How adjusting elicited health utilities after the fact can adversely affect shared decision making

Background: The elicitation of inconsistent health-state utility values (HSUVs) is a prevalent problem. There are two approaches to address this problem: (1) intervention during the process ensure that patients estimate consistent HSUVs; (2) no and HSUVs adjusted after fact. This paper studies three models recently proposed for adjusting some may consider unrealistic. Analysis: analyzed using sound theoretical framework: mathematical equivalence elicited standard gamble probabilities, Fréchet bounds, preference theory. It proven none these accounts lower bound health conditions substitutes. Results: A clinical vignette proves may recommend treatments result in premature death over cause acceptable adverse effects. Conclusions: incorrect mislead physicians poor medical decisions. In spirit shared decision making, should be given opportunity reassess confirm revised reflect their preferences.