Is it time to move beyond the QALY in vision research?
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Economic evaluation of health programs is the science of weighing the benefit of a health intervention against its cost. The metric used to evaluate this relationship is the incremental cost-effectiveness ratio (ICER), which represents the cost of each unit of effectiveness ‘‘purchased’’ through the health program. 1 For instance, if effectiveness of a medical treatment for diabetic retinopathy was measured in letters correct on an Early Treatment Diabetic Retinopathy Study (ETDRS) chart, an economic evaluation would compare the new intervention to the existing standard practice, estimating the difference in letters correct and the difference in cost. The cost-effectiveness of the intervention would be measured by dividing the difference in cost by the difference in letters correct, resulting in the ICER. The decision as to whether the intervention is ‘‘cost-effective’’ is based on comparing the ICER to the ‘‘willingness to pay’’ for that unit of effectiveness. If the ICER is less than the willingness to pay, the program would be adopted. 2 While this process is straightforward in theory, the problem in practice is that there are few payors who have established the willingness to pay for any unit of effectiveness – be it letters correct, lives saved, or cases screened. The notable exceptions to this are payors in Canada, the United Kingdom, and the European Union who established a standard willingness to pay for a quality-adjusted life year (QALY) gained through a health program. 3–5 The QALY is a composite measure in which a year lived is weighed by a value representing the quality of life enjoyed during that year. The metric used to estimate the quality of life associated with that year is a preference-based measure referred to as a utility. It is measured on a scale ranging from perfect health (1.0) to death (zero) 6 which, in theory, encompasses all possible health states. Therefore, a health-related utility elicited in this manner provides a common measure of effectiveness by which all health-related interventions might be judged and a standard willingness to pay for a QALY might be established. Estimating utilities in this fashion is a time consuming and cognitively difficult task for most study participants requiring that the respondent engage in a series of trade-offs in which they balance their desire for perfect health against a risk of death or
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.210 | 0.189 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.103 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it