It’s All in the Name, or Is It? The Impact of Labeling on Health State Values

• Published in: Medical decision making 2012-01, Vol.32 (1), p.31-40
• Main Authors: Rowen, Donna, Brazier, John, Tsuchiya, Aki, Young, Tracey, Ibbotson, Rachel
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Attitude to Health; Female; Health Status; Humans; Interviews as Topic; Male; Middle Aged; Patient Preference; Surveys and Questionnaires; United Kingdom; Young Adult
• ISSN: 0272-989X; 1552-681X
• DOI: 10.1177/0272989X11408435

Background. Many descriptions of health used in vignettes and condition-specific measures name the medical condition. This article assesses the impact of referring to the medical condition in the descriptions of health states valued by members of the general population. Methods. A valuation study was conducted using face-to-face interviews involving the time trade-off valuation technique. All respondents valued essentially the same health states, but for each respondent, the descriptions featured an irritable bowel syndrome (IBS) label, a cancer label, or no label. Random effects generalized least squares regressions were used to estimate the impact of each label and experience of the condition on health state values. Data. A sample of 241 members of the UK general population each valued 8 states, generating 1910 observations (response rate = 39%, completion rate = 99% for all states). Results. The authors find no significant difference between health state values when the description contains no label or an IBS label. They find that the inclusion of a cancer label in health state descriptions affects health state values and that the impact is dependent on the severity of the state, with a significant reduction in values for more severe health states (up to −0.25 for the worst possible state) but no significant difference for mild states. Conclusions. A condition label can affect health state values, but this is dependent on the specific condition and severity. The authors recommend avoiding condition labels in health state descriptions (where possible) to ensure that values are not affected by prior knowledge or preconception of the condition that may distort the health state being valued.