Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment

McCarthy, I. 2015. "Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment." Health Economics 24(12):1588-1603.

27 Pages Posted: 22 Sep 2013 Last revised: 27 Apr 2016

See all articles by Ian M. McCarthy

Ian M. McCarthy

Emory University - Department of Economics; National Bureau of Economic Research (NBER)

Date Written: September 20, 2013

Abstract

This paper proposes a novel two-stage approach to modeling health-related quality-of-life (HRQoL) outcomes. The approach allows a patient-centered interpretation by estimating regression coefficients based on the multi-dimensional HRQoL profi le, but maintains the parsimony of the quality-adjusted life-year (QALY) framework by re-interpreting incremental eff ects in the QALY domain. Through a series of Monte Carlo simulations, the proposed methodology is shown to be more robust to the distributional properties of QALYs, thereby avoiding the potential bias introduced when converting the multi-dimensional HRQoL into a one-dimensional QALY. The approach also allows researchers to more easily update cost- and comparative-eff ectiveness results as new HRQoL scoring algorithms develop for new patient populations. I provide an application to the estimation of incremental eff ects of demographic and clinical variables on HRQoL following surgical treatment for adult scoliosis and spinal deformity patients.

Keywords: cost-effectiveness, comparative-effectiveness, patient-reported outcome measures, quality-adjusted life years, scoliosis, adult spinal deformity

JEL Classification: I10, C24, C25, C34, C35, C51

Suggested Citation

McCarthy, Ian M., Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment (September 20, 2013). McCarthy, I. 2015. "Putting the Patient in Patient Reported Outcomes: A Robust Methodology for Health Outcomes Assessment." Health Economics 24(12):1588-1603., Available at SSRN: https://ssrn.com/abstract=2328804 or http://dx.doi.org/10.2139/ssrn.2328804

Ian M. McCarthy (Contact Author)

Emory University - Department of Economics ( email )

1602 Fishburne Drive
Atlanta, GA 30322
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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