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The Standard Gamble (SG) is felt by many to be the gold standard method of utility derivation, but SG has not hitherto been applied to anesthesia side effects.
Each health state has been previously defined using the time trade-off method of utility analysis based on the response of a sample of the Spanish population [ 19].
This prompted method of utility assessment has face, content, and construct validity, and good test-retest reliability [ 11, 12, 15, 16], but it is time-consuming and requires a trained interviewer and visual props.
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We refer to this group of methods as indirect methods of utility measurement.
This should use time trade-off or standard gamble methods of utility elicitation"[ 5].
It is well known that different methods of utility estimation yield systematically different values.
Our findings show that the versatile and convenient indirect methods of utility measurement yield different results from those obtained by the direct methods.
*Total number of studies is greater than 77, as some studies evaluated multiple conditions and/or used multiple methods of utility measurement.
The studies covered many different diseases and several different methods of utility elicitation allowing a general trend to be identified that indirect methods tend to yield lower utilities than direct methods.
Information abstracted included study characteristics (country of study, study design, inclusion criteria), characteristics of respondents (age, gender, mean visual acuity at baseline, if provided), methods of utility elicitation, mean HSUVs and HSUVs for defined VA levels.
It is generally recognised that the sensitivity of the QALY can vary across different disease areas [ 4], that different methods of utility measurement yield different results and there is no clear consensus as to which instrument is the preferred method for utility elicitation [ 19]; although NICE have opted for the EQ-5D as a preferred instrument.
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