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The standard gamble is a method for valuing health states that is grounded in expected-utility theory, in which respondents choose between remaining in a given health state with certainty and taking a gamble between the best outcome, usually full health, and the worst, usually death, with the probability of the good outcome varied until the respondent is indifferent between the certain state and the gamble. The probability at that point of indifference is taken as the utility of the health state, reflecting the risk the respondent is willing to accept to escape it. Because it requires respondents to trade off against the risk of death, it captures the strength of preference under uncertainty and is regarded as a theoretically well-founded valuation technique. Its cognitive demands and the influence of attitudes to risk are recognised limitations, and it is one of the principal methods for deriving the utilities used in quality-adjusted life years.

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