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APPLICATION OF CONCEPTS FROM PROSPECT THEORY AND RESPONSE SHIFT WHEN ESTIMATING THE MINIMALLY IMPORTANT DIFFERENCE FOR HEALTH UTILITY MEASURES
by
Joshua Davin Epstein
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(PHARMACEUTICAL ECONOMICS AND POLICY)
May 2011
Copyright 2011 Joshua Davin Epstein
Object Description
| Title | Application of concepts from prospect theory and response shift when estimating the minimally important difference for health utility measures |
| Author | Epstein, Joshua Davin |
| Author email | jdepstei@usc.edu; joshua.davin.epstein@gmail.com |
| Degree | Doctor of Philosophy |
| Document type | Dissertation |
| Degree program | Pharmaceutical Economics & Policy |
| School | School of Pharmacy |
| Date defended/completed | 2010-11-18 |
| Date submitted | 2011 |
| Restricted until | Unrestricted |
| Date published | 2011-01-18 |
| Advisor (committee chair) | Nichol, Michael |
| Advisor (committee member) |
Doctor, Jason Azen, Stanley |
| Abstract | Introduction: Minimally important differences (MIDs) are estimated to help interpret what changes on a patient reported outcome (PRO) measure are meaningful. The overall objective of this dissertation was to identify how MID estimates can differ by baseline health, direction of change, and scale recalibration response shift.; Methods: Two data sources were utilized for this research. The impact of baseline health and direction of change on MID estimation was assessed using SF-36 data collected during a two-year longitudinal study of 6,932 members of a California managed care organization. Health utilities were estimated from the SF-36 data. MID estimates for health utility were derived using an anchor-based method and validated using distribution-based methods. Differences in MID estimates were tested between patients reporting minimal gains and minimal losses. Patients were also grouped by baseline health utility scores to estimate the MID and results were compared. Global ratings of change and a thentest visual analog scale (VAS) were included in a prospective longitudinal study of 730 prostate cancer undergoing treatment to identify patients who underwent a response shift. Separate MIDs were estimated for patients with and without response shift and tested for differences.; Results: Results indicated that MID estimates were different for those reporting minimal gains and losses. Baseline health was also highly significant in explaining the variation in MID estimates. Finally, MID estimates in gains were impacted by patients who were identified as undergoing a scale recalibration response shift.; Conclusion: MID estimates for a PRO are impacted by patient baseline health, whether patients were improving or declining, and if patients changed their standards of how they evaluate their health state. Therefore, investigators who seek to utilize a published MID should ensure that their patient population is similar to the population that was originally used to estimate that MID. |
| Keyword | minimally important difference; MID; patient reported outcome; PRO; health utility; health related quality of life; HRQOL; prospect theory; response shift |
| Geographic subject (state) | California; Washington |
| Language | English |
| Part of collection | University of Southern California dissertations and theses |
| Publisher (of the original version) | University of Southern California |
| Place of publication (of the original version) | Los Angeles, California |
| Publisher (of the digital version) | University of Southern California. Libraries |
| Provenance | Electronically uploaded by the author |
| Type | texts |
| Legacy record ID | usctheses-m3612 |
| Rights | Epstein, Joshua Davin |
| Repository name | Libraries, University of Southern California |
| Repository address | Los Angeles, California |
| Repository email | http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/ |
| Filename | etd-Epstein-4224 |
| Archival file | uscthesesreloadpub_Volume17/etd-Epstein-4224.pdf |
Description
| Title | Page 1 |
| Full text | APPLICATION OF CONCEPTS FROM PROSPECT THEORY AND RESPONSE SHIFT WHEN ESTIMATING THE MINIMALLY IMPORTANT DIFFERENCE FOR HEALTH UTILITY MEASURES by Joshua Davin Epstein A Dissertation Presented to the FACULTY OF THE USC GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY (PHARMACEUTICAL ECONOMICS AND POLICY) May 2011 Copyright 2011 Joshua Davin Epstein |
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