Utility Functions for Life Years and Health Status

TLDR

The analysis is motivated by the need to balance life years and health status when choosing treatments for coronary artery disease and chronic kidney disease. Multiattribute utility theory is employed to propose a utility function over life years and health status. By assuming plausible independence properties, the authors derive a quasi‑additive utility function, emphasizing life‑year utilities with constant proportional risk posture. Empirical assessment confirms that stated preferences align with the proposed functional form, and the derived utility functions have been applied to guide coronary artery bypass graft surgery decisions in coronary artery disease patients.

Abstract

Multiattribute utility theory is used to suggest a form for a utility function over life years and health status. The analysis is motivated by consideration of two diseases—coronary artery disease and chronic kidney disease—in which the choice of treatment may depend on the patient's tradeoff between these attributes. Certain plausible independence properties lead to a quasi-additive utility function for life years and health status. Particular attention is given to utility functions for life years exhibiting constant proportional risk posture. An empirical assessment shows that stated preferences appear consistent with this functional form. The derived utility functions have been applied to the treatment decision of whether to prescribe coronary artery bypass graft surgery in patients with coronary artery disease.