Correcting biases in standard gamble and time tradeoff utilities

Med Decis Making. 2004 Sep-Oct;24(5):511-7. doi: 10.1177/0272989X04268955.


The standard gamble (SG) method and the time tradeoff (TTO) method are commonly used to measure utilities. However, they are distorted by biases due to loss aversion, scale compatibility, utility curvature for life duration, and probability weighting. This article applies corrections for these biases and provides new data on these biases and their corrections. The SG and TTO utilities of 6 rheumatoid arthritis health states were assessed for 45 healthy respondents. Various corrections of utilities were considered. The uncorrected TTO scores and the corrected (for utility curvature) TTO scores provided similar results. This article provides arguments suggesting that the TTO scores are biased upward rather than having balanced biases. The only downward bias in TTO scores was small and probably cannot offset the upward biases. TheTTOscores are higher than the theoretically most preferred correction of the SG, the mixed correction. These findings suggest that uncorrected SG scores, which are higher than TTO scores, are too high.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arthritis, Rheumatoid / psychology
  • Arthritis, Rheumatoid / therapy*
  • Bias*
  • Choice Behavior
  • Gambling
  • Health Status Indicators*
  • Humans
  • Life Expectancy
  • Models, Statistical*
  • Patient Acceptance of Health Care*
  • Probability*
  • Quality-Adjusted Life Years*
  • Reproducibility of Results
  • Risk Assessment / methods*
  • Risk-Taking