A new preference reversal in health utility measurement

A central assumption in health utility measurement is that preferences are invariant to the elicitation method that is used. This assumptioin is challenged by preferences reversals. Previous studies have observed prefrence resersals between choise and matching tasks and between choise and ranking tasks. We present a new preference reversal that entirely choise-based. Because choise is the basic primitive of economics and utility theory, this preference reversal is more fundamental and troubling. The preference reversal was observed in two studies regarding health states after stroke. Both studies involved large representative samples from the Spanish population, interwied professionally and face-to-face. Possible explanations for the preference reversal are the anticipation of disappointment and elation is risky choise anda the impact of ethical co0nsiderations about the value of live.