It is unusual, after 46 years of database development to point out that there is a basic flaw that unfortunately renders the entire exercise irrelevant. This is the situation that the Tufts University Cost-Effectiveness Analysis (CEA) database finds itself in once questions of the axioms of fundamental measurement are raised. The concern rests on two considerations: first, the properties, from a measurement perspective, of the direct and indirect multiattribute preference instrument that have been widely accepted and applied in modeling over the

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