The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) is planning to hold a workshop entitled """"""""Building a Pragmatic Road Forward: An ISPOR Consensus Development Workshop on the Future of the QALY."""""""" The quality-adjusted life year (QALY) is a utility-based measure used by outcomes researchers and healthcare professionals that combines gains or losses in both quantity and quality of life. It enables comparisons across diseases, populations, and programs, and thus is of use to decision-makers in assessing healthcare interventions. The use of the QALY, however, has been intensely debated. One school of thought argues that it is not an adequate measure on which to base decisions, primarily due to a paradigm shift from decision utility (which underlies the measure) to behavioral economics, which can provide a measurement of patients' direct experience rather than extrapolating from choices made, as QALY methodology does. This group urges researchers to formulate a better measure. Others counter that, despite its limitations, the lack of a simple better alternative makes the QALY very useful. Some researchers argue that the QALY should be retained and used pragmatically, but that a broader set of data should be developed as well. Finally, some researchers argue that, since outcomes research methods have arisen from different fields, the underlying assumptions need to be analyzed. ISPOR plans a two-day workshop during April 2007 at which thought leaders will discuss and debate 1) developing alternative paradigms and measures; 2) defining and refining the QALY via analyzing the assumptions underlying it; 3) retaining the QALY and maximizing additional methods; and 4) incorporating decision-makers' needs. The goal is establishing a thought leader consensus on these broad categories, with recommendations oriented toward specific, applicable action. A further, larger meeting open to the public would be developed from the consensus recommendations, as would papers for a state-of-the science summary in a peer-reviewed journal. The resulting research agenda would serve as a catalyst for 1) healthcare professionals who use the QALY; 2) those interested in using it in combination with other methods; and 3) those interested in moving beyond it. Relevance: The QALY is widely used in healthcare, but its use is the subject of intense debate. ISPOR's consensus development workshop would set a research agenda aimed at clarifying and expanding the issues. It would lead to further avenues of research, and have a major impact on the assessment of healthcare interventions. It will thus make enormous contributions both to research development and design and methodology. The QALY is widely used in healthcare, but its use is the subject of intense debate. ISPOR's consensus development workshop would set a research agenda aimed at clarifying and expanding the issues. It would lead to further avenues of research, and have a major impact on the assessment of healthcare interventions. It will thus make enormous contributions both to research development and design and methodology. ? ? ?
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