Validating holistic scoring for writing assessment

The response numbers for different questions are simply added and the total number rescaled so that the instrument score varies between 0-1 or 0-100. Typically cost utility analysis ranks programs by comparing the dollar cost per QALY obtained in the different programs of interest.In principle, a dollar value could be attached to each QALY and dollar costs compared with dollar benefits (thereby converting 'cost utility analysis into cost benefits analysis). Cost effectiveness and cost utility analysis were introduced specifically to avoid the need to place a dollar value upon life per se.

The result of an economic evaluation can be no better than the rigor of the clinical/epidemiological evaluation upon which it is based. Each of these allows people to express the strength of their preference for a health state relative to death and good health.

The assumptions employed in measuring QALYs are (or should be) transparent and may be subject to sensitivity analysis.

However the most compelling reason for using QALYs is that there is no alternative approach to combining the length and quality of life.

The purpose of cost utility is to rank the overall program and not to provide advice to clinicians or program managers about individuals. This could occur if participants in a study completed the AQo L before and after an intervention.

The difference between the obtained scores would provide a measure of the effect size of the program.

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When a decision is finally made relating to the funding or not of a program an implicit or explicit importance weight will have been applied to the length of life and the quality of life. MAU and other QALY instruments have nothing to do with costs.

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