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Using Time Trade-Off Methods to Elicit Short-Term Utilities Associated with Treatments for Bulbar Urethral Stricture

Lookup NU author(s): Dr Jing Shen, Dr Matthew Breckons, Professor Luke ValeORCiD, Rob Pickard



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Recurrent urethral stricture is usually treated with either open urethroplasty or endoscopic urethrotomy. Both of the procedures cause short-term utility loss, which may not be captured by standard utility questionnaires due to the challenges of completing a standard instrument at the time of an acute episode of short duration, especially within a clinical trial setting. We propose to use time trade-off (TTO) methods to estimate these short-term utility losses.OBJECTIVE:The aim was to compare the use of two alternative TTO methods to elicit patients' short-term utilities following surgical treatments for recurrent urethral stricture.METHOD:Two variants of TTO (chained and conventional) were used. Six health profiles were developed-three for each procedure. Forty participants took part, with 20 randomly allocated to each TTO method.RESULTS:Thirty-eight participants provided usable data for analysis. Estimated utility values decreased as the severity of the health profiles increased. There was no evidence that utility values differed between elicitation methods or procedures for mild {ranging from 0.79 (standard deviation [SD] 0.17) to 0.83 [SD 0.20]} and moderate (ranging from 0.54 [SD 0.24] to 0.67 [SD 0.21]) health states, although they appeared to differ for severe health states (ranging from 0.29 [SD 0.20] to 0.56 [SD 0.24]).CONCLUSION:The study demonstrates the feasibility and value of eliciting patients' short-term utilities. Given the small sample size, the study findings are tentative. Further research with a larger sample size is needed to determine the appropriate TTO method to use and how the elicited utilities can be used in combination with standard cost-utility assessments to aid decision making.

Publication metadata

Author(s): Shen J, Breckons M, Vale L, Pickard R, OPEN Trial Investigators The

Publication type: Article

Publication status: Published

Journal: PharmacoEconomics - Open

Year: 2019

Volume: 3

Pages: 551–558

Print publication date: 01/12/2019

Online publication date: 25/06/2019

Acceptance date: 19/03/2019

Date deposited: 27/08/2019

ISSN (electronic): 2509-4254

Publisher: Adis International Ltd.


DOI: 10.1007/s41669-019-0133-4


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