Utility Assessment Based on Individualized Patient Perspectives

Duane Steward

A novel approach to utility assessment is presented which enables the elicitation of an individualized understanding of the patient’s perspective. The result illuminates what dimensions of health are regarded as important in the patient’s own terms. This approach is in contrast to traditional utility assessment, which is conducted in prescribed terms, is difficult to apply with confidence on an individual basis and solicits a non-reusable single value for a specific outcome of a decision context. This paper discusses a method which attempts to elicit a complete, comprehensive and operational system of attribute scales to describe the relevant attributes of health in an individual’s personal perspective. The result is a personalized model that can be used to score any health in those terms with re-usable components. Piloting investigations with this fundamental approach reveal potential as a foundation for simple or complex multiattribute modeling and as promising with respect to psychometric evaluation. The systematic approach is grounds for expectation of automation and consistency which could raise the level of applied decision analysis in medical decisions.

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