Write a reflection of a research assignment

Econ 317 Group Assignment 4

· Health condition and describe:

The main goal of our group is to do health intervention for the elder people aged 75 years and over, so it is mainly aimed at the senile diseases. We chose senile pneumonia this time. This is a temporary disease. Clinical manifestations are atypical, such as insidious onset, often without cough, expectoration, fever, chest pain and other symptoms. More common symptoms are increased breathing frequency, shortness of breath or dyspnea. On the contrary, systemic toxic symptom is more common and can appear early, including spirit flagging, lack of power, loss of appetite, disgusting vomiting, fast heart rate, wrong rhythm of the heart, delirium, ambiguous consciousness, heavy blood pressure drops and coma. Based on the data from 1988 to 2002, for influenza and pneumonia hospitalizations in Ontario, females had an average annualized peak rate of 250/100 000 compared to 400/100 000 for males. (Eric, et al.,2004) in 2016, the death rate of for influenza and pneumonia in Canada is 17.2%. (Statista, 2019) As can be seen, senile pneumonia can lead to hospitalization and even death.

Reference:

ER IC J. CR IGHTON, et al. (2004). Influenza and pneumonia hospitalizations in Ontario: a time-series analysis. Epidemiol Infect. 132, 1167–1174.

Statistic. (2019). Influenza and pneumonia death rate Canada 2000-2016 .Retrieved March 22, 2019, from https://www.statista.com/statistics/434445/death-rate-for-influenza-and-pneumonia-in-canada/

· Questionnaire

As the interviewees are all Chinese, the questionnaires are provided in Chinese in interviews. After the visit, the result is rewritten in the English electronic version of the document.

· Relevant rating list:

Table 1

· QALY list:

Table 2

· QALY calculations:

· Visual scale measurement

QALY = (LH – L0)/(L1 – L0)

For No.1, LH=0.38, L0=0, L1=1.

QALY=0.38

· Standard Gamble

For temporary health condition,

p + S x (1 – p) = H

H=QALY(heartburn)=0.82

For

p=0.7

S=(H-p)/(1-p)=0.4

· Time trade-off

H = 1 - A/B x (1 – S)

S=QALY(heartburn)=0.82

A=one week

For No.1

B=0.3*one week

H=1-1/0.3*(1-0.82)=0.4

Following the same method, the QALY for the left 4 perople:

· Discussion:

1. Were your QALY values close together or far apart?

According to Figure, we can say QALY values were far apart.

Figure 1

2. Did one method (SG or TTO) provide consistently higher or lower QALY values than the other? If so, how do you explain it?


Standard gamble provides consistently higher QALY values than visual scale measurement. In visual scale measurement, people's discomfort about pneumonia was actually very vague, and they may have randomly selected a value within a large acceptable range. It could be that standard gamble, with heartburn as a reference, gave people a clearer sense of the discomfort of pneumonia.

3. Do you think your interviewee’s characteristics affected the QALY measures? If so, which ones, and how? (e.g. Age, Gender, Cultural Background, whether they’d experienced the health state before)


Table 3

All interviewees are Chinese. Only No.3 had experienced pneumonia before.

According to the above summary table, we can see that no observed characteristics affects QALY significantly.

4. If you were to do this assignment again, what would you change to improve the reliability of your results?

We hope to collect more samples. We also plan to collect more detailed information on the basic information and characteristics of the interviewees.

· Summary

According to Table 2, we can see that the QALY values provided by different method vary a lot, so that different ways of interview will cause different psychological feelings and cognition. For the same measurement method, visual scale measurement and standard gamble both provide relatively centralized QALY values, although there is a deviation value. However, the QALY values obtained by time trade-off method are scattered, especially there are negative values. Negative values stand for more uncomfortable than death, which we think is unreasonable. Therefore, we believe that time trade-off is not effective in this application. Standard gamble provides heartburn as a reference, so we think people have a clearer understanding of the discomfort of pneumonia under this interview method, compared with visual scale measurement. All above, standard gamble is the most effective method in this application.

QALY