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Multiattribute Structure for QALYs

Department of Industrial Engineering and Management Sciences, Northwestern University, Evanston, Illinois 60208
hazen{at}iems.northwestern.edu

Health status is inherently a multiattribute construct. We examine multiattribute utility decompositions for the quality-adjusted life year (QALY) utility model commonly employed in medical decision and cost-effectiveness analyses. We consider several independence conditions on preference, including the classical notions of preferential independence and utility independence, as well as new related notions of standard-gamble independence and time-tradeoff independence. The latter conditions are helpful in simplifying standard-gamble utility assessment procedures and time-tradeoff assessment procedures in the presence of multiple health attributes. Under the QALY model, all these conditions are equivalent and result in a purely multiplicative decomposition of utility over health states.

Key Words: multiattribute utility; QALYs; medical decision analysis; standard gamble; time tradeoff; multiplicative
History: Received on June 25, 2002. Accepted on June 3, 2003.

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