How are health-state utilities typically measured (which instruments are used)?

• A. Utilities are derived from life expectancy data.
• B. Utilities are measured by patient satisfaction surveys.
• C. Utilities are assigned by expert opinion.
• D. Utilities are derived from instruments like EQ-5D, HUI, or SF-6D that assign preference-based scores.

Answer: (D)

Health-state utilities are quantified through standardized preference-based instruments. These tools—such as EQ-5D, HUI, and SF-6D—describe a health state across multiple dimensions (like mobility, pain, anxiety, etc.) and then attach a utility value to that state based on population- or patient-derived preferences. The scores come from valuation methods (time trade-off, standard gamble, or similar techniques) that translate how much people value different health outcomes into a single number, typically between 0 (death) and 1 (perfect health), with some states valued as worse than death in extreme cases. These instruments provide consistent, comparable utility measurements needed for cost-utility analyses and calculating QALYs. Other options miss this standard approach: life expectancy data reflect quantity of life but not quality; patient satisfaction surveys capture satisfaction rather than health-state preferences; expert opinion lacks the broad, standardized valuation that these instruments provide.