Exploring the importance of controlling heteroskedasticity and heterogeneity in health valuation: a case study on Dutch EQ-5D-5L

Suzana Karim*, Benjamin M. Craig, Catharina G.M. Groothuis-Oudshoorn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
57 Downloads (Pure)

Abstract

Background: Respondents in a health valuation study may have different sources of error (i.e., heteroskedasticity), tastes (differences in the relative effects of each attribute level), and scales (differences in the absolute effects of all attributes). Although prior studies have compared values by preference-elicitation tasks (e.g., paired comparison [PC] and best–worst scaling case 2 [BWS]), no study has yet controlled for heteroskedasticity and heterogeneity (taste and scale) simultaneously in health valuation.

Methods: Preferences on EQ-5D-5L profiles were elicited from a random sample of 380 adults from the general population of the Netherlands, using 24 PC and 25 BWS case 2 tasks. To control for heteroskedasticity and heterogeneity (taste and scale) simultaneously, we estimated Dutch EQ-5D-5L values using conditional, heteroskedastic, and scale-adjusted latent class (SALC) logit models by maximum likelihood.

Results: After controlling for heteroskedasticity, the PC and BWS values were highly correlated (Pearson's correlation: 0.9167, CI: 0.9109–0.9222) and largely agreed (Lin's concordance: 0.7658, CI: 0.7542–0.7769) on a pits scale. In terms of preference heterogeneity, some respondents (mostly young men) failed to account for any of the EQ-5D-5L attributes (i.e., garbage class), and others had a lower scale (59%; p-value: 0.123). Overall, the SALC model produced a consistent Dutch EQ-5D-5L value set on a pits scale, like the original study (Pearson's correlation:0.7295; Lin's concordance: 0.6904).

Conclusions: This paper shows the merits of simultaneously controlling for heteroskedasticity and heterogeneity in health valuation. In this case, the SALC model dispensed with a garbage class automatically and adjusted the scale for those who failed the PC dominant task. Future analysis may include more behavioral variables to better control heteroskedasticity and heterogeneity in health valuation. Highlights: The Dutch EQ-5D-5L values based on paired comparison [PC] and best-worst scaling [BWS] responses were highly correlated and largely agreed after controlling for heteroskedasticity.Controlling for taste and scale heterogeneity simultaneously enhanced the Dutch EQ-5D-5Lvalues by automatically dispensing with a garbage class and adjusting the scale for those who failed the dominant task.After controlling for heteroskedasticity and heterogeneity, this study produced Dutch EQ-5D-5L values on a pits scale moderately concordant with the original values.

Original languageEnglish
Article number85
JournalHealth and quality of life outcomes
Volume20
Issue number1
Early online date25 May 2022
DOIs
Publication statusPublished - Dec 2022

Keywords

  • Best–worst scaling
  • EQ-5D
  • Health valuation
  • Heteroskedasticity
  • Scale heterogeneity

Fingerprint

Dive into the research topics of 'Exploring the importance of controlling heteroskedasticity and heterogeneity in health valuation: a case study on Dutch EQ-5D-5L'. Together they form a unique fingerprint.

Cite this