National Academy of Sciences | 150 Year Anniversary

Questions? Call 800-624-6242

| Items in cart [0]

The National Academies Press

HARDBACK
price:$52.95
add to cart

Rights & Permissions

topleft topright

Vaccines for the 21st Century: A Tool for Decisionmaking (2000)
Institute of Medicine (IOM)

Citation Manager

. "Review of the Analytical Model." Vaccines for the 21st Century: A Tool for Decisionmaking. Washington, DC: The National Academies Press, 2000.

Please select a format:

BibTeX EndNote RefMan


Page
96
bottomleft bottomright

The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy.


Vaccines for the 21st Century: A Tool for Decisionmaking

Quality-Adjustment Weights Based on the Health Utilities Index

The committee considered two basic options for determining the quality-adjustment weights used to represent the impact of morbidity associated with the conditions under study. One option was for the committee, on the basis of its judgment and that of other experts, to assign quality-adjustment weights to each health state in each morbidity scenario associated with each condition. The other option was to use an existing generic health status assessment tool to characterize each health state. The committee chose to use a standard assessment tool to promote the comparability of the assessments for each condition. This approach also allows others who use the committee’s work to use the same instrument to make their own assessments of these or other conditions.

The committee selected the Health Utilities Index (HUI) Mark II (Feeny et al., 1995: Torrance et al., 1995). The HUI Mark II characterizes morbidity by using seven health attributes (sensation, mobility, emotion, cognition, self-care, pain, and fertility), each of which is divided into three, four, or five levels. Each level has a fixed quantitative score between 0 and 1.0 representing the strength of the “preference” for that level of morbidity relative to full health (1.0) or death (0).

A health state is described by assigning to it a specific level from each attribute. The HUI quality-adjustment weight for the health state is then derived from the following formula:

U=1.06 (b1 • b2 • b3 • b4 • b5 • b6 • b7)−0.06, (4)

where U is the utility of the health state (i.e., the quality weight), and bx is the score for the level assigned for attribute x (Torrance et al., 1995). U corresponds to Wi in Equation 3.

Although HUI Mark II was originally developed for a study of childhood cancer survivors, it has been adapted for use with adult populations. It has also been used with the Ontario Health Survey (Berthelot et al., 1992; Roberge et al., 1995) and the Canadian National Population Health Survey (NPHS) (Catlin and Will, 1992; Wolfson, 1996) to develop provisional estimates of age-specific health status at the population level.*

*  

Final estimates for the NPHS will be based on the scoring system under development for the HUI Mark III, a revised HUI with eight component attributes (Torrance et al., 1992; Boyle et al., 1995).

Page
96
Front Matter (R1-R12)
Executive Summary (1-10)
Introduction (11-16)
Progress in Vaccine Development (17-38)
Considerations of Candidate Vaccines (39-52)
Overview of Analytic Approach and Results (53-92)
Review of the Analytical Model (93-108)
Ethical Considerations and Caveats (109-122)
Observations (123-132)
References (133-142)
Appendix 1: Borrelia burgdorferi (143-148)
Appendix 2: Chlamydia (149-158)
Appendix 3: Coccidioides Immitis (159-164)
Appendix 4: Cytomegalovirus (165-172)
Appendix 5: Enterotoxigenic E. coli (173-176)
Appendix 6: Epstein-Barr Virus (177-180)
Appendix 7: Helicobacter pylori (181-188)
Appendix 8: Hepatitis C (189-194)
Appendix 9: Herpes Simplex Virus (195-206)
Appendix 10: Histoplasma capsulatum (207-212)
Appendix 11: Human Paillomavirus (213-222)
Appendix 12: Influenza A and B (223-232)
Appendix 13: Insulin-Dependent Diabetes Mellitus (233-238)
Appendix 14: Melanoma (239-244)
Appendix 15: Multiple Sclerosis (245-250)
Appendix 16: Mycobacterium tuberculosis (251-256)
Appendix 17: Neisseria gonnorrhea (257-266)
Appendix 18: Neisseria meningitidis (267-272)
Appendix 19: Parainfluenza Virus (273-278)
Appendix 20: Respiratory Syncytial Virus (279-284)
Appendix 21: Rheumatoid Arthritis (285-290)
Appendix 22: Rotavirus (291-294)
Appendix 23: Shigella (295-298)
Appendix 24: Streptococcus, Group A (299-304)
Appendix 25: Streptococcus, Group B (305-312)
Appendix 26: Streptococcus pneumoniae (313-322)
Appendix 27: Information on accessing Electronic Spreadsheets (323-324)
Appendix 28: Summary of Workshops (325-434)
Appendix 29: Questions Posed to Outside Experts and List of Responders (435-442)
Index (443-460)