caa a22 4500 606179917 CHVBK 20210128100803.0 cr unu---uuuuu 210128e20150801xx s 000 0 eng 10.1007/s11136-015-0926-6 doi (NATIONALLICENCE)springer-10.1007/s11136-015-0926-6 Why do multi-attribute utility instruments produce different utilities: the relative importance of the descriptive systems, scale and ‘micro-utility' effects [Elektronische Daten] [Jeff Richardson, Angelo Iezzi, Munir Khan] Purpose: Health state utilities measured by the major multi-attribute utility instruments differ. Understanding the reasons for this is important for the choice of instrument and for research designed to reconcile these differences. This paper investigates these reasons by explaining pairwise differences between utilities derived from six multi-attribute utility instruments in terms of (1) their implicit measurement scales; (2) the structure of their descriptive systems; and (3) ‘micro-utility effects', scale-adjusted differences attributable to their utility formula. Methods: The EQ-5D-5L, SF-6D, HUI 3, 15D and AQoL-8D were administered to 8,019 individuals. Utilities and unweighted values were calculated using each instrument. Scale effects were determined by the linear relationship between utilities, the effect of the descriptive system by comparison of scale-adjusted values and ‘micro-utility effects' by the unexplained difference between utilities and values. Results: Overall, 66% of the differences between utilities was attributable to the descriptive systems, 30.3% to scale effects and 3.7% to micro-utility effects. Discussion: Results imply that the revision of utility algorithms will not reconcile differences between instruments. The dominating importance of the descriptive system highlights the need for researchers to select the instrument most capable of describing the health states relevant for a study. Conclusions: Reconciliation of inconsistent utilities produced by different instruments must focus primarily upon the content of the descriptive system. Utility weights primarily determine the measurement scale. Other differences, attributable to utility formula, are comparatively unimportant. The Author(s), 2015 MAU instruments nationallicence Cost-utility analysis nationallicence Utility nationallicence Richardson Jeff Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut Iezzi Angelo Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut Khan Munir Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut Quality of Life Research Springer International Publishing 24/8(2015-08-01), 2045-2053 0962-9343 24:8<2045 2015 24 11136 https://doi.org/10.1007/s11136-015-0926-6 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-015-0926-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Richardson Jeff Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut NATIONALLICENCE 700 1- Iezzi Angelo Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut NATIONALLICENCE 700 1- Khan Munir Centre for Health Economics, Monash Business School, Monash University, Wellington Road, 3800, Clayton, VIC, Australia aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/8(2015-08-01), 2045-2053 0962-9343 24:8<2045 2015 24 11136