Talk:Quality-adjusted life year

message: What does this have to do with philosophy? I could draw a connection if forced, but...--Chinawhitecotton 07:50, 21 February 2006 (UTC)
thread_title: Why Philosophy?

message: This article deals with a concept in economics, not medicine or philosophy. Healthcare planners use these to estimate resource allocation. It is rarely used in resolving ethical dilemmas in health care, except on the large-scale planning (economic) level.~~ —The preceding unsigned comment was added by 142.161.33.142 (talk) 14:02, 4 May 2007 (UTC)
thread_title: Wrong categorization

message: "The meaning and usefulness of QALY is debated."
I think we should put an emphasis on QALY, that it is a VERY simple "tool/model" for measuring quality (in life, of health etc). 
A simple tool can never become extremely complex/sophisticated, it just stays simple and helps trying to compare information - in this case QALY data of different i.e. humans. :)  —Preceding unsigned comment added by 80.108.103.172 (talk) 03:14, 27 September 2007 (UTC)
thread_title:  Debate 

message: I believe QALYs were originally derived from a table which summarised the valuations a group of healthy people gave to various combinations of pain and mobility. Some such states were regarded as "worse than death" and so gained negative values. This reflects the common remark, "I'd rather be dead than in a wheelchair!" which results in the lives of disabled people being valued less by healthcare economists than those of the mobile and pain-free. I think hospital patients and professionals working with disabled people turned out to have similar values. The original work was led by Rachel Rosser, a professor of psychiatry in London, in the 1980s. I can't lay hands on the reference just now. NRPanikker 07:48, 2 October 2007 (UTC)
thread_title:  Rosser & Kind Matrix 

message: I've added the following comment :
QALYs may also be inherently biased against older people who have fewer expected years of life.  Many people
may object to the implicit assumption that saving a younger person's life is worth many times that of
saving an older person's life.  At least, this implicit assumption should be made clear whenever QALYs are the
basis for scarce resource allocation.  QALYs therefore also violate the Pareto improvement principle which
is at the core of all modern microeconomics, because QALYs inherently make interpersonal utility comparisons and
therefore rely on "greater good" arguments rather than efficiency and mutual gain arguments for its 
theoretical underpinnings.
This comes from my understanding of QALYs from my past reading and reflection on this modeling approach.
I do not have a reference for this material, since it comes from inference based on the model's definition.
It is quite likely that someone out there (or perhaps many) have come up with similar critiques and published
them.  I would appreciate if you could add some references for this section if you have found some.
I would also appreciate if you could email me at ghol7955@gmp.usyd.edu.au with this info.
Thank you.           - G. Holt  —Preceding unsigned comment added by 115.69.9.11 (talk) 05:06, 11 April 2009 (UTC)
thread_title:  Added discussion on the implicit underlying interpersonal utility assumptions in QALYs 

message: Is this pronounced "Q-A-L-Y" or like a word, "kwa-lee" or "kay-lee" or some such? - Jieagles (talk) 21:08, 15 July 2009 (UTC)
replies: text: This article asserts that it's "quolly".  WhatamIdoing (talk) 20:28, 12 August 2009 (UTC)
replies: text: How you pronounce a new word depends on how you pronounce everything else. If, as you say it, "quality" sounds like "kwa-lit-ee," then "QALY" might well be "kwa-lee." But if your "quality" resembled "quolly-tee" then your "QALY" could be "quolly." NRPanikker (talk) 00:48, 13 August 2009 (UTC)
thread_title:  Pronounciation? 

message: Before I embark on modifications, and I think the article is generally quite good, I draw attention to, and thus solicit input regarding, these issues:
1. The first (definition) sentence of this article is technically wrong. It's kind of close to right, but it needs correction, and should correspond to the two good refs that accompany it. This is not hard to do.
2. The article presently lacks international perspective, I think showing an overly UK-centric approach, and would benefit from, amongst others, German and US perspectives. This is not hard to do.
3. Both preventive care and care that avoids complications can be conceptualized as preventing loss of quality of health, so the present linguistic notion I perceive in the article that only actual "improvement" can be "captured" in QALY needs gentle expansion to allow for this (for the "prevention of loss"). This is not hard to do.
4. The QALY concept is the "standard" metric in the field, but as the article presently points out, the scoring systems for "what is Q" is often highly subjective, and has been shown to be dissimilar between different diseases or conditions, and between different "tester populations," impacting cost considerations by factors of as much as 10-fold (obviously very significant!) I agree with the tag that indicates that refs to high quality, secondary sources that are easily accessible and understandable is needed. A brief encyclopedic approach to this would not be too hard on my QALY either.
So, if someone wants to get on with these edits that's great, or if there is some initial input that other editors want to make, I am holding off any edits for, say, 2-3 weeks, but I am then going to get into it.FeatherPluma (talk) 22:42, 5 April 2011 (UTC)
thread_title:  Proposed edits 

message: It would be helpful if some actual examples of QALY values were included. For example what is the QALY (adjustment factor) corresponding to: 1) partial blindness, 2) total blindness, 3) Loss of a leg, 4) Loss of an arm, 5) Contracting Type 2 diabetes, etc. (Sorry to be gruesome, but this seems to be inherent to the topic). I assume there is considerable variation in the estimation of these (inherently subjective) values, so that can also be illustrated and addressed. Thanks! --Lbeaumont (talk) 02:34, 21 May 2016 (UTC)
replies: text: Good suggestion. I think this would be very helpful to somebody new to the concept. A number of meta-analyses of health state utility values for certain conditions have been carried our recently; I would advise that these be used as sources. --ChrisSampson87 (talk) 11:14, 21 May 2016 (UTC)
replies: text:  I found a reference that gives figures for HIV and HCV. See: http://www.health.gov.au/internet/publications/publishing.nsf/Content/illicit-pubs-needle-return-1-rep-toc~illicit-pubs-needle-return-1-rep-5~illicit-pubs-needle-return-1-rep-5-3  It seems there are several published papers on the topic of QALY League Tables, which seems to be related. --Lbeaumont (talk) 19:10, 21 May 2016 (UTC)
replies: text:  Another good reference is at: https://research.tufts-nemc.org/cear4/Resources/LeagueTable.aspx  but the most comprehensive information seems to be only available to their sponsors.--Lbeaumont (talk) 19:22, 21 May 2016 (UTC)
thread_title:  Including some example values 

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thread_title:  External links modified 

message: I think the calculation uses 1 and negative or 0 to calculate the quality of life lived but i will double check my source tomorrow and come back.  W;ChangingUsername (talk) 21:34, 22 May 2024 (UTC)
thread_title:  Calculation