Generating utilities for the CS-Base: a novel, generic, and patient-centered health-outcome measure

OBJECTIVES: We have developed a new patient-centered, preference-based generic health-outcome measure, CS-Base, which is based on a novel multi-attribute preference response (MAPR) measurement framework. This study aimed to generate a first utility set for the CS-Base, making it suitable for use in health-economic evaluations.

METHODS: CS-Base comprises 12 health attributes: mobility, vision, hearing, cognition, mood, anxiety, pain, fatigue, social functioning, daily activities, self-esteem, and independence, each with four levels. Our methodology to generate utilities for the CS-Base was twofold. First, we derived coefficients from patient MAPR data to calculate CS-Base values. Subsequently, these were normalized to a 0.0-1.0 utility scale, where 0.0 signifies "dead". The "dead" position was estimated using general population data from a discrete choice experiment (DCE+Dead), using a "division value" strategy which localize the position of states better or worse than dead.

RESULTS: We analyzed MAPR data from 3,222 patients and DCE+Dead data from 1,995 respondents. All MAPR coefficients were negative, logically ordered, and significantly different from the reference level. The "dead" position was denoted by a division value of -148.385. Utility values spanned from -0.071 to 1.0, and only 53 of 16,777,216 states were deemed worse than dead.

CONCLUSION: This study introduced the first CS-Base utility set, underlining a two-step utility derivation method. This method, blending societal and patient views, surpasses traditional preference-based approaches, yielding firmer results. However, improvement of the normalization procedure is expected. Estimating CS-Base utilities is an ongoing process that gains precision over time.