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19 results

  • OP94 Online Elicitation Of Personal Utility Functions (OPUF): A New Tool For Eliciting EQ-5D-5L Value Sets On The Societal-, Group-, Subgroup-, And Individual-Level

  • Paul Schneider, John Brazier, Nancy Devlin
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 38 / Issue S1 / December 2022
    Published online by Cambridge University Press:
    23 December 2022, pp. S35-S36
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  • Introduction

    The ‘Online elicitation of Personal Utility Functions’ (OPUF) is a new method for valuing health states. It is based on compositional preference elicitation techniques. In contrast to established, decompositional techniques, such as time trade-off or discrete choice experiment (DCE), the OPUF approach does not require hundreds or thousands of respondents, but allows estimating utility functions for small (patient) groups and even on the individual level. The objective of this study was to generate and compare EQ-5D-5L value sets on the societal-, group-, subgroup-, and individual-level.

    Methods

    A demonstration version of the EQ-5D-5L OPUF Tool is available at: https://eq5d5l.me. It broadly consists of three valuation steps: dimension weighting, level rating, and anchoring. Responses were combined on the individual level to construct personal utility functions. Every respondent also completed three conventional DCEs. Preferences were aggregated across individuals to estimate a societal and various group-level preference functions. We then assessed the heterogeneity of preferences between groups using descriptive statistics and k-means cluster analysis.

    Results

    A representative sample (n = 1,000) of the United Kingdom (UK) population was recruited through the prolific online platform. On average, it took participants about 7 minutes to complete the survey. Data of 874 respondents were included in the analysis. For each respondent, we constructed a personal EQ-5D-5L value set. The derived utility functions predicted respondents’ choices in DCE with an accuracy of 78 percent. On the societal level, the predicted values for the EQ-5D-5L health states ranged from -0.376 to 1. Health state preference varied greatly between groups. This was largely due to differences in the anchoring, while there was near consensus on the relative importance of the five EQ-5D dimensions between groups. Demographic characteristics explained only a small proportion of the variability.

    Conclusions

    Using the OPUF approach, we were not only able to estimate a new EQ-5D-5L value set for the UK, but also to examine the underlying individual preferences in an unprecedented level of detail.

Ralph Ellison in Context
  • Edited by Paul Devlin
  • Published online:
    14 January 2022
    Print publication:
    02 December 2021
  • Ralph Ellison's Invisible Man is the second-most assigned American novel since 1945 and is one of the most enduring. It is studied by many thousands of high school and college students every year and has been since the 1950s. His landmark essays, with their blend of personal history and cultural theory, have been extraordinarily influential. Ralph Ellison in Context includes authoritative chapters summing up longstanding conversations, while offering groundbreaking essays on a variety of topics not yet covered in the copious critical and biographical literature. It provides fresh perspectives on some of the most important people and places in Ellison's life, and explores where his work and biography cross paths with some of the pressing topics of his time. It includes chapters on Ellison's literary influences and offers a definitive overview of his early writings. It also provides an overview of Ellison's reception and reputation from his death in 1994 through 2020.

  • Chapter 5 - The United States Merchant Marine

  • from Part I - Geographical, Institutional, and Interpersonal Contexts
  • Edited by Paul Devlin, United States Merchant Marine Academy, New York
  • Book:
    Ralph Ellison in Context
    Published online:
    14 January 2022
    Print publication:
    02 December 2021, pp 55-70

  • Summary

    Ellison served as a cook and baker in the U.S. Merchant Marine during World War II, visited Wales and France, and was a member of the National Maritime Union. This marks a critical turning point in his life and career. This paper considers those experiences as an important context for his life and work. All of his subsequent fiction and some significant nonfiction was informed by and reflects this experience to some extent.

  • Chapter 9 - Albert Murray after 1962

  • from Part I - Geographical, Institutional, and Interpersonal Contexts
  • Edited by Paul Devlin, United States Merchant Marine Academy, New York
  • Book:
    Ralph Ellison in Context
    Published online:
    14 January 2022
    Print publication:
    02 December 2021, pp 101-114

  • Summary

    This chapter explores the friendship between Ellison and the writer Albert Murray after 1962, commenting on Murray's personal and intellectual importance to Ellison in the 60s, the later distance that seems to have developed between them, and Murray's work on behalf of Ellison's legacy. It also illustrates the differences between them by exploring their differing approaches to critiquring Norman Mailer.

  • Introduction

  • Edited by Paul Devlin, United States Merchant Marine Academy, New York
  • Book:
    Ralph Ellison in Context
    Published online:
    14 January 2022
    Print publication:
    02 December 2021, pp 1-12

  • Summary

    This book is an attempt to situate Ralph Ellison’s dynamic life and work within appropriate contexts. Ellison (1913–1994) is best known as the author of the novel Invisible Man (1952), one of the most frequently taught and debated novels of the past sixty years, and secondarily as one of the finest American essayists. Through his essays he has become an influential theorist of culture and identity. Scholars have been unraveling the many mysteries of the sprawling novel that he worked on from the 1950s through 1994, called “The Hickman Novel” in this book, according to emerging convention.

  • Chapter 29 - Critical Reputation, 1994–2020

  • from Part IV - Reception and Reputation
  • Edited by Paul Devlin, United States Merchant Marine Academy, New York
  • Book:
    Ralph Ellison in Context
    Published online:
    14 January 2022
    Print publication:
    02 December 2021, pp 313-326

  • Summary

    Ralph Ellison's reputation as a major American writer has been secured in the past twenty-five years. This period has witnessed a remarkable resurgence in Ellison scholarship, stimulated partly by the availability of previously unpublished materials and the opening of The Ralph Ellison Papers in the Library of Congress. This chapter surveys major events and trends in Ellison studies since his death in 1994.

  • PRIORITIZING PATIENTS FOR ELECTIVE SURGERY: A Prospective Study of Clinical Priority Assessment Criteria in New Zealand

  • Sarah Derrett, Nancy Devlin, Paul Hansen, Peter Herbison
  • Journal:
    International Journal of Technology Assessment in Health Care / Volume 19 / Issue 1 / January 2003
    Published online by Cambridge University Press:
    22 January 2003, pp. 91-105

  • Objectives: Many hospitals in New Zealand have been using clinical priority assessment criteria (CPAC) to select and prioritize patients for access to publicly funded elective surgery. CPAC usually consist of clinical, patient-experienced, and social measures. The objective of this study was to determine how robust patient rankings were and the extent to which the patients selected were those who benefited the most from surgery.

    Methods: Patients prioritized for cataract (n = 101), prostate (n = 103), and hip or knee joint replacement (n = 137) surgery according to CPAC were assessed using the EQ-5D, SF-12, and condition-related patient-experienced health status measures before and after treatment. Correlations between the rankings of patients on the CPACs and the alternative instruments were explored.

    Results: For each surgery group, the CPAC ranking of patients was not strongly correlated with rankings obtained using their before-treatment EQ-5D (valued) profiles or the SF-12, although there was some correlation with rankings according to the condition-related measures. Improvements in the health status of patients who were operated on, as measured by the change in their EQ-5D values, were poorly correlated with equivalent changes on the SF-12 and condition-related measures. Patients' baseline health status according to the CPAC, the EQ-5D, and the SF-12 patient-experienced measures was only slightly related to the magnitude of benefit following surgery. The strongest predictors of improvement in health status were the baseline condition-related measures.

    Conclusions: The current method of prioritizing patients in New Zealand requires reconsideration, although a gold standard method for prioritization is not immediately apparent from these results.