DEVELOPING AND TESTING A MULTIMEDIA PRESENTATION OF A HEALTH-STATE DESCRIPTION

Quality-adjustment weights for health states are an essential componen t of cost-utility analysis (CUA). Quality-adjustment weights are obtai ned by presenting large numbers of subjects with multiattribute descri ptions of health states for rating. Comprehending multiattribute healt h states is a difficult task for most respondents. The authors hypothe sized that multimedia (MM) presentation using computers might facilita te this task better than would a paper-based text (Text). To test this hypothesis, they developed closely matched MM and Text descriptions o f health states in the first-person narrative style, and developed a m ethod of testing the presentation of a health state. Subjects were ran domized to exposure to either MM or Text and subject recall of the hea lth state and recognition of features of the health state were tested. How well defined the preferences of the subjects were after each pres entation method was assessed by having the subjects mark on a double-a nchored visual-analog scale the ''best'' and ''worst'' they believed t he quality of life in the health state might be. MM subjects had bette r recall (11.85 vs 9.44 of a total of 24 meaning units, p = 0.098) and better recognition (4.71 vs 4.22, p = 0.08). The average interval bet ween the ''best'' and ''worst'' ratings was shorter for the MM subject s (2.19 cm vs 3.26 cm, p = 0.12). The results suggest that: 1) MM pres entation results in better recall and recognition, indicating better t ransfer of information; 2) MM presentation appears to result in better definition of preferences (a smaller preference interval), suggesting better integration of information into subject preference; and 3) rec all and recognition testing of a health-state description can identify material in the description that has an unintended impact on the resp ondents.