Valuing Treatments for Parkinson Disease Incorporating Process Utility: Performance of Best-Worst Scaling, Time Trade-Off, and Visual Analogue Scales

Marieke G.M. Weernink*, Catharina G.M. Groothuis-Oudshoorn, Maarten J. Ijzerman, Janine A. Van Til

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Scopus)
8 Downloads (Pure)


Objective The objective of this study was to compare treatment profiles including both health outcomes and process characteristics in Parkinson disease using best-worst scaling (BWS), time trade-off (TTO), and visual analogue scales (VAS). Methods From the model comprising of seven attributes with three levels, six unique profiles were selected representing process-related factors and health outcomes in Parkinson disease. A Web-based survey (N = 613) was conducted in a general population to estimate process-related utilities using profile-based BWS (case 2), multiprofile-based BWS (case 3), TTO, and VAS. The rank order of the six profiles was compared, convergent validity among methods was assessed, and individual analysis focused on the differentiation between pairs of profiles with methods used. Results The aggregated health-state utilities for the six treatment profiles were highly comparable for all methods and no rank reversals were identified. On the individual level, the convergent validity between all methods was strong; however, respondents differentiated less in the utility of closely related treatment profiles with a VAS or TTO than with BWS. For TTO and VAS, this resulted in nonsignificant differences in mean utilities for closely related treatment profiles. Conclusions This study suggests that all methods are equally able to measure process-related utility when the aim is to estimate the overall value of treatments. On an individual level, such as in shared decision making, BWS allows for better prioritization of treatment alternatives, especially if they are closely related. The decision-making problem and the need for explicit trade-off between attributes should determine the choice for a method.

Original languageEnglish
Pages (from-to)226-232
Number of pages7
JournalValue in Health
Issue number2
Publication statusPublished - Mar 2016
Externally publishedYes

Bibliographical note

Funding Information:
Source of financial support: This study was funded by ZonMw, the Netherlands Organization for Health Research and Development (grant no. 80-82500-98-11234). Besides the initial review process before funding and amendments, ZonMw did not have any involvement in the study design, management of the study, data analysis, writing, and publications. All researcher activities were independent of the funding source.

Publisher Copyright:
© 2016 Published by Elsevier Inc. on behalf of International Society for Pharmacoeconomics and Outcomes Research (ISPOR).


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