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#HEJC for 04/02/2013

This month’s meeting will take place Monday 4th February, at 8pm London time. That’ll be 9pm in Oslo and 2pm in Mexico City. Join the Facebook event here. For more information about the Health Economics Twitter Journal Club and how to take part, click here.

The paper for discussion this month is published in Social Science & Medicine and the authors are Clara Mukuria and John Brazier. The title of the paper is:

“Valuing the EQ-5D and the SF-6D health states using subjective well-being: A secondary analysis of patient data”

Following the meeting, a transcript of the discussion can be downloaded here.

Links to the article



Other:!/file/HEDS_DP_11-07.pdf [extended, pre-publication]

Summary of the paper

Standard methods of economic evaluation in health care use public preferences to assign utility weights to health state classifications. There has been some research into the use of subjective well-being or happiness measures as an alternative to valuations based on preferences or ‘decision utility’. However, these studies have conformed to the standard practice of using well-being values from the general public, rather than from patients. As a result, these valuations may not sufficiently capture a full range of health experiences. This study uses data from a large patient sample (n=15,184), collected from inpatients and outpatients, from a hospital in Wales. The authors use responses to a frequency-based happiness question to value EQ-5D and SF-6D health states. Ordered logit regressions are used to estimate the relationship between happiness and EQ-5D and SF-6D classifications. Furthermore, results are compared to valuations based on existing standard gamble and time trade-off exercises. The authors find that valuing EQ-5D and SF-6D health states using happiness, rather than standard techniques, attributes a greater weight to the dimensions of anxiety/depression, social functioning and vitality, while less weight is attributed to pain and physical health.

Discussion points

  • Is there merit in valuing health states from a non-specific patient group?
  • Is it reasonable to assume interval properties for the happiness measure?
  • Why might problems in physical functioning increase happiness?
  • Why might the effect of the SF-6D ‘Most’ term be positive?

Missed the meeting? Add your thoughts on the paper in the comments below.


  • Chris Sampson

    Founder of the Academic Health Economists' Blog. Senior Principal Economist at the Office of Health Economics. ORCID: 0000-0001-9470-2369

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