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The 6 D 5 L description system for health state valuation

When we ask a person to value time spent in a health state without any information about the key domains of health, (s)he must guess a description of the health state. The description visualized by the valuer would usually be implicit in the valuation task. This will inevitably introduce measurement error and a potential for bias in the results. Another consideration is how to convey relevant information about a hypothetical health state to the individual undertaking the valuation, who might not have personally encountered the state. Disease labels are short and parsimonious, but do not convey adequate information about functional status. Moreover, disease labels are vulnerable to different interpretations based on cultural and personal settings. Here we report the 6D5L description system developed and used by the Andhra Pradesh Health State Valuation Study 1999 (APHSV99). Results from this study are presented in chapter 9.4. More details of design, methods, data collection and analysis have been reported (Mahapatra et al. 2000). We first review current literature on the theoretical question of how to describe health states for valuation. We then describe components of the 6D5L system developed to describe health states for valuation. In the third and final section of this chapter we present some results about the usage of the 6D5L system by valuers in the APHSV99 Study.