Grant: CIHR Fellowship

Difficult decisions about the provision of health care treatments are unavoidable in a modern society where resources are limited; seeking value for money from the public purse is a clear social objective. To make decisions about the allocation of health care resources across many competing demands, measurements of health benefit need to ensure that comparisons can be made across medical specialties. This notion of a 'common currency' allows, for example, the benefits of cancer therapies to be legitimately compared to management strategies for low back pain. A key question within the discipline of economics is how to value such benefits. Currently, the common standard for valuing benefit for the purposes of resource allocation combines survival (whether you are alive or not) and quality of life within a single measure. Survival is a relatively simple concept because an individual is either alive or dead; measurement of quality of life is the more complicated component, and the focus of my research. A review of existing literature has shown that the spinal cord research community has been slow to embrace current quality of life measures suitable for economic evaluation. Typically, comparing alternative validated measures within the same group of individuals is highlighted as a necessary area of research within particular clinical conditions. However, for people with spinal cord injuries, this is premature because of the alarming lack of evidence that exists. Accordingly, my research begins with focus groups, with SCI patients, to explore the suitability of all available instruments. This will enable an evidence-based judgment to be made as to which measures are subsequently considered for empirical, quantitative evaluation in order to identify the instrument best suited to capture the benefits of health care that are valued by individuals with spinal cord injury.