Cost-effectiveness and cost-utility analysis (CEA/CUA) is increasingly used for clinical and policydecision making in health and medicine. Utilities are critical inputs to economic analyses, providing theweighting factor for the common outcome measure 'quality adjusted life years.' The accuracy and validity ofmeasurement and application of utility measures are essential to producing meaningful and informativeresults from such analyses. The proposed research will provide insight to understand the appropriate useand application of existing utility measurement methods, and to guide the development of improvements andalternatives. It will focus on cancer, a disease for which quality of life effects are of particular importance inclinical decision making and policy. The research proposes a series of studies to investigate the measurement of utilities, to explore theapplication of utilities, and to develop guidelines for improvements in utility assessment methodology. Thefirst study will employ survey research and process tracing methods to identify cognitive factors that createbiases in utility assessment methods, and develop and test modifications to avoid such biases. The secondstudy will determine whether utilities vary systematically by individuals' age, race and gender using metaanalytic techniques. The research will culminate in recommendations for the use of existing utilitymeasurement methods and values, and the construction of a framework for the development of newmethods to value health. A useful by-product of the research will be estimates of utility values for cancerhealth states for use by CEA/CUA and other applied researchers. The candidate has studied preference and utility assessment methods and their application in herdissertation, post-doctoral research, and current position as Instructor at Massachusetts General Hospitaland Harvard Medical School. She is beginning a career as a quality of life methodologist, focusing oncancer interventions. This career development award would contribute to the initiation of her independentresearch agenda. She will be guided in her career development by the Director of her department, the MGHInstitute for Technology Assessment, as well as senior researchers in this field who have establishedworking relationships with the candidate (including her dissertation and post-doctoral advisors). She hasstrong institutional support and faculty mentorship to guarantee her success in the proposed research.
