Skip to main content
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2000 Jul;54(7):537–543. doi: 10.1136/jech.54.7.537

Exploring health preferences in sociodemographic and health related groups through the paired comparison of the items of the Nottingham Health Profile

L Prieto 1, J Alonso 1
PMCID: PMC1731711  PMID: 10846197

Abstract

BACKGROUND—Preference weighted measures of health related quality of life are necessary for cost effectiveness calculations involving quality of life adjustment. There are conflicting data about the influence of factors such as sociodemographic and health related variables on health preferences.
STUDY OBJECTIVE—The relative values attached to the items of the Spanish version of the Nottingham Health Profile (NHP) were assessed to make comparisons across social and health subgroups.
DESIGN AND PARTICIPANTS—Preference values were obtained in sets of 250 to 253 persons (total n=1258) using the method of paired comparisons after all possible pairs of NHP items had been presented to respondents for judgement of severity. χ2 Tests and Spearman's correlations among item ranks were calculated.
MAIN RESULTS—Findings show that preferences elicited with the method of paired comparisons are consistent and independent of the sample from which they are obtained (mean correlation coefficients across subgroups range from 0.87 to 0.96). Conclusion—The evaluation of health did not seem to be related to sociodemographic variables (gender, age, social class) or to the health status of the respondents, suggesting that health preferences are stable across different populations.


Keywords: health preferences; Nottingham Health Profile; psychometrics

Full Text

The Full Text of this article is available as a PDF (166.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alonso J., Anto J. M., Moreno C. Spanish version of the Nottingham Health Profile: translation and preliminary validity. Am J Public Health. 1990 Jun;80(6):704–708. doi: 10.2105/ajph.80.6.704. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Alonso J., Prieto L., Antó J. M. The Spanish version of the Nottingham Health Profile: a review of adaptation and instrument characteristics. Qual Life Res. 1994 Dec;3(6):385–393. doi: 10.1007/BF00435390. [DOI] [PubMed] [Google Scholar]
  3. Alonso J., Pérez P., Sáez M., Murillo C. Validez de la ocupación como indicador de la clase social, según la clasificación del British Registrar General. Gac Sanit. 1997 Sep-Oct;11(5):205–213. doi: 10.1016/s0213-9111(97)71299-8. [DOI] [PubMed] [Google Scholar]
  4. Boyle M. H., Furlong W., Feeny D., Torrance G. W., Hatcher J. Reliability of the Health Utilities Index--Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual Life Res. 1995 Jun;4(3):249–257. doi: 10.1007/BF02260864. [DOI] [PubMed] [Google Scholar]
  5. Bucquet D., Condon S., Ritchie K. The French version of the Nottingham Health Profile. A comparison of items weights with those of the source version. Soc Sci Med. 1990;30(7):829–835. doi: 10.1016/0277-9536(90)90207-9. [DOI] [PubMed] [Google Scholar]
  6. Burrows C., Brown K. QALYs for resource allocation: probably not and certainly not now. Aust J Public Health. 1993 Sep;17(3):278–286. doi: 10.1111/j.1753-6405.1993.tb00150.x. [DOI] [PubMed] [Google Scholar]
  7. Danis M., Garrett J., Harris R., Patrick D. L. Stability of choices about life-sustaining treatments. Ann Intern Med. 1994 Apr 1;120(7):567–573. doi: 10.7326/0003-4819-120-7-199404010-00006. [DOI] [PubMed] [Google Scholar]
  8. Dolan P. The effect of experience of illness on health state valuations. J Clin Epidemiol. 1996 May;49(5):551–564. doi: 10.1016/0895-4356(95)00532-3. [DOI] [PubMed] [Google Scholar]
  9. Domingo Salvany A., Marcos Alonso J. Propuesta de un indicador de la "clase social" basado en la ocupación. Gac Sanit. 1989 Jan-Feb;3(10):320–326. doi: 10.1016/s0213-9111(89)70948-1. [DOI] [PubMed] [Google Scholar]
  10. Froberg D. G., Kane R. L. Methodology for measuring health-state preferences--I: Measurement strategies. J Clin Epidemiol. 1989;42(4):345–354. doi: 10.1016/0895-4356(89)90039-5. [DOI] [PubMed] [Google Scholar]
  11. Froberg D. G., Kane R. L. Methodology for measuring health-state preferences--II: Scaling methods. J Clin Epidemiol. 1989;42(5):459–471. doi: 10.1016/0895-4356(89)90136-4. [DOI] [PubMed] [Google Scholar]
  12. Froberg D. G., Kane R. L. Methodology for measuring health-state preferences--III: Population and context effects. J Clin Epidemiol. 1989;42(6):585–592. doi: 10.1016/0895-4356(89)90155-8. [DOI] [PubMed] [Google Scholar]
  13. Froberg D. G., Kane R. L. Methodology for measuring health-state preferences--IV: Progress and a research agenda. J Clin Epidemiol. 1989;42(7):675–685. doi: 10.1016/0895-4356(89)90011-5. [DOI] [PubMed] [Google Scholar]
  14. Guyatt G. H., Cook D. J. Health status, quality of life, and the individual. JAMA. 1994 Aug 24;272(8):630–631. [PubMed] [Google Scholar]
  15. Hadorn D. C., Hays R. D., Uebersax J., Hauber T. Improving task comprehension in the measurement of health state preferences. A trial of informational cartoon figures and a paired-comparison task. J Clin Epidemiol. 1992 Mar;45(3):233–243. doi: 10.1016/0895-4356(92)90083-y. [DOI] [PubMed] [Google Scholar]
  16. Hunt S. M., Alonso J., Bucquet D., Niero M., Wiklund I., McKenna S. Cross-cultural adaptation of health measures. European Group for Health Management and Quality of Life Assessment. Health Policy. 1991 Sep;19(1):33–44. doi: 10.1016/0168-8510(91)90072-6. [DOI] [PubMed] [Google Scholar]
  17. Hunt S. M., McEwen J., McKenna S. P. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985 Apr;35(273):185–188. [PMC free article] [PubMed] [Google Scholar]
  18. Hunt S. M., McKenna S. P., McEwen J., Backett E. M., Williams J., Papp E. A quantitative approach to perceived health status: a validation study. J Epidemiol Community Health. 1980 Dec;34(4):281–286. doi: 10.1136/jech.34.4.281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Hunt S. M., McKenna S. P., McEwen J., Williams J., Papp E. The Nottingham Health Profile: subjective health status and medical consultations. Soc Sci Med A. 1981 May;15(3 Pt 1):221–229. doi: 10.1016/0271-7123(81)90005-5. [DOI] [PubMed] [Google Scholar]
  20. Jenkinson C. Why are we weighting? A critical examination of the use of item weights in a health status measure. Soc Sci Med. 1991;32(12):1413–1416. doi: 10.1016/0277-9536(91)90202-n. [DOI] [PubMed] [Google Scholar]
  21. Kaplan R. M., Bush J. W., Berry C. C. Health status index: category rating versus magnitude estimation for measuring levels of well-being. Med Care. 1979 May;17(5):501–525. [PubMed] [Google Scholar]
  22. Kapp M. B. Enforcing patient preferences. Linking payment for medical care to informed consent. JAMA. 1989 Apr 7;261(13):1935–1938. doi: 10.1001/jama.261.13.1935. [DOI] [PubMed] [Google Scholar]
  23. Katz J. N., Phillips C. B., Fossel A. H., Liang M. H. Stability and responsiveness of utility measures. Med Care. 1994 Feb;32(2):183–188. doi: 10.1097/00005650-199402000-00009. [DOI] [PubMed] [Google Scholar]
  24. Kiebert G. M., Stiggelbout A. M., Leer J. W., Kievit J., de Haes H. J. Test-retest reliabilities of two treatment-preference instruments in measuring utilities. Med Decis Making. 1993 Apr-Jun;13(2):133–140. doi: 10.1177/0272989X9301300207. [DOI] [PubMed] [Google Scholar]
  25. Kind P. A comparison of two models for scaling health indicators. Int J Epidemiol. 1982 Sep;11(3):271–275. doi: 10.1093/ije/11.3.271. [DOI] [PubMed] [Google Scholar]
  26. Llewellyn-Thomas H. A., Sutherland H. J., Thiel E. C. Do patients' evaluations of a future health state change when they actually enter that state? Med Care. 1993 Nov;31(11):1002–1012. doi: 10.1097/00005650-199311000-00003. [DOI] [PubMed] [Google Scholar]
  27. Llewellyn-Thomas H., Sutherland H. J., Tibshirani R., Ciampi A., Till J. E., Boyd N. F. Describing health states. Methodologic issues in obtaining values for health states. Med Care. 1984 Jun;22(6):543–552. [PubMed] [Google Scholar]
  28. Llewellyn-Thomas H., Sutherland H. J., Tibshirani R., Ciampi A., Till J. E., Boyd N. F. The measurement of patients' values in medicine. Med Decis Making. 1982 Winter;2(4):449–462. doi: 10.1177/0272989X8200200407. [DOI] [PubMed] [Google Scholar]
  29. McKenna S. P., Hunt S. M., McEwen J. Weighting the seriousness of perceived health problems using Thurstone's method of paired comparisons. Int J Epidemiol. 1981 Mar;10(1):93–97. doi: 10.1093/ije/10.1.93. [DOI] [PubMed] [Google Scholar]
  30. McQuellon R. P., Muss H. B., Hoffman S. L., Russell G., Craven B., Yellen S. B. Patient preferences for treatment of metastatic breast cancer: a study of women with early-stage breast cancer. J Clin Oncol. 1995 Apr;13(4):858–868. doi: 10.1200/JCO.1995.13.4.858. [DOI] [PubMed] [Google Scholar]
  31. Prieto L., Alonso J., Viladrich M. C., Antó J. M. Scaling the Spanish version of the Nottingham Health Profile: evidence of limited value of item weights. J Clin Epidemiol. 1996 Jan;49(1):31–38. doi: 10.1016/0895-4356(95)00064-x. [DOI] [PubMed] [Google Scholar]
  32. Read J. L., Quinn R. J., Berwick D. M., Fineberg H. V., Weinstein M. C. Preferences for health outcomes. Comparison of assessment methods. Med Decis Making. 1984;4(3):315–329. doi: 10.1177/0272989X8400400307. [DOI] [PubMed] [Google Scholar]
  33. Revicki D. A. Relationship between health utility and psychometric health status measures. Med Care. 1992 May;30(5 Suppl):MS274–MS282. doi: 10.1097/00005650-199205001-00027. [DOI] [PubMed] [Google Scholar]
  34. Sackett D. L., Torrance G. W. The utility of different health states as perceived by the general public. J Chronic Dis. 1978;31(11):697–704. doi: 10.1016/0021-9681(78)90072-3. [DOI] [PubMed] [Google Scholar]
  35. Schwartz S., Richardson J., Glasziou P. P. Quality-adjusted life years: origins, measurements, applications, objections. Aust J Public Health. 1993 Sep;17(3):272–278. doi: 10.1111/j.1753-6405.1993.tb00149.x. [DOI] [PubMed] [Google Scholar]
  36. Smith R., Dobson M. Measuring utility values for QALYs: two methodological issues. Health Econ. 1993 Dec;2(4):349–355. doi: 10.1002/hec.4730020407. [DOI] [PubMed] [Google Scholar]
  37. Stiggelbout A. M., Kiebert G. M., Kievit J., Leer J. W., Habbema J. D., De Haes J. C. The "utility" of the Time Trade-Off method in cancer patients: feasibility and proportional Trade-Off. J Clin Epidemiol. 1995 Oct;48(10):1207–1214. doi: 10.1016/0895-4356(95)00011-r. [DOI] [PubMed] [Google Scholar]
  38. Sutherland H. J. Assessing patients' preferences. Med Decis Making. 1995 Jul-Sep;15(3):286–287. doi: 10.1177/0272989X9501500312. [DOI] [PubMed] [Google Scholar]
  39. Torrance G. W., Feeny D. H., Furlong W. J., Barr R. D., Zhang Y., Wang Q. Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care. 1996 Jul;34(7):702–722. doi: 10.1097/00005650-199607000-00004. [DOI] [PubMed] [Google Scholar]
  40. Torrance G. W. Measurement of health state utilities for economic appraisal. J Health Econ. 1986 Mar;5(1):1–30. doi: 10.1016/0167-6296(86)90020-2. [DOI] [PubMed] [Google Scholar]
  41. Tversky A., Kahneman D. The framing of decisions and the psychology of choice. Science. 1981 Jan 30;211(4481):453–458. doi: 10.1126/science.7455683. [DOI] [PubMed] [Google Scholar]
  42. Veit C. T., Rose B. J., Ware J. E., Jr Effects of physical and mental health on health-state preferences. Med Care. 1982 Apr;20(4):386–401. doi: 10.1097/00005650-198204000-00004. [DOI] [PubMed] [Google Scholar]
  43. Worsley A. Laypersons' evaluation of health: an exploratory study of an Australian population. J Epidemiol Community Health. 1990 Mar;44(1):7–11. doi: 10.1136/jech.44.1.7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. van Dalen H., Williams A., Gudex C. Lay people's evaluations of health: are there variations between different subgroups? J Epidemiol Community Health. 1994 Jun;48(3):248–253. doi: 10.1136/jech.48.3.248. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES