gms | German Medical Science

Background and state of research: Patient-reported outcomes (PROs) are increasingly used to monitor and assess the (cost-) effectiveness of healthcare interventions. However, the lack of an easy way to summarise and holistically evaluate the multi-dimensional information contained in PROs remains a major barrier for use in routine care.

Research question and objectives, hypothesis: In this presentation, we will discuss the potential of personalised preference elicitation approaches to overcome this challenge, and to enable evaluating health care services in a more meaningful and comprehensive way from the user/patient perspective. As an example of a larger class of novel approaches for personalised preference elicitation, we will present the Online elicitation of Personal Utility Functions (OPUF) method. We will show use cases and outline potential benefits and limitations, and how it could be implemented in practice.

Method: We show the results from a recent pilot study using the OPUF approach to elicit EQ-5D-5L health state preferences from a sample of 122 patients with rheumatic diseases in Germany, recruited by a patient organisation (Rheuma-Liga e.V.). The open source OPUF tool combines multiple compositional preference elicitation method into an easy-to-use online survey. It broadly consists of three steps: dimension weighting, level rating, and anchoring. Responses from all three steps are combined to calculate the overall preference scores, in terms quality-adjusted life years (QALYs) for each of the EQ-5D-5L health states. A demo version of the survey can be accessed at: https://valorem.health/eqra-demo.

Results: The online survey was easy to implement and was well received by the respondents. We were able to construct personal utility functions for each respondent and calculate personalised EQ-5D-5L tariffs. While pain and discomfort was, on average, the most important dimension, the weights assigned to the other dimensions varied significantly across patients, indicating that personal preferences should be taken into account when evaluating PROs.

Discussion: The results of this pilot study show that personalised preference elicitation approaches can be used to construct personal utility functions and calculate personalised EQ-5D-5L tariffs. While this is a promising approach, further research is needed to evaluate the feasibility and effectiveness of these approaches in routine clinical practice. In particular, more research is needed to identify and address potential barriers to implementation, such as patient engagement and data privacy.

Implication for research: The use of personalised preference elicitation approaches has the potential to enable the holistic evaluation of PROs in routine care, providing a more meaningful insight into the impact of healthcare interventions from the patient perspective. We will discuss the potential benefits and limitations of the two approaches, and how they can be implemented in practice.

Funding: Other funding; Wellcome Trust