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Abstract：
BACKGROUND: Health economists have shown a growing interest in deliberation and multi-criteria decision analysis (MCDA) as possible pathways to transparently integrate value judgments in cost-utility analyses. In line with these developments, this study piloted a consensus process to derive a German value set for the Short-Form Six-Dimension (SF-6D). In a conference setting, a group was tasked to deliberate on scores and weights for the SF-6D from the perspective of a self-determined and independent life.
METHODS: The one-day consensus conference was based on a deliberative process in combination with the MCDA method MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique). According to MACBETH, participants were asked to qualitatively rate pairwise comparisons of SF-6D health states. The scoring within each dimension was conducted in parallel group sessions. Final agreement on the scores as well as weights for the SF-6D dimensions were derived in a subsequent plenary assembly. Results were analyzed using the software M-MACBETH and qualitative content analysis.
RESULTS: A total of 34 participants were recruited. While each of the 6 small groups presented a consented score, the plenary assembly reached consensus on all dimensions apart from pain. Concerning dimension weights, some participants favored prioritizing pain and mental health. Others disputed that trade-offs between dimensions and thus assigning weights were not acceptable in a context where this may involve withholding care from someone. As a consequence, no consensus on a value set was reached. Participants identified the group size of the plenary session and the applied weighting procedure as main obstacles to the process.
CONCLUSIONS: This pilot study presents a consensus-based approach for valuing health-related quality of life. However, further research is needed on deliberative processes that yield quantifiable results. Future conferences should explore smaller group sizes, longer durations of the deliberative process and alternatives to the additive value function applied in MACBETH.
METHODS: The one-day consensus conference was based on a deliberative process in combination with the MCDA method MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique). According to MACBETH, participants were asked to qualitatively rate pairwise comparisons of SF-6D health states. The scoring within each dimension was conducted in parallel group sessions. Final agreement on the scores as well as weights for the SF-6D dimensions were derived in a subsequent plenary assembly. Results were analyzed using the software M-MACBETH and qualitative content analysis.
RESULTS: A total of 34 participants were recruited. While each of the 6 small groups presented a consented score, the plenary assembly reached consensus on all dimensions apart from pain. Concerning dimension weights, some participants favored prioritizing pain and mental health. Others disputed that trade-offs between dimensions and thus assigning weights were not acceptable in a context where this may involve withholding care from someone. As a consequence, no consensus on a value set was reached. Participants identified the group size of the plenary session and the applied weighting procedure as main obstacles to the process.
CONCLUSIONS: This pilot study presents a consensus-based approach for valuing health-related quality of life. However, further research is needed on deliberative processes that yield quantifiable results. Future conferences should explore smaller group sizes, longer durations of the deliberative process and alternatives to the additive value function applied in MACBETH.
摘要：
背景：健康经济学家对审议和多标准决策分析（MCDA）表现出越来越大的兴趣，这些可能是将价值判断透明地整合到成本效用分析中的可能途径。根据这些发展，这项研究试行了一个共识过程，以得出简短六维（SF-6D）的德国值集。在会议设置中，一个小组的任务是从自主和独立生活的角度考虑SF-6D的分数和权重.
方法：为期一天的共识会议基于与MCDA方法MACBETH（通过基于类别的评估技术来衡量吸引力）相结合的审议过程。根据MACBETH的说法,参与者被要求对SF-6D健康状态的成对比较进行定性评价.每个维度内的评分在平行小组会议中进行。在随后的全体会议上得出了关于SF-6D尺寸的分数和权重的最终协议。结果使用M-MACBETH软件和定性内容分析进行分析。
结果：共招募了34名参与者。虽然6个小组中的每个小组都给出了同意的分数，全体会议就除了痛苦之外的所有方面达成了共识。关于尺寸重量，一些参与者赞成优先考虑疼痛和心理健康。其他人则质疑，在可能涉及拒绝某人的护理的情况下，尺寸之间的权衡以及因此分配权重是不可接受的。因此,没有就价值集达成共识。与会者认为，全体会议的小组规模和适用的加权程序是这一进程的主要障碍。
结论：这项初步研究提出了一种基于共识的评估健康相关生活质量的方法。然而,需要对产生可量化结果的审议过程进行进一步研究。未来的会议应该探索更小的团体规模，商议过程的持续时间更长，以及在MACBETH中应用的附加值函数的替代方案。
方法：为期一天的共识会议基于与MCDA方法MACBETH（通过基于类别的评估技术来衡量吸引力）相结合的审议过程。根据MACBETH的说法,参与者被要求对SF-6D健康状态的成对比较进行定性评价.每个维度内的评分在平行小组会议中进行。在随后的全体会议上得出了关于SF-6D尺寸的分数和权重的最终协议。结果使用M-MACBETH软件和定性内容分析进行分析。
结果：共招募了34名参与者。虽然6个小组中的每个小组都给出了同意的分数，全体会议就除了痛苦之外的所有方面达成了共识。关于尺寸重量，一些参与者赞成优先考虑疼痛和心理健康。其他人则质疑，在可能涉及拒绝某人的护理的情况下，尺寸之间的权衡以及因此分配权重是不可接受的。因此,没有就价值集达成共识。与会者认为，全体会议的小组规模和适用的加权程序是这一进程的主要障碍。
结论：这项初步研究提出了一种基于共识的评估健康相关生活质量的方法。然而,需要对产生可量化结果的审议过程进行进一步研究。未来的会议应该探索更小的团体规模，商议过程的持续时间更长，以及在MACBETH中应用的附加值函数的替代方案。
