Doctoral dissertation

Dissertation: Patients with severe chronic diseases may differ from the general public in their preferences for health

The findings of a dissertation to be examined at the Tampere University highlight the importance of using patient preferences for medical decision-making and cost-effectiveness of medical treatments.

Many countries across the world are promoting patient-centric approaches in healthcare management. However, consensus has not been reached on the question of whose preferences, patients’ or the general public’s (tax payers’), should be used in the reimbursement for healthcare cost. Furthermore, it is not clear whether patients and the general public rate health benefits from treatments in the same way.

Patients’ rating (preferences) for health or treatment benefit are believed to be more accurate as patients who have experienced the disease conditions can appraise their conditions more accurately than individuals who have not experienced such conditions.

In his dissertation, Mihir Gandhi found that patients with certain chronic diseases, such as heart disease, might vary from those in the general public when it came to their preferences for the same given health conditions.

The difference in preferences may depend on the type of the disease they have experienced, the patient’s age, and how severe the health condition is that they are asked to rate. Consequently, using the general public preferences for deciding the effectiveness of medical treatments may not be similarly appraised by such patients. These findings highlight the importance of using patient preferences for medical decision making and cost-effectiveness of medical treatments.

Mihir Gandhi comes from India. He is working as a medical statistician for Singapore Clinical Research Institute and Duke-NUS Medical School, Singapore. He has been accredited as a Chartered Statistician and Chartered Scientist from the Royal Statistical Society, UK. He is currently working on several clinical trials and studies evaluating health-related quality of life in patients with chronic diseases.

The doctoral dissertation of Mihir Gandhi in the field of International Health titled Methodological Issues in Health State Valuation in the General and Patient Populations will be publicly examined in the Faculty of Medicine and Health Technology at Tampere University at 12 o’clock on Friday 22.2.2019 in Auditorium F114 in the Arvo building, address: Arvo Ylpon katu 34, Tampere. The opponent will be Professor Feng Xie from McMaster University, Canada. The Custos will be Professor Per Ashorn.

The dissertation is available online at