PT  - JOURNAL ARTICLE
AU  - MARK J. HARRISON
AU  - NICK J. BANSBACK
AU  - CARLO A. MARRA
AU  - MICHAEL DRUMMOND
AU  - PETER S. TUGWELL
AU  - ANNELIES BOONEN
TI  - Valuing Health for Clinical and Economic Decisions: Directions Relevant for Rheumatologists
AID  - 10.3899/jrheum.110404
DP  - 2011 Aug 01
TA  - The Journal of Rheumatology
PG  - 1770--1775
VI  - 38
IP  - 8
4099  - http://www.jrheum.org/content/38/8/1770.short
4100  - http://www.jrheum.org/content/38/8/1770.full
SO  - J Rheumatol2011 Aug 01; 38
AB  - The quality-adjusted life-year (QALY) is a construct that integrates the value or preference for a health state over the period of time in that health state. The main use of QALY is in cost-utility analysis, to help make resource allocation decisions when faced with choices. Although the concept of the QALY is appealing, there is ongoing debate regarding their usefulness and approaches to deriving QALY. In 2008, OMERACT engaged in an effort to agree on QALY approaches that can be used in rheumatology. Based on a Web questionnaire and a subsequent meeting, rheumatologists questioned whether it was relevant for OMERACT (1) to investigate use of a QALY that represents the patients’ perspective, (2) to explore the validity of the visual analog scale (VAS) to value health, and (3) to understand the validity of mapping health-specific instruments on existing preference instruments. This article discusses the pros and cons of these points in light of current insight from the point of view of health economics and decision-making theory. It also considers the further research agenda toward a QALY approach in rheumatology.