Public deliberation on health gain measures

TL;DR

This study explores how different groups understand and value health gain measures, finding that QALY is most preferred.

Contribution

The study provides new insights into community preferences for health gain measures through stakeholder deliberation.

Findings

Quality-adjusted life year (QALY) was the top-ranked health gain measure among stakeholders.

Participants emphasized the importance of incorporating patient values into health gain measures.

Measures that are intuitive and easy to understand were preferred by stakeholders.

Abstract

Researchers and decision-makers use health gain measures to assess the value of health interventions. However, our current understanding of how these measures are understandable and accessible to the community is limited. This study examined a diverse group of stakeholders’ attitudes and preferences for 9 commonly used health gain measures. We recruited 20 stakeholders, including patients, caregivers, pharmacists, allied health professionals, and citizens. We conducted 2 in-person deliberative meetings in which participants learned, discussed, deliberated on, and ranked 9 health gain measures. The final ranking conducted after unified deliberation showed the quality-adjusted life year (QALY) as the top-ranked measure, followed by the clinical benefit rating method used by the U.S. Preventive Services Task Force, and multicriteria decision analysis (MCDA). We identified 3 themes during deliberations: the importance of using patient values in population-based health gain measures, examining complementary measures together, and choosing measures that are intuitive and easy to understand. Future policymaking should consider incorporating the QALY, clinical benefit rating, and MCDA into prioritization decisions.

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