Time and lexicographic preferences in the valuation of EQ-5D-Y with time trade-off methodology

Stefan A. Lipman*, Liying Zhang, Koonal K. Shah, Arthur E. Attema

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
18 Downloads (Pure)


In the valuation of EQ-5D-Y-3L, adult respondents are asked to complete composite time trade-off (cTTO) tasks for a 10-year-old child. Earlier work has shown that cTTO utilities elicited in such a child perspective are generally higher than when adults take their own perspective. We explore how differences in time preference in child and adult perspectives could explain this effect. Furthermore, as cTTO valuation in a child perspective involves explicit consideration of immediate death for a child, we also consider how cTTO utilities could be affected by decision-makers lexicographically avoiding death in children. We report the results of an experiment in which 219 respondents valued 5 health states in both adult and child perspectives with either a standard cTTO or a lead-time TTO only approach, in which immediate death is less focal. Time preferences were measured in both perspectives. Our results suggest that utilities were lower when lead-time TTO, rather than cTTO, was used. We find large heterogeneity in time preference in both perspectives, with predominantly negative time preference. The influence of time preferences on utilities, however, was small, and correcting for time preferences did not reduce differences between utilities elicited in both perspectives. Surprisingly, we found more evidence for differences in utilities between adult and child perspectives when lead-time TTO was used. Overall, these results suggest that time and lexicographic preferences affect time trade-off valuation in child and adult perspectives, but are not the explanation for differences between these perspectives. We discuss the implications of our findings for EQ-5D-Y-3L valuation.

Original languageEnglish
Pages (from-to)293-305
Number of pages13
JournalEuropean Journal of Health Economics
Issue number2
Publication statusPublished - 1 Mar 2023

Bibliographical note

Funding Information:
Koonal Shah is member of the EuroQol Group. Stefan Lipman, Arthur Attema, and Koonal Shah have received funding from the EuroQol Research Foundation for research outside the current manuscript.

Publisher Copyright:
© 2022, The Author(s).


Dive into the research topics of 'Time and lexicographic preferences in the valuation of EQ-5D-Y with time trade-off methodology'. Together they form a unique fingerprint.

Cite this