The importance of accounting for the uncertainty around the preference-based health-related quality-of-life measures value sets: a systematic review

Preference-based measures of health-related quality-of-life including, but not limited to, the EQ-5D, HUI2 and the SF-6D have been increasingly used in calculations of quality-adjusted life years for cost effectiveness analyses. However, the uncertainty around the measures’ value sets is commonly ignored in economic evaluation. There are several types of uncertainties, including methodological, structural, and parameter uncertainties, with the latter being the focus of this review paper. The objective is to highlight the gap in the literature regarding the existence of uncertainty in the value sets, focusing mainly on the EQ-5D and SF-6D. To the best of the authors’ knowledge, this is the first systematic review revolving around uncertainty. After searching extensively for studies involving uncertainties in all preference-based measures, the results showed that uncertainty has been approached through different means, while parameter uncertainty has been ignored in most, if not all, cases. These findings suggest that uncertainty should be accounted for when using preference-based measures in economic evaluations. Ignoring this additional information could impact misleadingly on policy decisions.     

Crises, Volatility, and Growth

How do volatility and liquidity crises affect growth? When creditis constrained, a bias toward short-term debt can arise in financinglong-term investments, generating maturity mismatches and leadingpotentially to liquidity crises. The frequency of liquiditycrises ("abnormal" volatility) and the volatility of growth("normal" volatility) are found to have independent negativeeffects on growth. Financial development however dampens thegrowth cost of volatility, but only in the case of normal volatility.The growth cost of volatility therefore depends critically onthe composition of normal and abnormal volatility, the latterbeing more costly for growth.