Valuing well-being alongside health: What can and should be done?

Health preferences inform resource allocation decisions around which treatments are recommended for use on the basis of their relative cost-effectiveness. Typically generic preference-based measures of health that can be applied across all conditions are used to generate quality adjusted life years (QALYs) to inform cost-effectiveness analyses. The QALY combines both quantity and quality of life by assigning a value to quality of life on a 0 (for states as bad as being dead) to 1 (for full health) scale where values below 0 indicate that the state is worse than being dead. A generic preference-based measure of health consists of: 1) a classification system that is used to describe the health of a person and 2) a value set that generates a utility value that reflects how good or bad people think living in the health state would be.

Recent research has focussed on widening the classification system used to measure health to capture aspects beyond health to focus on dimensions such as quality of life. This presents challenges for the methods used to elicit utility values as well as around the scope of the QALY itself and its role in informing cost-effectiveness analyses. This PhD will contribute to methodological developments and understanding in the area of eliciting preferences for states that combine both health and wellbeing and that may contain a large number of both overlapping and independent dimensions. The feasibility and appropriateness of different preference elicitation methods for use to value a widened classification system have not been fully explored.

The PhD will involve a literature review and primary research using a mixed methods approach involving both qualitative and quantitative research. In particular, the PhD will explore how discrete choice experiments (DCE) can be designed and undertaken to meet the challenges raised through a widened classification system including overlapping concepts and a large number of dimensions (potentially beyond the number that can be considered all at the same by a research participant). This will include both quantitative aspects of design alongside qualitative exploration of how participants undertake the DCE tasks, what influences their choices, and whether they understand the tasks. Towards the end of the project an online survey will be used to determine the feasibility of the use of DCE using a design building upon the findings from the qualitative research. In year 2 the student will visit Professor Deborah Street and Dr Richard Norman in Australia to collaborate around potential options for the DCE design and analysis. Deborah Street and Richard Norman will be advisers on the PhD project.

Aim of the research:
The PhD project will develop and assess discrete choice experiment (DCE) methods to value a large classification system that combines both health and wellbeing. The project will:
a) explore how discrete choice experiments (DCE) can be designed, framed, undertaken and analysed to meet the challenges raised through both a widened classification system including overlapping concepts of health and wellbeing and a large number of dimensions (potentially beyond the number that can be considered all at the same by a participant);
b) explore the anchoring of the DCE results onto the full health-dead 1-0 scale required to be able to generate quality adjusted life years;
c) assess (using qualitative research) whether participants are able to meaningfully complete and understand the proposed DCE tasks and that their responses are not influenced by the design;
d) undertake an online survey to determine the feasibility of the use of DCE in this context drawing on the qualitative work.

Entry Requirements:
Candidates must have a first or upper second class honors degree, and a Merit at masters or significant research experience in relevant subjects, for example economics, health economics or psychology.

How to apply:
Please complete a University Postgraduate Research Application form available here: www.shef.ac.uk/postgraduate/research/apply

Please clearly state the title of the studentship and the names of the supervisors, and select ScHARR as the department.

You will also need to include:
• a draft outline of your proposed PhD study, in line with the research described above, of approximately 500 words
• a covering letter explaining why you wish to apply for this studentship.
• a copy of your CV.