Seeing and doing: Feasibility study towards valuing visual impairment using simulation spectacles

Elicitation of utilities from those who do not have the health condition of interest generally uses verbal description of health states. This paper reports on the results of a small-scale investigation on the feasibility of an alternative approach, where health states are simulated and thus directly experienced by respondents. Three visual impairment health states were simulated using plastic spectacles, and were evaluated using the time trade-off. The first group of respondents (n = 19) found it difficult to assess visually impaired health states without referring to their own current health. With a further group of respondents (n = 14), we investigated the use of the respondents’ current health as the upper anchor of the time trade-off. Regression analysis shows that whilst there is a positive effect (p = 0.05) of the respondent’s own health state on the values from the first group, there is a non-significant negative effect (p = 0.36) on the values from the latter group with this revised method. Thus, it is feasible to simulate visual impairment in valuation exercises, but care must be taken to ensure what health state is effectively being valued

Seeing and doing: Feasibility study towards valuing visual impairment using simulation spectacles

Elicitation of utilities from those who do not have the health condition of interest generally uses verbal description of health states. This paper reports on the results of a small-scale investigation on the feasibility of an alternative approach, where health states are simulated and thus directly experienced by respondents. Three visual impairment health states were simulated using plastic spectacles, and were evaluated using the time trade-off. The first group of respondents (n = 19) found it difficult to assess visually impaired health states without referring to their own current health. With a further group of respondents (n = 14), we investigated the use of the respondents’ current health as the upper anchor of the time trade-off. Regression analysis shows that whilst there is a positive effect (p = 0.05) of the respondent’s own health state on the values from the first group, there is a non-significant negative effect (p = 0.36) on the values from the latter group with this revised method. Thus, it is feasible to simulate visual impairment in valuation exercises, but care must be taken to ensure what health state is effectively being valued

Modelling the consequences of a reduction in alcohol consumption among patients with alcohol dependence based on real-life observational data.

BACKGROUND: Most available pharmacotherapies for alcohol-dependent patients target abstinence; however, reduced alcohol consumption may be a more realistic goal. Using randomized clinical trial (RCT) data, a previous microsimulation model evaluated the clinical relevance of reduced consumption in terms of avoided alcohol-attributable events. Using real-life observational data, the current analysis aimed to adapt the model and confirm previous findings about the clinical relevance of reduced alcohol consumption. METHODS: Based on the prospective observational CONTROL study, evaluating daily alcohol consumption among alcohol-dependent patients, the model predicted the probability of drinking any alcohol during a given day. Predicted daily alcohol consumption was simulated in a hypothetical sample of 200,000 patients observed over a year. Individual total alcohol consumption (TAC) and number of heavy drinking days (HDD) were derived. Using published risk equations, probabilities of alcohol-attributable adverse health events (e.g., hospitalizations or death) corresponding to simulated consumptions were computed, and aggregated for categories of patients defined by HDDs and TAC (expressed per 100,000 patient-years). Sensitivity analyses tested model robustness. RESULTS: Shifting from >220 HDDs per year to 120-140 HDDs and shifting from 36,000-39,000 g TAC per year (120-130 g/day) to 15,000-18,000 g TAC per year (50-60 g/day) impacted substantially on the incidence of events (14,588 and 6148 events avoided per 100,000 patient-years, respectively). Results were robust to sensitivity analyses. CONCLUSIONS: This study corroborates the previous microsimulation modeling approach and, using real-life data, confirms RCT-based findings that reduced alcohol consumption is a relevant objective for consideration in alcohol dependence management to improve public health