Do Misconceptions about Health-Related Quality of Life Affect General Population Valuations of Health States?

Published:October 30, 2022DOI:
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      • Previous research conjectures that misconceptions about ill-health’s consequences for quality of life (QOL) may affect evaluations of health states by the general population.
      • We found that people who were given information on the QOL consequences of experiencing each health state evaluated, reported a higher relative preference for avoiding living with moderate anxiety / depression.
      • Our results show that providing information about QOL consequences of health states affects preferences, so policymakers may wish to consider supplementing existing QALY outcome measures with QALYs computed using general population preferences that are informed about the QOL consequences of health states.



      Healthcare resource allocation decisions are often informed by the expected gains in patients’ quality-adjusted life years (QALYs). Misconceptions about ill-health’s consequences for quality of life may however affect evaluations of health states by the general population and hence distort resource allocation decisions informed by QALYs. We examine whether people selectively misestimate the quality of life consequences of moderate anxiety / depression as compared to other dimensions of health, and we test whether informing people of actual changes in quality of life associated with health states changes appraisals of their relative undesirability.


      UK general population participants (N = 1259; in 2017) expressed preferences over moderate problems: of anxiety / depression, with self-care, of pain / discomfort. A randomized control trial design was used whereby a control group was given a functional description of each health state while two intervention groups were additionally given information on the actual differences in either life satisfaction (LS) or day affect (DA) associated with experiencing each health state.


      The LS (DA) group reported a higher preference for avoiding living with moderate anxiety / depression, being 13.4% (13.9%) more likely to choose it as most undesirable.


      Informing people of the change in LS or DA associated with health states before they appraise them is a feasible way to obtain informed preferences.


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