Bayesian modeling of health state preferences: could borrowing strength from existing countries' valuations produce better estimates

Eur J Health Econ. 2021 Jul;22(5):773-788. doi: 10.1007/s10198-021-01289-x. Epub 2021 Mar 24.

Abstract

Background: Valuations of preference-based measure such as EQ-5D and/or SF6D have been conducted in different countries. There is potential to borrow strength from existing countries' valuations to generate better representative utility estimates. This is explored using two case studies modelling UK data alongside Japan samples to generate Japan estimates.

Methods: Data from two SF-6D valuation studies were analyzed, where using similar standard gamble protocols, values for 241 and 249 states were devised from representative samples of Japan and UK general adult populations, respectively. Two nonparametric Bayesian models were applied to estimate a Japan value set, where the UK results were used as informative priors in the first model and subsets of the Japan data set for 25 and 50 health states were modelled alongside the full UK data set in the second. Generated estimates were compared to a Japan value set estimated using Japan values alone using different prediction criterion.

Results: The results allowed the UK data to provide significant prior information to the Japan analysis by generating better estimates than using Japan data alone. Also, using Japan data elicited for 50 health states alongside the existing UK data produces roughly similar predicted valuations as the Japan data by itself.

Conclusion: The promising results suggest that the existing preference data could be combined with data from a valuation study in a new country to generate preference weights, thus making own country value sets more achievable for low-middle income countries. Further research and application to other countries and preference-based measures are encouraged.

Keywords: Nonparametric Bayesian methods; Preference-based health measures; QALYs; SF-6D; Standard gamble.

MeSH terms

  • Adult
  • Bayes Theorem
  • Health Status
  • Health Status Indicators*
  • Humans
  • Japan
  • Poverty
  • Quality of Life*
  • Surveys and Questionnaires