It seems like an important crux in your analysis is quantifying the intensity of CH.
I’d like to point out that QALYs as a metric is not mentioned here. In the QALY-paradigm, the utility weights are anchored at 1 = full health and 0 = dead. Importantly, negative utility weights are also theoretically possible. For example, an utility weight of −10.0 would imply that removing one person-year of CH would be equivalent to 11 QALYs (which is equivalent to the absolute prognosis loss for one person with chronic migraine, according to one random report from the Norwegian Medical Products Agency i just dug up). However, current methods for eliciting negative values are imprecise and somewhat arbitrary. I’ve been thinking about whether developing better metrics within the QALY paradigm can be useful, since it is more widely adopted. CHs would be the perfect example case. Curious to hear if you have any thoughts on this.
Actually, someone else brought up this point separately, so I agree there’s more to say here. I’d love to dig deeper into this question and possibly write a paper on the topic (e.g. for this collection). If you have literature to recommend (either by you or otherwise), please send it my way. And also let me know if you’d like to get involved in such a project. :)
Thank you for a very interesting read.
It seems like an important crux in your analysis is quantifying the intensity of CH.
I’d like to point out that QALYs as a metric is not mentioned here. In the QALY-paradigm, the utility weights are anchored at 1 = full health and 0 = dead. Importantly, negative utility weights are also theoretically possible. For example, an utility weight of −10.0 would imply that removing one person-year of CH would be equivalent to 11 QALYs (which is equivalent to the absolute prognosis loss for one person with chronic migraine, according to one random report from the Norwegian Medical Products Agency i just dug up). However, current methods for eliciting negative values are imprecise and somewhat arbitrary. I’ve been thinking about whether developing better metrics within the QALY paradigm can be useful, since it is more widely adopted. CHs would be the perfect example case. Curious to hear if you have any thoughts on this.
Thanks so much for your comment!
Actually, someone else brought up this point separately, so I agree there’s more to say here. I’d love to dig deeper into this question and possibly write a paper on the topic (e.g. for this collection). If you have literature to recommend (either by you or otherwise), please send it my way. And also let me know if you’d like to get involved in such a project. :)