Probability weighting and utility curvature in QALY-based decision making

Quality-Adjusted Life-Years (QALYs) are currently the most important utilit y model in medical decision making. QALYs are calculated by adjusting years of life for the utility of the health state in which these years are spent . For normative reasons the standard gamble is the preferred method to meas ure health state utilities, but concern exists about its descriptive proper ties. Recent theoretical work has suggested that probability weighting can explain anomalies in standard gamble measurement. This paper shows that app lying probability weighting in standard gamble measurement increases the co nsistency of QALYs with individual preferences. The consistency of QALYs wi th individual preferences is not significantly increased further if utility curvature is also taken into account. (C) 1999 Academic Press.