Richard Norman

• PhD (Health Economics)
• Professor (Associate) at Curtin University

Background Women’s empowerment directly influences the quality and timeliness of the maternal health care they receive; a lack thereof, particularly in low- and middle-income countries (LMICs), is likely to contribute to poor uptake of maternal healthcare. We aimed to evaluate the role of women's empowerment in maternal healthcare in LMICs. Method...

Background Discrete choice experiment (DCE) methods are an increasingly popular valuation method, particularly for the EQ-5D-5L. While EQ-5D-5L value sets developed using DCE have traditionally assumed linear time preferences, this assumption has been challenged. This has led to the development of DCE modelling methods that allow for nonlinear time...

The Quality of Life (QoL) Utility measure, QLU-C10D, is derived of the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire, QLQ-C30. Based on the cancer-specific nature, the QLU-C10D is expected to be sensitive and responsive in lung cancer patients.This retrospective analysis used data from four international lung...

The Quality of Life Utility – Core 10 Dimensions (QLU-C10D) is a disease-specific preference-based measure (PBM) designed to obtain health state utility values from patients with cancer. Previously, satisfactory psychometric properties were established from retrospective trial analyses using clinical anchors. This study aimed to validate the QLU-C1...

This systematic review examines how different perspectives influence the valuation of child health-related quality of life (HRQoL). Specifically, it explores differences in values when health states are assessed by children, adolescents, or adults (or some combination of these), from the perspective of the first person (self) or the third person (o...

Objective Myasthenia gravis is a chronic neuromuscular disease that causes weakness. It’s uncertain whether generic health instruments can adequately capture its impact. This study aimed to develop a scoring system to generate utility values for all health states defined by the myasthenia gravis quality of life 6-dimension (MGQoL-6D) classification...

Aims Since 2016, more than one million new patients with chronic health conditions have been prescribed medicinal cannabis in Australia. We aimed to assess overall health-related quality of life (HRQL), pain, fatigue, sleep, anxiety, depression, and motor function in a large real-world sample of patients prescribed medicinal cannabis. We previously...

Introduction: Comparison of patient health-related quality of life (HRQOL) scores to a reference group is needed to quantify the HRQOL impact of disease or treatment. This study aimed to establish population norms for 2 HRQOL questionnaires—EuroQol 5-dimension 5-level questionnaire (EQ-5D-5L) and European Organisation for Research and Treatment of...

Current measurement systems focus mostly on health, and not on multiple constructs of quality of life outcomes (for example health and social outcomes) together. This means we don’t capture all that is of value to those receiving treatments, and to society more broadly. Recent research has explored how to extend the quality adjusted life year (QALY...

Introduction Discrete choice experiments (DCEs) are increasingly applied to develop value sets for health-related quality-of-life instruments, but respondents may adopt various simplifying heuristics that affect the resulting health state values. Attribute level overlap can make these DCE tasks easier and thereby increase respondent engagement. Thi...

Providing health-related quality of life (HRQoL) value sets to enable estimation of quality adjusted life years (QALYs) is important in facilitating economic evaluation and in supporting reliable decision-making about healthcare. However, as the field matures, many value sets across a range of HRQoL instruments are now old, based on potentially out...

Objectives Standard economic evaluation methods assume that quality-adjusted life years (QALYs) have equal social value, regardless of recipient. However, evidence suggests that people place greater social value on health gains for children. This study examines the factors driving age-related preferences for health gains. Methods Think-aloud, semi-...

Background Traditional birth attendance (TBA) remains common in Sub-Saharan Africa (SSA), impacting maternal and neonatal mortality rates. This study aimed at producing high-resolution geospatial estimates and identifying predictors of TBA-assisted childbirth in SSA. Methods We used the latest Demographic and Health Survey (DHS) data (2012–2023) f...

Purpose The Functional Assessment of Cancer Therapy General (FACT-G) questionnaire is frequently used to assess health-related quality of life (HRQOL) in cancer patients. However, data obtained using the FACT-G cannot be directly used to calculate quality-adjusted life years (QALYs). The newly developed FACT Eight Dimensions (FACT-8D) is a preferen...

Introduction Ghana’s reference case, developed to guide the conduct of economic evaluation as part of health technology assessment (HTA) guidelines, recommends the conduct of cost–utility analysis using outcomes such as quality-adjusted life years (QALYs). There is no national value set available for the Ghanaian population to be used in estimating...

Background The reasons why women seek assistance from non-healthcare providers during childbirth, despite having received antenatal care (ANC), remains unclear. This study aimed to identify the determinants and geographic variations of non-healthcare provider-assisted childbirth among women who received antenatal care (ANC) in Ethiopia. Methods We...

Introduction Many health economic evaluations rely on the validity of the utility measurement for health-related quality of life (HRQoL). While generic utility measures perform well in HRQoL assessments of many diseases and patient populations, appropriateness for cancer-specific disease burdens needs attention and condition-specific measures could...

Introduction Prevention of mother-to-child transmission contributes to avert nearly 4000 new HIV infections in 2022. HIV testing and counselling (HTC) during antenatal care (ANC) is an effective strategy to reduce the vertical transmission of HIV. While the utilisation of HTC services in Ethiopia has been explored, there is limited evidence explori...

Purpose This study aimed to develop utility weights for the European Organization for Research and Treatment of Cancer (EORTC) QLU-C10D, a cancer-specific utility instrument, tailored to the Norwegian and Swedish populations. The utility weights are intended for use in the specific welfare contexts of Norway and Sweden to support more precise healt...

Background: Health economic appraisals often rely on the assessment of health utilities using preference-based measures (PBM). The cancer-specific PBM, European Organisation for Research and Treatment of Cancer Quality of Life Utility - Core 10 Dimensions (EORTC QLU-C10D), was developed recently, and now needs to be validated in various clinical po...

The aim of the study was to develop and compare utility value sets for the EORTC QLU-C10D, a cancer-specific utility instrument based on the EORTC QLQ-C30, using the preferences of the general public and cancer patients in Singapore, and to assess their measurement properties. A total of 600 individuals from the general public were recruited using...

Objective The aim of this study is to provide Chinese utility weights for the European Organization for Research and Treatment of Cancer Quality of Life Utility Measure-Core 10 Dimensions (EORTC QLU-C10D) which is a preference-based cancer-specific utility instrument derived from the EORTC QLQ-C30. Methods We conducted an online survey of the gene...

Background Adolescence and young adulthood are critical life stages with varied healthcare needs. Adolescents and young adults (AYAs) are often confronted with challenges in their sexual and reproductive health (SRH) and rights. Uptake of SRH services among AYAs groups remains limited, especially in resource-limited settings. This could be partly a...

Introduction: Utility values offer a quantitative means to evaluate the impact of novel cancer treatments on patients' quality of life (QoL). However, the multiple methods available for valuing QoL present challenges in selecting the most appropriate method across different contexts. Areas covered: This review provides cancer clinicians and rese...

Background: Olpasiran and pelacarsen are gene-silencing therapies that lower lipoprotein(a). Cardiovascular outcome trials are ongoing. Mendelian randomisation studies estimated clinical benefits from lipoprotein(a) lowering. Objective: Our study estimated prices at which olpasiran and pelacarsen, in addition to standard-of-care, would be deemed c...

Background Almost a third of Australian adults are living with obesity, yet most cannot access medical nutrition therapy from dietitians, that is, the health professionals trained in dietary weight management services. Across the health system, primary care doctors readily identify people who may benefit from weight management services, but there a...

BACKGROUND Almost a third of Australian adults are living with obesity, yet most cannot access medical nutrition therapy from dietitians, that is, the health professionals trained in dietary weight management services. Across the health system, primary care doctors readily identify people who may benefit from weight management services, but there a...

Genetic and genomic testing can provide valuable information on individuals’ risk of chronic diseases, presenting an opportunity for risk-tailored disease screening to improve early detection and health outcomes. The acceptability, uptake and effectiveness of such programmes is dependent on public preferences for the programme features. This study...

Background Untreated hepatitis C virus (HCV) infection can result in cirrhosis and hepatocellular cancer. Direct-acting antiviral (DAA) therapies are highly effective and have few side effects compared to older interferon-based therapy. Despite the Australian government providing subsidised and unrestricted access to DAA therapy for chronic HCV inf...

Background Economic evaluation of healthcare typically assumes that an identical health gain to different patients has the same social value. There is some evidence that the public may give greater value to gains for children and young people, although this evidence is not always consistent. We present a mixed methods study protocol where we aim to...

Introduction Telehealth service provision and uptake has rapidly increased since the COVID-19 pandemic, allowing healthcare to be delivered safely and reducing non-essential face-to-face (F2F) contact. In Australia, the expansion of subsidisation of telehealth during COVID has led to its permanent installation within Australian primary care in 2022...

Background As co-design and community-based participatory research gain traction in health and disability, the challenges and benefits of collaboratively conducting research need to be considered. Current literature supports using co-design to improve service quality and create more satisfactory services. However, while the ‘why’ of using co-design...

Purpose This study aimed to develop a Japanese value set for the EORTC QLU-C10D, a multi-attribute utility measure derived from the cancer-specific health-related quality-of-life (HRQL) questionnaire, the EORTC QLQ-C30. The QLU-C10D contains ten HRQL dimensions: physical, role, social and emotional functioning, pain, fatigue, sleep, appetite, nause...

Cost-utility analysis generally requires valid preference-based measures (PBMs) to assess the utility of patient health. While generic PBMs are widely used, disease-specific PBMs may capture additional aspects of health relevant for certain patient populations. This study investigates the construct and concurrent criterion validity of the cancer-sp...

Background Technology-assisted 24-h dietary recalls (24HRs) have been widely adopted in population nutrition surveillance. Evaluations of 24HRs inform improvements, but direct comparisons of 24HR methods for accuracy in reference to a measure of true intake are rarely undertaken in a single study population. Objectives To compare the accuracy of e...

Background Cost-utility analysis typically relies on preference-based measures (PBMs). While generic PBMs are widely used, disease-specific PBMs can capture aspects relevant for certain patient populations. Here the EORTC QLU-C10D, a cancer-specific PBM based on the QLQ-C30, is validated using Dutch trial data with the EQ-5D-3L as a generic compara...

Objectives The Quality of Life (QoL) Utility measure, QLU-C10D, is derived of the European Organisation for Research and Treatment of Cancer (EORTC) QoL Questionnaire, QLQ-C30. Based on the cancer-specific nature, the QLU-C10D is expected to be sensitive and responsive in lung cancer patients. Methods This retrospective analysis used data from four...

Introduction Telepractice service delivery of allied health interventions to people with disability can potentially reduce access barriers and improve service equity. However, questions remain regarding telepractice functionality for people with disability. This study addressed questions related to how allied health clinicians and managers perceive...

Objective:The Interdisciplinary Home-bAsed Reablement Program (I-HARP) integrates evidence-based rehabilitation strategies into a dementia-specific person-centred, time-limited, home-based, interdisciplinary rehabilitation package. I-HARP was a 4-month model of care, incorporated into community aged care services and hospital-based community geriat...

The methods and strategies utilised to facilitate focus group discussion within a co-design context have a fundamental impact on the opportunity for participants to actively engage with the content. This is a description of the strategies our project utilized including visual prompts and preparation guide to assist both service users and staff part...

Purpose In this study, we developed Danish utility weights for the European Organisation for Research and Treatment of Cancer (EORTC) QLU-C10D, a cancer-specific utility instrument based on the EORTC QLQ-C30. Methods Following a standardized methodology, 1001 adult participants from the Danish general population were quota-sampled and completed a...

Background This project evaluated a model of care integrating evidence‐based dementia rehabilitation strategies into a time‐limited, home‐based, interdisciplinary rehabilitation package: Interdisciplinary Home‐bAsed Reablement Program (I‐HARP). The aims were: to determine I‐HARP effectiveness on functional independence, mobility, quality of life an...

To develop a value set reflecting the United States (US) general population’s preferences for health states described by the Functional Assessment of Cancer Therapy (FACT) eight-dimensions preference-based multi-attribute utility instrument (FACT-8D), derived from the FACT-General cancer-specific health-related quality-of-life (HRQL) questionnaire....

Introduction Telepractice has the potential to align with the directive to reduce inequalities by United Nations Sustainable Development Goal 10. Telepractice additionally addresses a national digital health strategic plan for accessible digitally enabled models of care. To plan improvements, it is essential to understand the experience of teleprac...

No guidance currently exists as to the cognition threshold beyond which self-reported quality of life for older people with cognitive impairment and dementia is unreliable. Older aged care residents (≥ 65 years) were randomly assigned to complete the EQ-5D-5L in computer-based (eye movements were tracked) or hard copy (participants were encouraged...

Objective To investigate public willingness to share sensitive health information for research, health policy and clinical practice. Methods A total of 1,003 Australian respondents answered an online, attribute-driven, survey in which participants were asked to accept or reject hypothetical choice sets based on a willingness to share their health...

We aimed to synthesise knowledge on the relative social value of child and adult health. Quantitative and qualitative studies that evaluated the willingness of the public to prioritise treatments for children over adults were included. A search to September 2023 was undertaken. Completeness of reporting was assessed using a checklist derived from J...

Background: Excessive worry is an invisible disruptive force that has adverse health outcomes and may advance to other forms of disorder, such as anxiety or depression. Addressing worry and its influences is challenging yet crucial for informing public health policy. Methods: We examined parents' worries, influences, and variability before and d...

Objective The EORTC QLU-C10D is a new preference-based measure derived from the EORTC QLQ-C30. Country-specific value sets are required to support the cost-utility analysis of cancer-related interventions. This study aimed to generate an EORTC QLU-C10 value set for Hong Kong (HK). Methods A HK online panel was quota-sampled to achieve an adult gen...

Empirical evidence on the effect of the COVID-19 pandemic on children’s health and its variation across geography. The outcome has implications with international relevance: children living in stressful environments, such as during the COVID-19 pandemic, are highly vulnerable despite not personally being at a high health risk.

Aims Patients with chronic health conditions not responding to conventional treatment can access medicinal cannabis (MC) prescriptions from clinicians in Australia. We aimed to assess overall health-related quality of life (HRQL), pain, fatigue, sleep, anxiety, and depression in a large real-world sample of patients accessing prescribed medicinal c...

Introduction There is evidence from previous studies that adults value paediatric health-related quality of life (HRQoL) and adult HRQoL differently. Less is known about how adolescents value paediatric HRQoL and whether their valuation and decision-making processes differ from those of adults. Discrete choice experiments (DCEs) are widely used to...

Purpose Increasingly there are calls to routinely assess the health-related quality of life (HRQoL) of older people receiving aged care services, however the high prevalence of dementia and cognitive impairment remains a challenge to implementation. Eye-tracking technology facilitates detailed assessment of engagement and comprehension of visual st...

Value sets for the EQ-5D-Y-3L published to date appear to have distinctive characteristics compared with value sets for corresponding adult instruments: in many cases, the value for the worst health state is higher and there are fewer values < 0. The aim of this paper is to consider how and why values for child and adult health differ; and what the...

Purpose Many generic patient-reported instruments are available for the measurement of health outcomes, including EQ-5D-5L, and the Patient-Reported Outcome Measurement Information System (PROMIS). Assessing their measurement characteristics informs users about the consistency between, and limits of, evidence produced. The aim was to assess the mea...

Introduction: Discrete choice experiments (DCE) are increasingly being conducted using online panels. However, the comparability of such DCE-based preferences to traditional modes of data collection (e.g., in-person) is not well established. In this study, supervised, face-to-face DCE was compared with its unsupervised, online facsimile on face va...

Importance: The Netherlands is one of the few countries that has a long-term history of active screening for familial hypercholesterolemia (FH), enabling health-economic analyses. Objective: To investigate cost-effectiveness and the return on investment (ROI) of a nationwide cascade case-finding and preventive treatment program starting with ide...

This study aims to elicit consumer preferences regarding telehealth and face-to-face consultations in Australia. It used a discrete choice experiment, presenting participants with a series of hypothetical choices, and based on their responses, infer what is most important to them. Data were analysed using conditional logit regression and latent cla...

Background: The availability and use of telehealth to support health care access from a distance has expanded in response to the COVID-19 pandemic. Telehealth services have supported regional and remote health care access for many years and could be augmented to improve health care accessibility, acceptability and overall experiences for both cons...

Background: The EQ Health and Wellbeing Short (EQ-HWB-S) is a new generic measure that covers health and wellbeing developed for use in economic evaluation in health and social care. Objective: The aim was to test the feasibility of using composite time trade-off (cTTO) and a discrete choice experiment (DCE) based on an international protocol to...

Background/aims: Discrete choice experiments (DCEs) with either duration included an attribute or with dead included as an option can be used as a stand-alone approach to value health states. This paper reports on a DCE with both of these features to develop an EQ-5D-5L value set for Australia. Methods: A DCE was undertaken using a large Austral...

Background In children, chronic wet cough may be a sign of underlying lung disease, including protracted bacterial bronchitis (PBB) and bronchiectasis. Chronic (> 4 weeks in duration) wet cough (without indicators pointing to alternative causes) that responds to antibiotic treatment is diagnostic of PBB. Timely recognition and management of PBB can...

BackgroundA new preference-based measure (MacNew-7D) has recently been developed to allow condition-specific data to be used to capture the quality of life in health economic evaluations in cardiology; however, a general population value set has not yet been developed. This study developed a population utility value set for the MacNew-7D heart dise...

BACKGROUND The COVID-19 pandemic triggered a rapid scale up of telehealth services in Australia as a means to provide continued care through periods of physical restrictions. The factors that influence engagement in telehealth remain unclear. OBJECTIVE To understand the experience of Australian people who engaged in a telehealth consultation durin...

Background The European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Utility-Core 10 Dimensions (QLU-C10D) is a novel cancer-specific preference-based measure (PBM) for which value sets are being developed for an increasing number of countries. This is done by obtaining health preferences from the respective general pop...

Objectives: The objective of this study was to compare the concurrent and construct validity as well as the sensitivity of five multi-attribute utility instruments (MAUIs) including the AQol-6D, EQ-5D-Y, HUI 2&3, and the CHU9D, one generic paediatric quality of life instrument, (PedsQL) to three routinely collected outcome measures in Australian m...

Objectives: The EORTC QLU-C10D is a cancer-specific preference-based measure, providing health utilit ies for use in economic evaluations derived from the widely used health-related quality of life measure, EORTC QLQ-C30. Several EORTC QLU-C10D country-specific value sets are available. This article aims to provide EORTC QLU-C10D general populatio...

Discrete choice experiments (DCEs) are becoming increasingly used to elicit preferences for children’s health states. However, DCE data need to be anchored to produce value sets, and composite time trade-off (cTTO) data are typically used in the context of EQ-5D-Y-3L valuation. The objective of this paper is to compare different anchoring methods,...

Objectives: In cost-effectiveness analysis of health technologies, health state utilities are needed. They are often elicited with a composite time trade-off (cTTO) method, particularly for the widely used EQ-5D-5L. Unfortunately, cTTO discriminatory power is hindered by (1) respondents' nontrading (NT) of time for quality, (2) censoring of utilit...

Introduction A recognised potential benefit of autonomous vehicles is increased mobility for older adults. However, this group is more apprehensive about adoption, which may hinder uptake. Shared autonomous vehicles (SAVs) represent a use case that may be especially relevant for older people due to emerging applications in retirement villages and s...

Introduction: Pulmonary exacerbations are associated with increased morbidity and mortality in people with cystic fibrosis (CF). There is no consensus about which outcomes should be evaluated in studies of pulmonary exacerbations or how these outcomes should be measured. Outcomes of importance to people with lived experience of the disease are fre...

Objective The aim of this study was to examine the level of agreement between self- and proxy-reporting of health-related quality of life (HRQoL) in children (under 18 years of age) using generic preference-based measures.MethodsA systematic review of primary studies that reported agreement statistics for self and proxy assessments of overall and/o...

Purpose Compare the health-related quality of life (HRQL) of the Australian general population during the COVID-19 pandemic (2020) with pre-pandemic data (2015–2016) and identify pandemic-related and demographic factors associated with poorer HRQL. Methods Participants were quota sampled from an online panel by four regions (defined by active COVI...

Background Australia has seen a rapid uptake of virtual care since the start of the COVID-19 pandemic. We aimed to describe the willingness of consumers to use digital technology for health and to share their health information; and explore differences by educational attainment and area of remoteness. Methods We conducted an online survey on consu...

Background Late-stage breast cancer (BC) is commonly diagnosed in limited-resource countries such as Indonesia. The lack of information for decision-making emphasizes the need for efforts to support evidence-informed practice for improving BC early detection in Indonesia. This study attempts to understand the local context evidence on policy implem...

Introduction Utility instruments are used to assess patients’ health-related quality of life for cost-utility analysis (CUA). However, for cancer patients, the dimensions of generic utility instruments may not capture all the information relevant to the impact of cancer. Cancer-specific utilities provide a useful alternative. Under the auspices of...

Background and objectives: Valuing children's health states for use in economic evaluations is globally relevant and is of particular relevance in jurisdictions where a cost-utility analysis is the preferred form of analysis for decision making. Despite this, the challenges with valuing child health mean that there are many remaining questions for...

Objective Elevated lipoprotein(a) [Lp(a)] is a common inherited condition associated with cardiovascular disease. This study investigated whether cascade testing for Lp(a) was effective in detecting new cases of elevated Lp(a) in families. Methods Relatives from adult probands with Lp(a) concentration ≥100 mg/dL were tested for elevated Lp(a) (≥50...