Paula Cronin is a health service researcher and health economist at the Centre for Health Economics Research and Evaluation (CHERE) where she has been employed as a part-time Research Fellow since 2006. During this time, she has worked largely in the Economic Evaluation team. Paula's main research interest is in the economics of childhood. In 2018, she completed her PhD in health economics at UTS. The title of her thesis was ‘The Economic Impact of Childhood Developmental Language Disorder’. Paula also has a Bachelor of Science and a Masters of Public Health .
Paula is a member of the Cancer Research Economics Support Team (CREST), which is national cancer-focussed health economics service funded by Cancer Australia as part of their Support for Clinical Trials program. She is an invited member of the Medical Services Advisory Committee Evaluation sub-committee (2017-2020). This role involves evaluating applications for new medical services to be funded on the MBS, which directly impacts national health policy. In 2012, she was an invited panel member for the Pharmaceutical Benefits Cost Recovery Review for the Commonwealth Department of Health. The conclusions of this review were used to inform pharmaceutical benefits reforms.
Can supervise: YES
Sommer, J, Gill, K, Stein Parbury, J, Cronin, P & Katsifis, V 2019, 'The Role of Recovery Colleges in Supporting Personal Goal Achievement', Psychiatric Rehabilitation Journal.
Cronin, PA, Kirkbidge, B, Bang, A, Smith, D, Parkinson, B & Haywood, P 2017, 'Long-term health care costs for patients with prostate cancer: A population-wide longitudinal study in New South Wales Australia', Asia Pacific Journal of Clinical Oncology, vol. 13, no. 3, pp. 160-171.View/Download from: UTS OPUS or Publisher's site
Cronin, PA, Reeve, R, Viney, R, McCabe, P & Goodall, S 2017, 'The impact of childhood language difficulties on healthcare costs from 4 to 13 years: Australian longitudinal study', International Journal of Speech-Language Pathology, vol. 19, pp. 381-391.View/Download from: UTS OPUS
Norman, R, Viney, RC, Brazier, JE, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2014, 'Valuing SF-6D health states using a Discrete Choice Experiment', Medical Decision Making, vol. 34, no. 6, pp. 773-786.View/Download from: Publisher's site
Background. SF-6D utility weights are conventionally produced using a standard gamble (SG). SG-derived weights consistently demonstrate a floor effect not observed with other elicitation techniques. Recent advances in discrete choice methods have allowed estimation of utility weights. The objective was to produce Australian utility weights for the SF-6D and to explore the application of discrete choice experiment (DCE) methods in this context. We hypothesized that weights derived using this method would reflect the largely monotonic construction of the SF-6D. Methods. We designed an online DCE and administered it to an Australia-representative online panel (n = 1017). A range of specifications investigating nonlinear preferences with respect to additional life expectancy were estimated using a random-effects probit model. The preferred model was then used to estimate a preference index such that full health and death were valued at 1 and 0, respectively, to provide an algorithm for Australian cost-utility analyses. Results. Physical functioning, pain, mental health, and vitality were the largest drivers of utility weights. Combining levels to remove illogical orderings did not lead to a poorer model fit. Relative to international SG-derived weights, the range of utility weights was larger with 5% of health states valued below zero. Conclusions. DCEs can be used to investigate preferences for health profiles and to estimate utility weights for multi-attribute utility instruments. Australian cost-utility analyses can now use domestic SF-6D weights. The comparability of DCE results to those using other elicitation methods for estimating utility weights for quality-adjusted life-year calculations should be further investigated.
Viney, RC, Norman, R, Brazier, JE, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2014, 'An Australian discrete choice experiment to value EQ-5D health states', Health Economics, vol. 23, no. 6, pp. 729-742.View/Download from: UTS OPUS or Publisher's site
Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n?=?1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses.
Cronin, PA, Goodall, S, Lockett, T, O'Keefe, C, Norman, R & Church, J 2013, 'Cost-effectiveness of an advance notification letter to increase colorectal cancer screening', International Journal of Technology Assessment in Health Care, vol. 29, no. 3, pp. 261-268.View/Download from: UTS OPUS or Publisher's site
Objectives: The aim of this study is to evaluate the cost-effectiveness of a patient-direct mailed advance notification letter on participants of a National Bowel Cancer Screening Program (NBCSP) in Australia, which was launched in August 2006 and offers free fecal occult blood testing to all Australians turning 50, 55, or 65 years of age in any given year. Methods: This study followed a hypothetical cohort of 50-year-old, 55-year-old, and 65-year-old patients undergoing fecal occult blood test (FOBT) screening through a decision analytic Markov model. The intervention compared two strategies: (i) advance letter, NBCSP, and FOBT compared with (ii) NBCSP and FOBT. The main outcome measures were life-years gained (LYG), quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio. Results: An advance notification screening letter would yield an additional 54 per 100,000 colorectal cancer deaths avoided compared with no letter. The estimated cost-effectiveness was $3,976 per LYG and $6,976 per QALY gained. Conclusions: An advance notification letter in the NBCSP may have a significant impact on LYG and cancer deaths avoided. It is cost-effective and offers a feasible strategy that could be rolled out across other screening program at an acceptable cost.
Norman, R, Cronin, PA & Viney, RC 2013, 'A pilot discrete choice experiment to explore preferences for EQ-5D-5L health states', Applied Health Economics and Health Policy, vol. 11, no. 3, pp. 287-298.View/Download from: UTS OPUS or Publisher's site
The EQ-5D-5L has recently been developed to improve the sensitivity of the widely used three-level version. Valuation studies are required before the use of this new instrument can be adopted. The use of discrete choice experiments (DCEs) in this area is a promising area of research. PURPOSE: To test the plausibility and acceptability of estimating an Australian algorithm for the newly developed five-level version of the EQ-5D using a DCE. METHODS: A choice experiment was designed, consisting of 200 choice sets blocked such that each respondent answered 10 choice sets. Each choice set presented two health state-duration combinations, and an immediate death option. The experiment was implemented in an online Australian-representative sample. A random-effects probit model was estimated. To explore the feasibility of the approach, an indicative algorithm was developed. The algorithm is transformed to a 0 to 1 scale suitable for use to estimate quality-adjusted life-year weights for use in economic evaluation. RESULTS: A total of 973 respondents undertook the choice experiment. Respondents were slightly younger and better educated than the general Australian population. Of the 973 respondents, 932 (95.8 %) completed all ten choice sets, and a further 12 completed some of the choice sets. In choice sets in which one health state-duration combination dominated another, the dominant option was selected on 89.5 % of occasions. The mean and median completion times were 17.9 and 9.4 min, respectively, exhibiting a highly skewed distribution. The estimation results are broadly consistent with the monotonic nature of the EQ-5D-5L. Utility is increasing in life expectancy (i.e., respondents tend to prefer health profiles with longer life expectancy), and mainly decreases in higher levels in each dimension of the instrument. A high proportion of respondents found the task clear and relatively easy to complete.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Knox, SA & Ratcliffe, J 2011, 'Time trade-off derived EQ-5D weights for Australia', Value in Health, vol. 14, no. 6, pp. 928-936.View/Download from: UTS OPUS or Publisher's site
Background: Cost-utility analyses (CUAs) are increasingly common in Australia. The EuroQol five-dimensional (EQ-5D) questionnaire is one of the most widely used generic preference-based instruments for measuring health-related quality of life for the estimation of quality-adjusted life years within a CUA. There is evidence that valuations of health states vary across countries, but Australian weights have not previously been developed. Methods: Conventionally, weights are derived by applying the time trade-off elicitation method to a subset of the EQ-5D health states. Using a larger set of directly valued health states than in previous studies, time trade-off valuations were collected from a representative sample of the Australian general population (n = 417). A range of models were estimated and compared as a basis for generating an Australian algorithm. Results: The Australia-specific EQ-5D values generated were similar to those previously produced for a range of other countries, but the number of directly valued states allowed inclusion of more interaction effects, which increased the divergence between Australia's algorithm and other algorithms in the literature. Conclusion: This new algorithm will enable the Australian community values to be reflected in future economic evaluations.
Norman, R, King, MT, Clarke, D, Viney, RC, Cronin, PA & Street, D 2010, 'Does mode of administration matter? Comparison of online and face-to-face administration of a time trade-off task', Quality of Life Research, vol. 19, no. 4, pp. 499-508.View/Download from: UTS OPUS or Publisher's site
Purpose Developments in electronic data collection methods have allowed researchers to generate larger datasets at lower costs, but relatively little is known about the comparative performance of the new methods. This paper considers the comparability of two modes of administration (face-to-face and remote electronic) for the time trade-off. Method Data were collected from a convenience sample of adults (n = 135) randomised to either a face-to-face time trade-off or a remote electronic tool. Patterns of responses were considered. For each sample, standard regression analysis was undertaken to generate a valuation set, which were then contrasted
Norman, R, Cronin, PA, Viney, RC, King, MT, Street, D & Ratcliffe, J 2009, 'International comparisons in valuing EQ-5D health states: A review and analysis', Value in Health, vol. 12, no. 8, pp. 1194-1200.View/Download from: UTS OPUS or Publisher's site
Objective: To identify the key methodological issues in the construction of population-level EuroQol 5-dimensions (EQ-5D)/time trade-off (TTO) preference elicitation studies. Method: This study involved three components. The first was to identify existing population-level EQ-5D TTO studies. The second was to illustrate and discuss the key areas of divergence between studies, including the international comparison of tariffs. The third was to portray the relative merits of each of the approaches and to compare the results of studies across countries. Results: While most articles report use of the protocol developed in the original UK study, we identified three key areas of divergence in the construction and analysis of surveys. These are the number of health states valued to determine the algorithm for estimating all health states, the approach to valuing states worse than immediate death, and the choice of algorithm. The evidence on international comparisons suggests differences between countries although it is difficult to disentangle differences in cultural attitudes with random error and differences as a result of methodological divergence. Conclusions: Differences in methods may obscure true differences in values between countries. Nevertheless, population-specific valuation sets for countries engaging in economic evaluation would better reflect cultural differences and are therefore more likely to accurately represent societal attitudes.
Cronin, PA, Reeve, R, Goodall, S, Viney, R & McCabe, T 2016, 'The implications of school quality on the academic achievements of children with language difficulties', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.
Cronin, P, Reeve, R, Goodall, S, McCabe, P & Viney, RC 2015, 'The impact of childhood language impairment on health service use and health care expenditure', IHEA, 11th World Congress on Health Economics, Milan, Italy.
Cronin, PA, Reeve, R, Goodall, S, McCabe, P & Viney, R 2015, 'The impact of childhood language impairment on health service use and health care expenditure-evidence from the Longitudinal Study of Australian Children', Childhood Language Symposium, Warwick, UK.
Cronin, PA, Goodall, S, Lockett, T, O'Keefe, R, Norman, R & Church, J 2013, 'Cost-effectiveness of a mailed advance notification letter to increase colorectal cancer screening', ISPOR 18th Annual International Meeting, New Orleans, USA.
Norman, R, Viney, RC, Street, D, Cronin, PA & Ratcliffe, J 2013, 'Using choice experiments to explore preferences for health profiles with different survival durations: experience from Australia', iHEA 9th World Congress on Health Economics, Sydney.
Cronin, PA, Hoggan, B, Goodall, S & Cameron, A 2012, 'CE3: Hyperbaric oxygen therapy for the treatment non-neurological soft tissue radiation injuries: A cost effectiveness analysis [conference abstract]', Value in Health, Elsevier, Taiwan, pp. 1-1.
Cronin, PA, Hoggan, B, Goodall, S & Cameron, A 2012, 'Hyperbaric oxygen therapy for the treatment non-neurological soft tissue radiation injuries: A cost effectiveness analysis', ISPOR 5th Asia-Pacific Conference, Taipei, Taiwan.
Norman, R, Brazier, JE, Viney, RC, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'Revaluing the SF-6D using ordinal methods for eliciting preferences', International Society for Quality of Life Research Congress, Budapest, Hungary.
Norman, R, Viney, RC, Brazier, JE, Burgess, LB, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'A DCE-derived algorithm for the SF-6D', 34th Australian Conference of Health Economists (AHES), Darwin.
Norman, R, Viney, RC, Brazier, JE, Cronin, PA, King, MT, Ratcliffe, J & Street, D 2012, 'Using discrete choice experiments to value health states for economic evaluation: The SF-6D in Australia', ISPOR Asia-Pacific Congress, Taiwan.
Norman, R, Viney, RC, Brazier, JE, King, MT, Cronin, PA, Ratcliffe, J & Street, D 2012, 'Australian algorithms for the EQ-5D-3L and EQ-5D-5L', International Society for Quality of Life Research Congress, Budapest, Hungary.
Cronin, PA, Reeve, RD & Goodall, S 2011, 'Measuring the economic impact of early intervention of speech impairment on educational outcomes and wellbeing: a study of the longitudinal study of Australian children', iHEA 8th World Congress, Toronto, Canada.
Cronin, PA, Reeve, RD & Goodall, S 2011, 'Measuring the economic impact of early intervention of speech impairment on educational outcomes and wellbeing: a study of the longitudinal study of Australian children', Longitudinal Study of Australian Children Conference, Melbourne.
Cronin, PA, Reeve, RD & Goodall, S 2011, 'Measuring the economic impact of early intervention of speech impairment on educational outcomes and wellbeing: a study of the longitudinal study of Australian children', 7th Health Services and Policy Research Conference, Adelaide.
Cronin, PA, Goodall, S, Norman, R & Church, J 2009, 'The impact of improving screening participation rate and diagnostic test sensitivity on colorectal cancer screening', 6th Health Services and Policy Research Conference 2009, Brisbane.
Cronin, PA, Norman, R, Viney, RC, King, MT, Street, D, Burgess, LB, Brazier, JE & Ratcliffe, J 2009, 'Can Time Trade Off be implemented online? A case study from Australia using the EQ-5D (Poster)', iHEA 7th World Congress, Beijing, China.
King, MT, Viney, RC, Norman, R, Cronin, PA, Street, D, Brazier, JE & Ratcliffe, J 2008, 'Valuation of EQ-5D health states using discrete choice experiments: effect of excluding implausible states', International Society for Quality of Life Research (ISOQOL) Conference, Montevideo, Uruguay.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Brazier, JE & Ratcliffe, J 2008, 'Application of discrete choice experiments to value multi-attribute health states for use in economic evaluation', Australian Conference of Health Economists, Adelaide.
Viney, RC, Norman, R, King, MT, Cronin, PA, Street, D, Ratcliffe, J & Brazier, JE 2008, 'Application of discrete choice experiments to value multi-attribute health states for use in economic evaluation', 13th National Health Outcomes Conference, Canberra.
Cronin, PA, Goodall, S, Cameron, A & Hoggan, B MSAC 2011, Review of interim funded services - Hyperbaric Oxygen Treatment (HBOT) for the treatment of chronic non-diabetic wounds and non-neurological soft tissue radiation injuries. MSAC Reference 1054.1, Canberra.
Cronin, PA, Goodall, S, Norman, R & Church, J CHERE University of Technology, Sydney 2010, The impact of a new bowel cancer screening test on detection of colorectal cancer: Part B Replacing FOBT with new test, Sydney.
Cronin, PA, Goodall, S, Norman, R & Church, J CHERE University of Technology, Sydney 2010, The impact of a new bowel cancer screening test on detection of colorectal cancer: Part B2 FOBT + New screening test in a triage model.
Overweight and obesity continue to contribute to increased risk of chronic diseases, including higher lifetime health expenditures and impacting on individuals? quality of life. Whilst international studies have compared individuals? perceptions of their body mass with more objective measures such as Body Mass Index (BMI) few Australian studies have examined this relationship in any detail. This study uses unit record data from the 2003 NSW Health Survey to identify factors associated with the accuracy of adults perceived body mass. Descriptive methods and logistical models are used to quantify the effects of a number of demographic, socio?economic, behavioural and health?related variables on the accuracy of self?assessed
The results support earlier findings that there are large gender differences in perception of body mass. Women are most likely to report they are overweight. In
contrast there is a pattern of underestimation of weight amongst men, particularly at the higher BMI deciles. Clearly these results have different policy implications. This information may be useful for public health programs to take into account the issue of whether individuals accurately perceive themselves at risk of developing weight?related health conditions.