A Framework For Modeling Health State Utility Values From An Online Survey Based On Health Survey Short Form 6-Dimension Version 2(SF-6Dv2)

The adopted health reform plan necessitates rigorous economic and clinical evaluations when considering new health technologies to optimize health resource allocation.Cost-utility analysis(CUA)is a vital tool in economic evaluations the uses utilities from Preference-Based Measurements such as Short form 6 Dimensions version 2(SF-6Dv2).Eliciting preferences can be done using several techniques the require optimization.Herein,it is aimed to examine and compare the feasibility of using an online Chinese population sample to elicit preference utility values for the SF-6Dv2 from Best-Worst Scaling case 2(BWS),Discrete Choice Experiment(DCE),and Time Trade-Off(TTO).The Mandarin Chinese version of the SF-6Dv2 was used with fractional factorial design to compose an online survey containing all three tasks;then was filled by a representative sample of the general population in terms of age,gender,educational level,and residence(N=997).Econometric methods assuming homogeneity(Conditional Logit and Linear Models)and heterogeneity of preferences(Latent Class Analysis and Hierarchical Bayes)were implemented,followed by a test-retest reliability examination.BWS estimation utilities were robust to modeling assumptions and were stable over the retest,especially from models assuming heterogeneous preferences and using self-anchor on death values.DCE utilities varied according to the modeling assumptions,and TTO data were abysmal.Accounting for choice-related behaviors improved the models.In general,Chinese weigh Pain and Physical activity the highest.The current thesis is a pioneer in using online surveys to elicit health preferences from Chinese populations and demonstrate its feasibility with BWS.It is also the first to demonstrate the application of BWS self-anchor in health utility valuation studies.The finding concludes with the urgent need to adopt a national health utility scoring algorithm for each preference-based instrument,and decisions should always favor health technologies that prioritize reducing Pain,improving physical health,and extending life.It is hoped that this thesis will support health utility research in China by opening more fields of research,guiding policy-making,and providing extra armor to the evolving health technology assessments(HTA)techniques.