this literature and concluded that Visual Analogue Scales have a limited but useful role in health state preference measurement. In this paper we critically review the arguments advanced by Torrance and colleagues and argue that it is increasingly clear that Visual Analogue Scales are not an appropriate method and that the time has come to accept that VAS should not be used for health state preference measurement