Health utility bias: A meta-analytic evaluation

A common assertion is that rating scale (RS) values are lower than both standard gamble (SG) and time tradeoff (TTO) values. However, differences among these methods may be due to method specific bias. While SG and TTO suffer systematic bias, RS responses are known to depend on the range and frequency of other health states being evaluated. Over many diverse studies this effect is predicted to diminish. Thus, a systematic review and data synthesis of RS-TTO and RS-SG difference scores may better reveal persistent dissimilarities. PURPOSE: To establish through systematic review and meta-analysis the net effect of biases that endure over many studies of utilities.