Estimating EQ-5D utilities based on the Short-Form Long Term Conditions Questionnaire (LTCQ-8)

Purpose: The aim of this work was to develop a mapping algorithm for estimating EuroQoL 5 Dimension (EQ-5D) utilities from responses to the Long-Term Conditions Questionnaire (LTCQ), thus increasing LTCQ’s potential as a comprehensive outcome measure for evaluating integrated care initiatives. Methods: We combined data from three studies to give a total sample of 1334 responses. In each of the three datasets, we randomly selected 75% of the sample and combined the selected random samples to generate the estimation dataset, which consisted of 1001 patients. The unselected 25% observations from each dataset were combined to generate an internal validation dataset of 333 patients. We used direct mapping models by regressing responses to the LTCQ-8 directly onto EQ-5D-5L and EQ-5D-3L utilities as well as response (or indirect) mapping to predict the response level that patients selected for each of the five EQ-5D-5L domains. Several models were proposed and compared on mean squared error and mean absolute error. Results: A two-part model with OLS was the best performing based on the mean squared error (0.038) and mean absolute error (0.147) when estimating the EQ-5D-5L utilities. A multinomial response mapping model using LTCQ-8 responses was used to predict EQ-5D-5L responses levels. Conclusions: This study provides a mapping algorithm for estimating EQ-5D utilities from LTCQ responses. The results from this study can help broaden the applicability of the LTCQ by producing utility values for use in economic analyses

Within-person adaptivity in frugal judgments from memory

Humans can exploit recognition memory as a simple cue for judgment. The utility of recognition depends on the interplay with the environment, particularly on its predictive power (validity) in a domain. It is, therefore, an important question whether people are sensitive to differences in recognition validity between domains. Strategic, intra-individual changes in the reliance on recognition have not been investigated so far. The present study fills this gap by scrutinizing within-person changes in using a frugal strategy, the recognition heuristic (RH), across two task domains that differed in recognition validity. The results showed adaptive changes in the reliance on recognition between domains. However, these changes were neither associated with the individual recognition validities nor with corresponding changes in these validities. These findings support a domain-adaptivity explanation, suggesting that people have broader intuitions about the usefulness of recognition across different domains that are nonetheless sufficiently robust for adaptive decision making. The analysis of metacognitive confidence reports mirrored and extended these results. Like RH use, confidence ratings covaried with task domain, but not with individual recognition validities. The changes in confidence suggest that people may have metacognitive access to information about global differences between task domains, but not to individual cue validities