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McGuinness MB, Ayton LN, Schofield D, Britten-Jones AC, Chen FK, Grigg JR, Qi Z, Kraindler J, Shrestha R, Mack HG. EQ-5D-5L health utility scores in Australian adults with inherited retinal diseases: A cross-sectional survey. Acta Ophthalmol 2024. [PMID: 38226448 DOI: 10.1111/aos.16634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/21/2023] [Accepted: 01/04/2024] [Indexed: 01/17/2024]
Abstract
PURPOSE Economic evaluations of interventions for ocular disease require utility scores that accurately represent quality of life in the target population. This study aimed to describe the distribution of EQ-5D-5L utility values among Australian adults with symptomatic inherited retinal diseases (IRDs) and to assess the relationship between these scores and vision-related quality of life. METHODS A survey was administered predominantly online in 2021. Participants completed the EQ-5D-5L general health utility instrument, the EQ vertical visual analogue scale (EQ-VAS) and the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25). Self-reported IRD diagnoses were classified as being associated with central or widespread retinal involvement. RESULTS Responses from 647 participants aged 18-93 years were included, 50.1% were men and 77.6% had an IRD associated with widespread retinal involvement. The majority reported no problems with self-care and no pain/discomfort but did report anxiety/depression and problems with work, study, housework, or family/leisure activities. Most people with widespread involvement reported problems with mobility. Median EQ-5D-5L utility was 0.88 and 0.91 among people with widespread and central involvement, respectively (age and sex-adjusted p = 0.029); and median EQ-VAS was 75 and 80, respectively (adjusted p = 0.003). A moderate curvilinear correlation was observed between EQ-5D-5L and NEI-VFQ-25 composite score (Spearman's ρ 0.69), but not all people with poor vision-related quality of life had low EQ-5D-5L utility values. CONCLUSIONS EQ-5D-5L health utility values are correlated with vision-related quality of life among adults with IRDs. However, the EQ-5D-5L may not be sensitive to the full impact of vision impairment on quality of life.
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Affiliation(s)
- Myra B McGuinness
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Lauren N Ayton
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Deborah Schofield
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Alexis Ceecee Britten-Jones
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Department of Optometry and Vision Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Fred K Chen
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Centre for Ophthalmology and Visual Sciences (incorporating Lions Eye Institute), The University of Western Australia, Perth, Western Australia, Australia
- Department of Ophthalmology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - John R Grigg
- Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
- Eye Genetics Research Unit, Sydney Children's Hospitals Network, Save Sight Institute, Children's Medical Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Ziyi Qi
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Joshua Kraindler
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Rupendra Shrestha
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Sydney, New South Wales, Australia
| | - Heather G Mack
- Centre for Eye Research Australia, Royal Victorian Eye & Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Song D, Fan S, Zhou Q, Yang X, Li S, Lohfeld L, Zhou W, Congdon N, Liang Y, Wang N. Impact of primary glaucoma on health-related quality of life in China: the handan eye study. BMC Ophthalmol 2023; 23:377. [PMID: 37710186 PMCID: PMC10503180 DOI: 10.1186/s12886-023-03106-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND We assessed health-related quality of life (HRQOL) and its determinants among rural glaucoma participants compared to age-matched normal controls in the population-based Handan Eye Study (HES), in rural Yongnian County, northern China. METHODS We enrolled 99 adults with glaucoma (mean age 63.0 ± 11.0 years), including primary open-angle glaucoma (POAG, n = 67) and primary angle-closure glaucoma (PACG, n = 32) and 102 controls (mean age 58.5 ± 5.3 years) with normal visual acuity and visual field and no history of glaucoma. Results of ophthalmic examinations and socioeconomic data were recorded. HRQOL was measured using the EQ-5D (converted to utility valves, UVs), and visual function (VF) and vision-related quality of life (VRQOL) were evaluated using the visual function-quality of life (VF-QOL) instrument. PRIMARY AND SECONDARY OUTCOME MEASURES EQ-5D and VF-QOL scores. RESULTS The mean UVs, VF, and VRQOL scores for glaucoma cases were 0.98 ± 0.04, 87.9 ± 15.2, and 95.5 ± 12.8, respectively, significantly worse than VF (94.4 ± 4.4) and VRQOL (100.0 ± 0.0) among controls, even after adjusting for age, gender, educational level, and family income (P = 0.015, P = 0.033). UVs were significantly lower among glaucoma participants with impaired VRQOL (55.4 ± 11.5) compared to those with normal VRQOL scores (99.1 ± 2.8) (UVs: 0.92 ± 0.08 vs. 0.99 ± 0.03, P = 0.036), also after adjustment for age and family income (P = 0.006). Participants with PACG had significantly lower VF and VRQOL scores compared to POAG (77.8 ± 21.4 vs. 92.9 ± 6.8, P < 0.001; 89.0 ± 18.1 vs. 98.7 ± 7.5, P < 0.001). CONCLUSION Participants with glaucoma have worse visual function and related quality of life compared to age-matched normal population controls. Participants with PACG have lower VF and VRQOL compared to those with POAG. UVs can be used for cost-effectiveness research and to support public health strategies for glaucoma in rural China.
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Affiliation(s)
- Di Song
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- The First People's Hospital of Huzhou, The First Affiliated Hospital of Huzhou Teacher College, Huzhou, Zhejiang, China
| | - Sujie Fan
- Handan Eye Hospital, Handan, Hebei, China
| | - Qiang Zhou
- Beijing Chaoyang Hospital, Beijing, China
| | - Xiaohui Yang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Sizhen Li
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Lynne Lohfeld
- Centre for Public Health, Queen's University, Belfast, UK
| | - Weihe Zhou
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, UK
- Orbis International, New York, NY, USA
| | - Yuanbo Liang
- National Clinical Research Center for Eye Diseases, The Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Ningli Wang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Philipson A, Hagberg L, Hermansson L, Karlsson J, Ohlsson-Nevo E, Ryen L. Mapping the World Health Organization Disability Assessment Schedule (WHODAS 2.0) onto SF-6D Using Swedish General Population Data. PHARMACOECONOMICS - OPEN 2023; 7:765-776. [PMID: 37322384 PMCID: PMC10471532 DOI: 10.1007/s41669-023-00425-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND OBJECTIVE Mapping algorithms can be used for estimating quality-adjusted life years (QALYs) when studies apply non-preference-based instruments. In this study, we estimate a regression-based algorithm for mapping between the World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the preference-based instrument SF-6D to obtain preference estimates usable in health economic evaluations. This was done separately for the working and non-working populations, as WHODAS 2.0 discriminates between these groups when estimating scores. METHODS Using a dataset including 2258 participants from the general Swedish population, we estimated the statistical relationship between SF-6D and WHODAS 2.0. We applied three regression methods, i.e., ordinary least squares (OLS), generalized linear models (GLM), and Tobit, in mapping onto SF-6D from WHODAS 2.0 at the overall-score and domain levels. Root mean squared error (RMSE) and mean absolute error (MAE) were used for validation of the models; R2 was used to assess model fit. RESULTS The best-performing models for both the working and non-working populations were GLM models with RMSE ranging from 0.084 to 0.088, MAE ranging from 0.068 to 0.071, and R2 ranging from 0.503 to 0.608. When mapping from the WHODAS 2.0 overall score, the preferred model also included sex for both the working and non-working populations. When mapping from the WHODAS 2.0 domain level, the preferred model for the working population included the domains mobility, household activities, work/study activities, and sex. For the non-working population, the domain-level model included the domains mobility, household activities, participation, and education. CONCLUSIONS It is possible to apply the derived mapping algorithms for health economic evaluations in studies using WHODAS 2.0. As conceptual overlap is incomplete, we recommend using the domain-based algorithms over the overall score. Different algorithms must be applied depending on whether the population is working or non-working, due to the characteristics of WHODAS 2.0.
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Affiliation(s)
- Anna Philipson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden.
| | - Lars Hagberg
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Liselotte Hermansson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Jan Karlsson
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Emma Ohlsson-Nevo
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
| | - Linda Ryen
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden
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Comparison of three health-related quality of life instruments in relation to visual acuity: EQ-5D, 15D, and EUROHIS-QOL8. Qual Life Res 2023; 32:543-552. [PMID: 36385360 PMCID: PMC9911483 DOI: 10.1007/s11136-022-03293-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To compare three health-related quality of life (HRQoL) instruments in detecting the effect of distance visual acuity (VA) on generic HRQoL in an adult population. METHODS We used cross-sectional, population-based data from a nationwide health survey conducted in Finland in 2011-2012. It included three self-reported HRQoL instruments, EuroQol-5 Dimension (EQ-5D), 15D, and EUROHIS-QOL8, and a health examination in which habitual distance VA was measured binocularly. We assessed 3764 survey participants aged 30 years and older with information available on these parameters. The comparability and sensitivity of the instruments were evaluated using Pearson correlation coefficients and multivariable linear regression in different VA groups. RESULTS EQ-5D and 15D index scores showed strong positive correlation (0.65-0.74) with each other regardless of distance VA, whereas EUROHIS-QOL8 index score showed moderate-to-strong correlation (0.46-0.79) with EQ-5D and 15D. All three instruments showed a negative trend with deteriorating VA, although EQ-5D and 15D showed better sensitivity than EUROHIS-QOL8. When adjusted for age, gender, and co-morbidities, adequate vision (VA 0.63-0.8), weak vision (VA 0.32-0.5), and impaired vision or worse (VA ≤ 0.25) were independently associated with declined EQ-5D and 15D, whereas declined EUROHIS-QOL8 was associated only with adequate and weak vision. CONCLUSION All three instruments can be viable tools in evaluating the relation between vision and HRQoL. While 15D is preferred due to its wide coverage of dimensions, EQ-5D can be an equal alternative, as it has less respondent burden. The feasibility of EUROHIS-QOL8 on detecting differences between lower VA levels may require further evidence.
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Flint I, Medjedovic J, Drogon O'Flaherty E, Alvarez-Baron E, Thangavelu K, Savic N, Meunier A, Longworth L. Mapping analysis to predict SF-6D utilities from health outcomes in people with focal epilepsy. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022:10.1007/s10198-022-01519-w. [PMID: 36260149 DOI: 10.1007/s10198-022-01519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Focal-onset seizures (FOS) are commonly experienced by people with epilepsy and have a significant impact on quality of life (QoL). This study aimed to develop a mapping algorithm to predict SF-6D values in adults with FOS for use in economic evaluations of a new treatment, cenobamate. METHODS An online survey, including questions on disease history, SF-36, and an epilepsy-specific measure (QOLIE-31-P) was administered to people with FOS in the UK, France, Italy, Germany, and Spain. A range of regression models were fitted to SF-6D scores including direct and response mapping approaches. RESULTS 361 individuals were included in the analysis. In the previous 28 days, the mean number of FOS experienced was 3, (range 0-43) and the mean longest period of consecutive days without experiencing a seizure was 14 days (range 1-28 days or more). Mean responses on all SF-36 dimensions were lower than general population norms. Mean SF-6D and QOLIE-31-P scores were 0.584 and 45.72, respectively. The best performing model was the ordinary least squares (OLS), with root mean squared error and mean absolute error values of 0.0977 and 0.0742, respectively. Explanatory variables which best predicted SF-6D included seizure frequency, severity, freedom, and age. CONCLUSION People with uncontrolled FOS have poor QoL. The mapping algorithm enables the prediction of SF-6D values from clinical outcomes in people with FOS. It can be applied to outcome data from clinical trials to facilitate cost-utility analysis.
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Affiliation(s)
- India Flint
- PHMR Limited, Berkeley Works, Berkley Grove, London, NW1 8XY, UK.
| | | | | | | | | | | | - Aurelie Meunier
- PHMR Limited, Berkeley Works, Berkley Grove, London, NW1 8XY, UK
| | - Louise Longworth
- PHMR Limited, Berkeley Works, Berkley Grove, London, NW1 8XY, UK
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Schofield D, Kraindler J, Tan O, Shrestha R, Jelovic D, West S, Ma A, Grigg J, Jamieson RV. Patient-Reported Health-Related Quality of Life in Individuals with Inherited Retinal Diseases. OPHTHALMOLOGY SCIENCE 2022; 2:100106. [PMID: 36246188 PMCID: PMC9560564 DOI: 10.1016/j.xops.2021.100106] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/25/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Deborah Schofield
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, North Ryde, Australia
| | - Joshua Kraindler
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, North Ryde, Australia
- Correspondence: Joshua Kraindler, GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, Level 4, 4 Easten Road, North Ryde, 2109, Australia.
| | - Owen Tan
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, North Ryde, Australia
| | - Rupendra Shrestha
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, North Ryde, Australia
| | - Diana Jelovic
- Eye Genetics Research Unit, Children’s Medical Research Institute, University of Sydney, Sydney, Australia
| | - Sarah West
- GenIMPACT: Centre for Economic Impacts of Genomic Medicine, Macquarie Business School, Macquarie University, North Ryde, Australia
| | - Alan Ma
- Eye Genetics Research Unit, Children’s Medical Research Institute, University of Sydney, Sydney, Australia
- Sydney Children’s Hospitals Network, Westmead, Australia
| | - John Grigg
- Sydney Children’s Hospitals Network, Westmead, Australia
- Save Sight Institute, University of Sydney, Sydney, Australia
- Sydney Eye Hospital, Sydney, Australia
| | - Robyn V. Jamieson
- Eye Genetics Research Unit, Children’s Medical Research Institute, University of Sydney, Sydney, Australia
- Sydney Children’s Hospitals Network, Westmead, Australia
- Save Sight Institute, University of Sydney, Sydney, Australia
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Zamora V, Garin O, Pardo Y, Pont À, Gutiérrez C, Cabrera P, Gómez-Veiga F, Pijoan JI, Litwin MS, Ferrer M. Mapping the Patient-Oriented Prostate Utility Scale From the Expanded Prostate Cancer Index Composite and the Short-Form Health Surveys. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1676-1685. [PMID: 34711369 DOI: 10.1016/j.jval.2021.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 03/01/2021] [Accepted: 03/29/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to develop mapping algorithms from the Expanded Prostate Cancer Index Composite (EPIC) and the Short-Form (SF) Health Surveys to the Patient-Oriented Prostate Utility Scale (PORPUS), an econometric instrument specifically developed for patients with prostate cancer. METHODS Data were drawn from 2 cohorts concurrently administering PORPUS, EPIC-50, and SF-36v2. The development cohort included patients who had received a diagnosis of localized or locally advanced prostate cancer from 2017 to 2019. The validation cohort included men who had received a diagnosis of localized prostate cancer from 2014 to 2016. Linear regression models were constructed with ln(1 - PORPUS utility) as the dependent variable and scores from the original and brief versions of the EPIC and SF as independent variables. The predictive capacity of mapping models constructed with all possible combinations of these 2 instruments was assessed through the proportion of variance explained (R2) and the agreement between predicted and observed values. Validation was based on the comparison between estimated and observed utility values in the validation cohort. RESULTS Models constructed with EPIC-50 with and without SF yielded the highest predictive capacity (R2 = 0.884, 0.871, and 0.842) in comparison with models constructed with EPIC-26 (R2 = 0.844, 0.827, and 0.776). The intraclass correlation coefficient was excellent in the 4 models (>0.9) with EPIC and SF. In the validation cohort, predicted PORPUS utilities were slightly higher than those observed, but differences were not statistically significant. CONCLUSIONS Mapping algorithms from both the original and the abbreviated versions of the EPIC and the SF Health Surveys allow estimating PORPUS utilities for economic evaluations with cost-utility analyses in patients with prostate cancer.
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Affiliation(s)
- Víctor Zamora
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Olatz Garin
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Universitat Pompeu Fabra, Barcelona, Spain.
| | - Yolanda Pardo
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | - Àngels Pont
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
| | | | - Patricia Cabrera
- Department of Radiation Oncology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Francisco Gómez-Veiga
- Complejo Hospitalario Universitario de Salamanca, Grupo de Investigación Translacional de Urología, Instituto de Investigación de Salamanca, Salamanca, Spain
| | - José Ignacio Pijoan
- CIBER en Epidemiología y Salud Pública, CIBERESP, Spain; Department of Clinical Epidemiology, Hospital Universitario de Cruces, Barakaldo, Vizcaya, Spain
| | - Mark S Litwin
- Schools of Medicine, Public Health and Nursing, University of California, Los Angeles, CA, USA
| | - Montse Ferrer
- Health Services Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain; Department of Paediatrics, Obstetrics and Gynaecology, and Preventive Medicine, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER en Epidemiología y Salud Pública, CIBERESP, Spain
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Rojananuangnit K, Sudjinda N. Utility Index and Patient-Reported Outcome Measures in Glaucomatous Patients Comparing with Normal Participants. Clin Ophthalmol 2021; 15:835-843. [PMID: 33658759 PMCID: PMC7920622 DOI: 10.2147/opth.s300226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/03/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Utility index is a significant outcome in terms of health economics assessment while patient-reported outcome measure (PROMs) evaluates quality of life (QOL) from patient’s perspective. Our objective was to evaluate both utility indices and PROMs using generic and eye specific QOL in glaucomatous patients compared with normal population. Methods This is a case-control study. We interviewed normal and glaucomatous participants with the European Quality of Life questionnaire (EQ-5D-5L), the European visual analogue scale (EQ-VAS) and the visual function questionnaire 28 (Thai version) (VFQ-28). The visual function questionnaire utility index (VFQ-UI) and generic utility index from EQ-5D-5L were calculated. Results There were 47 normal and 127 glaucomatous participants in this study. Amongst glaucoma group, 35 participants were in the early stage of the disease, 43 were in the moderate stage, 30 normal vision participants were in the severe stage, 14 participants had blindness one eye, and 5 had blindness both eyes. The mean age of the participants in both groups was statistically similar (63.78±6.84 vs 66.30±8.93 years old, respectively, p=0.062). Underlying diseases between groups were also comparable. The EQ-5D-5L utility index score and the EQ-VAS score were not statistically different between normal and glaucomatous groups, respectively (EQ-5D-5L: 0.874±0.122 vs 0.837±0.191, p=0.215; EQ VAS: 76.06±15.07 vs 74.02 ±15.10, p=0.43). By contrast, VFQ-UI of the glaucomatous group was significantly lower than that of the normal group, (VFQ-UI: 0.833±0.147 vs 0.895±0.070, accordingly, p<0.05). Conclusions Utility index from the VFQ-UI was a relevant PROMs for evaluating the QOL of glaucomatous patients in terms of visual function specificity and acceptable validity.
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Affiliation(s)
- Kulawan Rojananuangnit
- Glaucoma Unit, Ophthalmology Department, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand
| | - Nuttawan Sudjinda
- Glaucoma Unit, Ophthalmology Department, Mettapracharak (Wat Rai Khing) Hospital, Nakhon Pathom, Thailand
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Tsiachristas A, Potter CM, Rocks S, Peters M, Cundell M, McShane R, Batchelder L, Fox D, Forder JE, Jones K, Waite F, Freeman D, Fitzpatrick R. Estimating EQ-5D utilities based on the Short-Form Long Term Conditions Questionnaire (LTCQ-8). Health Qual Life Outcomes 2020; 18:279. [PMID: 32795317 PMCID: PMC7427949 DOI: 10.1186/s12955-020-01506-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 07/22/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of this work was to develop a mapping algorithm for estimating EuroQoL 5 Dimension (EQ-5D) utilities from responses to the Long-Term Conditions Questionnaire (LTCQ), thus increasing LTCQ’s potential as a comprehensive outcome measure for evaluating integrated care initiatives. Methods We combined data from three studies to give a total sample of 1334 responses. In each of the three datasets, we randomly selected 75% of the sample and combined the selected random samples to generate the estimation dataset, which consisted of 1001 patients. The unselected 25% observations from each dataset were combined to generate an internal validation dataset of 333 patients. We used direct mapping models by regressing responses to the LTCQ-8 directly onto EQ-5D-5L and EQ-5D-3L utilities as well as response (or indirect) mapping to predict the response level that patients selected for each of the five EQ-5D-5L domains. Several models were proposed and compared on mean squared error and mean absolute error. Results A two-part model with OLS was the best performing based on the mean squared error (0.038) and mean absolute error (0.147) when estimating the EQ-5D-5L utilities. A multinomial response mapping model using LTCQ-8 responses was used to predict EQ-5D-5L responses levels. Conclusions This study provides a mapping algorithm for estimating EQ-5D utilities from LTCQ responses. The results from this study can help broaden the applicability of the LTCQ by producing utility values for use in economic analyses.
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Affiliation(s)
- Apostolos Tsiachristas
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Caroline M Potter
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Stephen Rocks
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Michele Peters
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - Laurie Batchelder
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Diane Fox
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Julien E Forder
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Karen Jones
- Personal Social Services Research Unit, School of Social Policy Sociology and Social Research, University of Kent, Canterbury, UK
| | - Felicity Waite
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Daniel Freeman
- Oxford Health NHS Foundation Trust, Oxford, UK.,Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ray Fitzpatrick
- Health Services Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Ribeiro I, Batel Marques F, Mendes D, Alves C. A Systematic Review of Economic Studies Evaluating Ophthalmic Drugs: An Analysis of the Health-state Utilities. Ophthalmic Epidemiol 2020; 27:325-338. [PMID: 32691652 DOI: 10.1080/09286586.2020.1792938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To characterize the techniques used to derive health-state utilities (HSU) in the cost-utility studies (CUS) of ophthalmic drugs. METHODS A systematic review was conducted in Pubmed/Embase until October 2019. CUS evaluating ophthalmic drugs were included. Therapeutic area, technique to derive HSU and sources of HSU were extracted. It was assessed if the HSU and the other parameters of CUS were collected from the same population. The techniques to derive HSU used in the CUS were compared to the techniques recommended by the country-specific economic evaluation guidelines. RESULTS Seventy CUS were included. Forty-three (61.4%) used direct techniques to derive HSU, 19 (27.1%) used indirect, 1 (1.4%) used direct and indirect and the remaining (n = 7; 10.0%) used other or unknown techniques. Twelve (17.1%) CUS collected the HSU and the other parameters from the same population: nine (12.9%) retrieved utility data from experimental studies, two (2.9%) from observational and one (1.4%) from other sources. Forty-eight (68.6%) CUS collected the HSU and the other parameters from different populations: eight (11.4%) retrieved utility data from experimental studies, 33 (47.1%) from observational, one (1.4%) from both experimental and observational and six (8.6%) from other sources. It was not possible to identify the population from whom data were obtained in 10 (14.3%) CUS. Eleven (15.7%) CUS followed the recommendations of guidelines, 21 (30.0%) did not follow and for 38 (54.3%), it was not possible to assess. CONCLUSION Choosing different techniques to derive HSU may result in different results, which can preclude the comparison between cost-utility studies.
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Affiliation(s)
- Inês Ribeiro
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research , Coimbra, Portugal.,Faculty of Pharmacy, University of Coimbra , Coimbra, Portugal
| | - Francisco Batel Marques
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research , Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy, University of Coimbra , Coimbra, Portugal
| | - Diogo Mendes
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research , Coimbra, Portugal
| | - Carlos Alves
- AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research , Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, Faculty of Pharmacy, University of Coimbra , Coimbra, Portugal
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11
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Abstract
In clinical glaucoma research, the measurement of patient reported outcomes, functional assessment of disability, and health economic impact is critical. However, valid, time-efficient and comprehensive tools are not available and several current instruments lack in the appropriate precision for measuring the various dimensions of glaucoma-related quality of life (QoL), including functioning and mobility. Furthermore, statistical methods are inconsistently and sometimes incorrectly used in otherwise sound clinical studies. Standardizing and improving methods of patient-centered data collection and analysis in glaucoma studies are imperative. This paper outlines recommendations and provides a discussion of some of the pertinent issues relating to the optimization of patient-reported outcomes research in glaucoma.
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13
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Mukuria C, Rowen D, Harnan S, Rawdin A, Wong R, Ara R, Brazier J. An Updated Systematic Review of Studies Mapping (or Cross-Walking) Measures of Health-Related Quality of Life to Generic Preference-Based Measures to Generate Utility Values. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2019; 17:295-313. [PMID: 30945127 DOI: 10.1007/s40258-019-00467-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Mapping is an increasingly common method used to predict instrument-specific preference-based health-state utility values (HSUVs) from data obtained from another health-related quality of life (HRQoL) measure. There have been several methodological developments in this area since a previous review up to 2007. OBJECTIVE To provide an updated review of all mapping studies that map from HRQoL measures to target generic preference-based measures (EQ-5D measures, SF-6D, HUI measures, QWB, AQoL measures, 15D/16D/17D, CHU-9D) published from January 2007 to October 2018. DATA SOURCES A systematic review of English language articles using a variety of approaches: searching electronic and utilities databases, citation searching, targeted journal and website searches. STUDY SELECTION Full papers of studies that mapped from one health measure to a target preference-based measure using formal statistical regression techniques. DATA EXTRACTION Undertaken by four authors using predefined data fields including measures, data used, econometric models and assessment of predictive ability. RESULTS There were 180 papers with 233 mapping functions in total. Mapping functions were generated to obtain EQ-5D-3L/EQ-5D-5L-EQ-5D-Y (n = 147), SF-6D (n = 45), AQoL-4D/AQoL-8D (n = 12), HUI2/HUI3 (n = 13), 15D (n = 8) CHU-9D (n = 4) and QWB-SA (n = 4) HSUVs. A large number of different regression methods were used with ordinary least squares (OLS) still being the most common approach (used ≥ 75% times within each preference-based measure). The majority of studies assessed the predictive ability of the mapping functions using mean absolute or root mean squared errors (n = 192, 82%), but this was lower when considering errors across different categories of severity (n = 92, 39%) and plots of predictions (n = 120, 52%). CONCLUSIONS The last 10 years has seen a substantial increase in the number of mapping studies and some evidence of advancement in methods with consideration of models beyond OLS and greater reporting of predictive ability of mapping functions.
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Affiliation(s)
- Clara Mukuria
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Sue Harnan
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Andrew Rawdin
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Ruth Wong
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Roberta Ara
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - John Brazier
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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14
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Squires H, Poku E, Bermejo I, Cooper K, Stevens J, Hamilton J, Wong R, Denniston A, Pearce I, Quhill F. A systematic review and economic evaluation of adalimumab and dexamethasone for treating non-infectious intermediate uveitis, posterior uveitis or panuveitis in adults. Health Technol Assess 2018; 21:1-170. [PMID: 29183563 DOI: 10.3310/hta21680] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Non-infectious intermediate uveitis, posterior uveitis and panuveitis are a heterogeneous group of inflammatory eye disorders. Management includes local and systemic corticosteroids, immunosuppressants and biological drugs. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of subcutaneous adalimumab (Humira®; AbbVie Ltd, Maidenhead, UK) and a dexamethasone intravitreal implant (Ozurdex®; Allergan Ltd, Marlow, UK) in adults with non-infectious intermediate uveitis, posterior uveitis or panuveitis. DATA SOURCES Electronic databases and clinical trials registries including MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects and the World Health Organization's International Clinical Trials Registry Platform were searched to June 2016, with an update search carried out in October 2016. REVIEW METHODS Review methods followed published guidelines. A Markov model was developed to assess the cost-effectiveness of dexamethasone and adalimumab, each compared with current practice, from a NHS and Personal Social Services (PSS) perspective over a lifetime horizon, parameterised with published evidence. Costs and benefits were discounted at 3.5%. Substantial sensitivity analyses were undertaken. RESULTS Of the 134 full-text articles screened, three studies (four articles) were included in the clinical effectiveness review. Two randomised controlled trials (RCTs) [VISUAL I (active uveitis) and VISUAL II (inactive uveitis)] compared adalimumab with placebo, with limited standard care also provided in both arms. Time to treatment failure (reduced visual acuity, intraocular inflammation, new vascular lesions) was longer in the adalimumab group than in the placebo group, with a hazard ratio of 0.50 [95% confidence interval (CI) 0.36 to 0.70; p < 0.001] in the VISUAL I trial and 0.57 (95% CI 0.39 to 0.84; p = 0.004) in the VISUAL II trial. The adalimumab group showed a significantly greater improvement than the placebo group in the 25-item Visual Function Questionnaire (VFQ-25) composite score in the VISUAL I trial (mean difference 4.20; p = 0.010) but not the VISUAL II trial (mean difference 2.12; p = 0.16). Some systemic adverse effects occurred more frequently with adalimumab than with placebo. One RCT [HURON (active uveitis)] compared a single 0.7-mg dexamethasone implant against a sham procedure, with limited standard care also provided in both arms. Dexamethasone provided significant benefits over the sham procedure at 8 and 26 weeks in the percentage of patients with a vitreous haze score of zero (p < 0.014), the mean best corrected visual acuity improvement (p ≤ 0.002) and the percentage of patients with a ≥ 5-point improvement in VFQ-25 score (p < 0.05). Raised intraocular pressure and cataracts occurred more frequently with dexamethasone than with the sham procedure. The incremental cost-effectiveness ratio (ICER) for one dexamethasone implant in one eye for a combination of patients with unilateral and bilateral uveitis compared with limited current practice, as per the HURON trial, was estimated to be £19,509 per quality-adjusted life-year (QALY) gained. The ICER of adalimumab for patients with mainly bilateral uveitis compared with limited current practice, as per the VISUAL trials, was estimated to be £94,523 and £317,547 per QALY gained in active and inactive uveitis respectively. Sensitivity analyses suggested that the rate of blindness has the biggest impact on the model results. The interventions may be more cost-effective in populations in which there is a greater risk of blindness. LIMITATIONS The clinical trials did not fully reflect clinical practice. Thirteen additional studies of clinically relevant comparator treatments were identified; however, network meta-analysis was not feasible. The model results are highly uncertain because of the limited evidence base. CONCLUSIONS Two RCTs of systemic adalimumab and one RCT of a unilateral, single dexamethasone implant showed significant benefits over placebo or a sham procedure. The ICERs for adalimumab were estimated to be above generally accepted thresholds for cost-effectiveness. The cost-effectiveness of dexamethasone was estimated to fall below standard thresholds. However, there is substantial uncertainty around the model assumptions. In future work, primary research should compare dexamethasone and adalimumab with current treatments over the long term and in important subgroups and consider how short-term improvements relate to long-term effects on vision. STUDY REGISTRATION This study is registered as PROSPERO CRD42016041799. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Hazel Squires
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Edith Poku
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Inigo Bermejo
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Katy Cooper
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - John Stevens
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Jean Hamilton
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Ruth Wong
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Ian Pearce
- St Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK
| | - Fahd Quhill
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
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15
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Murphy A, McElnea E, Byrne S. Health technology assessment: A primer for ophthalmology. Eur J Ophthalmol 2018; 28:358-364. [DOI: 10.1177/1120672117747040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rising healthcare costs and increasing demands for health care require techniques to choose between competing uses and even rationing of health care. Economic evaluations and health technology assessments are increasingly a means to assess the cost effectiveness of healthcare interventions so as to inform such resource allocation decisions. To date, the adoption of health technology assessments, as a way of assessing cost effectiveness, in ophthalmology has been slower, relative to their implementation in other specialities. Nevertheless, demands for eye services are increasing due to an ageing population. The prevalence of conditions such as glaucoma, cataract, diabetic eye disease and age-related macular degeneration increases with age, and it is predicted that global blindness will triple by 2050. So there is a challenge for ophthalmologists to ensure that they can contribute to, interpret, critically evaluate, and use findings from economic evaluations in their clinical practice. To aid this, this article serves as a primer on the use of health technology assessments to assess cost effectiveness using economic evaluation techniques for ophthalmologists. Healthcare systems face many challenges worldwide – changing demographics and evolution of new technologies are only going to intensify. With this in mind, ophthalmology needs to be ready and able to engage with health economists to prepare, interpret, critically evaluate and use findings of economic evaluations and health technology assessments.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, Cork, Ireland
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16
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Prigent A, Kamendje-Tchokobou B, Chevreul K. Socio-demographic, clinical characteristics and utilization of mental health care services associated with SF-6D utility scores in patients with mental disorders: contributions of the quantile regression. Qual Life Res 2017. [PMID: 28638967 DOI: 10.1007/s11136-017-1623-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Health-related quality of life (HRQoL) is a widely used concept in the assessment of health care. Some generic HRQoL instruments, based on specific algorithms, can generate utility scores which reflect the preferences of the general population for the different health states described by the instrument. This study aimed to investigate the relationships between utility scores and potentially associated factors in patients with mental disorders followed in inpatient and/or outpatient care settings using two statistical methods. METHODS Patients were recruited in four psychiatric sectors in France. Patient responses to the SF-36 generic HRQoL instrument were used to calculate SF-6D utility scores. The relationships between utility scores and patient socio-demographic, clinical characteristics, and mental health care utilization, considered as potentially associated factors, were studied using OLS and quantile regressions. RESULTS One hundred and seventy six patients were included. Women, severely ill patients and those hospitalized full-time tended to report lower utility scores, whereas psychotic disorders (as opposed to mood disorders) and part-time care were associated with higher scores. The quantile regression highlighted that the size of the associations between the utility scores and some patient characteristics varied along with the utility score distribution, and provided more accurate estimated values than OLS regression. CONCLUSIONS The quantile regression may constitute a relevant complement for the analysis of factors associated with utility scores. For policy decision-making, the association of full-time hospitalization with lower utility scores while part-time care was associated with higher scores supports the further development of alternatives to full-time hospitalizations.
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Affiliation(s)
- Amélie Prigent
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France.
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France.
- Inserm, ECEVE, U1123, 75010, Paris, France.
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France.
| | - Blaise Kamendje-Tchokobou
- Centre Hospitalier Départemental Georges Daumézon, Fleury-Les-Aubrais, 45400, France
- Agence Régionale de Santé Centre-Val de Loire, Cité administrative Coligny, 131 Rue du Faubourg Bannier, 45000, Orléans, France
| | - Karine Chevreul
- AP-HP, URC Eco Ile-de-France, 1, place du parvis Notre Dame, 75004, Paris, France
- University Paris Diderot, Sorbonne Paris Cité, ECEVE, UMR 1123, 75010, Paris, France
- Inserm, ECEVE, U1123, 75010, Paris, France
- Fondation FondaMental, French National Science Foundation, Créteil, 94000, France
- Department of Public Health, AP-HP, Robert-Debré University Hospital, 75019, Paris, France
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17
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Myojin T, Ojima T, Kikuchi K, Okada E, Shibata Y, Nakamura M, Hashimoto S. Orthopedic, ophthalmic, and psychiatric diseases primarily affect activity limitation for Japanese males and females: Based on the Comprehensive Survey of Living Conditions. J Epidemiol 2016; 27:75-79. [PMID: 28142015 PMCID: PMC5328730 DOI: 10.1016/j.je.2016.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 03/17/2016] [Indexed: 11/30/2022] Open
Abstract
Background Healthy life expectancy (HLE) is used as one of the primary objectives of fundamental health promotion plans and social development plans. Activity limitation is used to calculate HLE, but little study has been done to identify determinants of activity limitation in order to extend HLE. The purpose of this study is to identify diseases and injuries that commonly lead to activity limitation to prioritize countermeasures against activity limitation. Methods We used anonymous data from the 2007 “Comprehensive Survey of Living Conditions,” collected by the Ministry of Health, Labour and Welfare of Japan according to the Statistics Act, Article 36. We used logistic regression analyses and calculated odds ratios (ORs) after adjusting for age and sex. Limitation in daily activities was applied as the dependent variable, and each disease/injury was applied as an independent variable in this analysis. Furthermore, population attributable fractions (PAFs) were calculated. Results The provided data included 98,789 subjects. We used data for 75,986 valid subjects aged 12 years or older. The following diseases showed high PAF: backache (PAF 13.27%, OR 3.88), arthropathia (PAF 7.61%, OR 4.82), eye and optical diseases (PAF 6.39%, OR 2.01), and depression and other mental diseases (PAF 5.70%, OR 11.55). PAFs of cerebrovascular diseases, hypertension, and diabetes were higher for males than for females; on the other hand, PAFs of orthopedic diseases were higher among females. Conclusions Our results indicate that orthopedic diseases, ophthalmic diseases, and psychiatric diseases particularly affect activity limitation.
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Affiliation(s)
- Tomoya Myojin
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan.
| | - Toshiyuki Ojima
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Keiko Kikuchi
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Eisaku Okada
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yosuke Shibata
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Mieko Nakamura
- Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Shuji Hashimoto
- Department of Hygiene, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
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18
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Muratov S, Podbielski DW, Jack SM, Ahmed IIK, Mitchell LAH, Baltaziak M, Xie F. Preference-based disease-specific health-related quality of life instrument for glaucoma: a mixed methods study protocol. BMJ Open 2016; 6:e012732. [PMID: 28186941 PMCID: PMC5129010 DOI: 10.1136/bmjopen-2016-012732] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION A primary objective of healthcare services is to improve patients' health and health-related quality of life (HRQoL). Glaucoma, which affects a substantial proportion of the world population, has a significant detrimental impact on HRQoL. Although there are a number of glaucoma-specific questionnaires to measure HRQoL, none is preference-based which prevent them from being used in health economic evaluation. The proposed study is aimed to develop a preference-based instrument that is capable of capturing important effects specific to glaucoma and treatments on HRQoL and is scored based on the patients' preferences. METHODS A sequential, exploratory mixed methods design will be used to guide the development and evaluation of the HRQoL instrument. The study consists of several stages to be implemented sequentially: item identification, item selection, validation and valuation. The instrument items will be identified and selected through a literature review and the conduct of a qualitative study. Validation will be conducted to establish psychometric properties of the instrument followed by a valuation exercise to derive utility scores for the health states described. ETHICS AND DISSEMINATION This study has been approved by the Trillium Health Partners Research Ethics Board (ID number 753). All personal information will be de-identified with the identification code kept in a secured location including the rest of the study data. Only qualified and study-related personnel will be allowed to access the data. The results of the study will be distributed widely through peer-reviewed journals, conferences and internal meetings.
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Affiliation(s)
- Sergei Muratov
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Dominik W Podbielski
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Susan M Jack
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Iqbal Ike K Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Trillium Health Partners, Mississauga, Ontario, Canada
| | - Levine A H Mitchell
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Monika Baltaziak
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Feng Xie
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Research Institute of St Joseph's Hamilton, and Program for Health Economics and Outcome Measures, Hamilton, Ontario, Canada
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19
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The Visual Function Questionnaire: Utility Index: Does It Measure Glaucoma-related Preference-based Status? J Glaucoma 2016; 25:822-829. [DOI: 10.1097/ijg.0000000000000441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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20
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Royle P, Mistry H, Auguste P, Shyangdan D, Freeman K, Lois N, Waugh N. Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy: systematic review and economic evaluation. Health Technol Assess 2016; 19:v-xxviii, 1-247. [PMID: 26173799 DOI: 10.3310/hta19510] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Diabetic retinopathy is an important cause of visual loss. Laser photocoagulation preserves vision in diabetic retinopathy but is currently used at the stage of proliferative diabetic retinopathy (PDR). OBJECTIVES The primary aim was to assess the clinical effectiveness and cost-effectiveness of pan-retinal photocoagulation (PRP) given at the non-proliferative stage of diabetic retinopathy (NPDR) compared with waiting until the high-risk PDR (HR-PDR) stage was reached. There have been recent advances in laser photocoagulation techniques, and in the use of laser treatments combined with anti-vascular endothelial growth factor (VEGF) drugs or injected steroids. Our secondary questions were: (1) If PRP were to be used in NPDR, which form of laser treatment should be used? and (2) Is adjuvant therapy with intravitreal drugs clinically effective and cost-effective in PRP? ELIGIBILITY CRITERIA Randomised controlled trials (RCTs) for efficacy but other designs also used. DATA SOURCES MEDLINE and EMBASE to February 2014, Web of Science. REVIEW METHODS Systematic review and economic modelling. RESULTS The Early Treatment Diabetic Retinopathy Study (ETDRS), published in 1991, was the only trial designed to determine the best time to initiate PRP. It randomised one eye of 3711 patients with mild-to-severe NPDR or early PDR to early photocoagulation, and the other to deferral of PRP until HR-PDR developed. The risk of severe visual loss after 5 years for eyes assigned to PRP for NPDR or early PDR compared with deferral of PRP was reduced by 23% (relative risk 0.77, 99% confidence interval 0.56 to 1.06). However, the ETDRS did not provide results separately for NPDR and early PDR. In economic modelling, the base case found that early PRP could be more effective and less costly than deferred PRP. Sensitivity analyses gave similar results, with early PRP continuing to dominate or having low incremental cost-effectiveness ratio. However, there are substantial uncertainties. For our secondary aims we found 12 trials of lasers in DR, with 982 patients in total, ranging from 40 to 150. Most were in PDR but five included some patients with severe NPDR. Three compared multi-spot pattern lasers against argon laser. RCTs comparing laser applied in a lighter manner (less-intensive burns) with conventional methods (more intense burns) reported little difference in efficacy but fewer adverse effects. One RCT suggested that selective laser treatment targeting only ischaemic areas was effective. Observational studies showed that the most important adverse effect of PRP was macular oedema (MO), which can cause visual impairment, usually temporary. Ten trials of laser and anti-VEGF or steroid drug combinations were consistent in reporting a reduction in risk of PRP-induced MO. LIMITATION The current evidence is insufficient to recommend PRP for severe NPDR. CONCLUSIONS There is, as yet, no convincing evidence that modern laser systems are more effective than the argon laser used in ETDRS, but they appear to have fewer adverse effects. We recommend a trial of PRP for severe NPDR and early PDR compared with deferring PRP till the HR-PDR stage. The trial would use modern laser technologies, and investigate the value adjuvant prophylactic anti-VEGF or steroid drugs. STUDY REGISTRATION This study is registered as PROSPERO CRD42013005408. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Pamela Royle
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Hema Mistry
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Peter Auguste
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Deepson Shyangdan
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Karoline Freeman
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Norman Waugh
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
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Dixon P, Dakin H, Wordsworth S. Generic and disease-specific estimates of quality of life in macular degeneration: mapping the MacDQoL onto the EQ-5D-3L. Qual Life Res 2015; 25:935-45. [PMID: 26462812 DOI: 10.1007/s11136-015-1145-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE The macular degeneration quality of life (MacDQoL) instrument is a validated condition-specific measure of quality of life in patients with macular degeneration. This paper presents the first mapping algorithm to predict EQ-5D from responses to the MacDQoL instrument. METHODS Responses to the MacDQoL and EQ-5D-3L instruments from 482 patients were collected from the IVAN multicentre trial of two alternative drug treatments for neovascular age-related macular degeneration. Regression specifications were estimated using OLS, censored least absolute deviation, Tobit and two-part models. Their predictive performance was assessed using mean squared error. An internal validation sample based on a random selection of 25 % of patients was used to assess the performance of the model estimated on the remaining 75 % of patients. RESULTS A two-part model had the best predictive performance on the full sample. The covariates of this model include responses and weighted impact scores for all 23 condition-specific domains of the MacDQoL, and responses to a general MacDQoL quality of life question. The selected models were successful at predicting means and standard deviations of target populations, but prediction is weaker at the upper and lower extremes of the EQ-5D-3L distribution. CONCLUSION The mapping algorithms provide a means of predicting EQ-5D-3L index scores from MacDQoL scores, and could facilitate cost-effectiveness analyses when the latter but not the former are available to researchers. Further validation of the performance of the algorithms using external data would provide a means of establishing the robustness of the algorithms.
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Affiliation(s)
- Padraig Dixon
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - Helen Dakin
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom
| | - Sarah Wordsworth
- Nuffield Department of Population Health, Health Economics Research Centre, University of Oxford, Old Road Campus, Oxford, OX3 7LF, United Kingdom
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Petrou S, Rivero-Arias O, Dakin H, Longworth L, Oppe M, Froud R, Gray A. The MAPS Reporting Statement for Studies Mapping onto Generic Preference-Based Outcome Measures: Explanation and Elaboration. PHARMACOECONOMICS 2015; 33:993-1011. [PMID: 26232200 DOI: 10.1007/s40273-015-0312-9] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
BACKGROUND The process of "mapping" is increasingly being used to predict health utilities, for application within health economic evaluations, using data on other indicators or measures of health. Guidance for the reporting of mapping studies is currently lacking. OBJECTIVE The overall objective of this research was to develop a checklist of essential items, which authors should consider when reporting mapping studies. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a checklist, which aims to promote complete and transparent reporting by researchers. This paper provides a detailed explanation and elaboration of the items contained within the MAPS statement. METHODS In the absence of previously published reporting checklists or reporting guidance documents, a de novo list of reporting items and accompanying explanations was created. A two-round, modified Delphi survey, with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, was used to identify a list of essential reporting items from this larger list. RESULTS From the initial de novo list of 29 candidate items, a set of 23 essential reporting items was developed. The items are presented numerically and categorised within six sections, namely, (i) title and abstract, (ii) introduction, (iii) methods, (iv) results, (v) discussion and (vi) other. For each item, we summarise the recommendation, illustrate it using an exemplar of good reporting practice identified from the published literature, and provide a detailed explanation to accompany the recommendation. CONCLUSIONS It is anticipated that the MAPS statement will promote clarity, transparency and completeness of reporting of mapping studies. It is targeted at researchers developing mapping algorithms, peer reviewers and editors involved in the manuscript review process for mapping studies, and the funders of the research. The MAPS working group plans to assess the need for an update of the reporting checklist in 5 years' time.
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Affiliation(s)
- Stavros Petrou
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Helen Dakin
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Louise Longworth
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - Mark Oppe
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Robert Froud
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- Norges Helsehøyskole, Campus Kristiania, Oslo, Norway
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Petrou S, Rivero-Arias O, Dakin H, Longworth L, Oppe M, Froud R, Gray A. The MAPS Reporting Statement for Studies Mapping onto Generic Preference-Based Outcome Measures: Explanation and Elaboration. PHARMACOECONOMICS 2015. [PMID: 26232200 DOI: 10.1016/j.jval.2015.09.2702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND The process of "mapping" is increasingly being used to predict health utilities, for application within health economic evaluations, using data on other indicators or measures of health. Guidance for the reporting of mapping studies is currently lacking. OBJECTIVE The overall objective of this research was to develop a checklist of essential items, which authors should consider when reporting mapping studies. The MAPS (MApping onto Preference-based measures reporting Standards) statement is a checklist, which aims to promote complete and transparent reporting by researchers. This paper provides a detailed explanation and elaboration of the items contained within the MAPS statement. METHODS In the absence of previously published reporting checklists or reporting guidance documents, a de novo list of reporting items and accompanying explanations was created. A two-round, modified Delphi survey, with representatives from academia, consultancy, health technology assessment agencies and the biomedical journal editorial community, was used to identify a list of essential reporting items from this larger list. RESULTS From the initial de novo list of 29 candidate items, a set of 23 essential reporting items was developed. The items are presented numerically and categorised within six sections, namely, (i) title and abstract, (ii) introduction, (iii) methods, (iv) results, (v) discussion and (vi) other. For each item, we summarise the recommendation, illustrate it using an exemplar of good reporting practice identified from the published literature, and provide a detailed explanation to accompany the recommendation. CONCLUSIONS It is anticipated that the MAPS statement will promote clarity, transparency and completeness of reporting of mapping studies. It is targeted at researchers developing mapping algorithms, peer reviewers and editors involved in the manuscript review process for mapping studies, and the funders of the research. The MAPS working group plans to assess the need for an update of the reporting checklist in 5 years' time.
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Affiliation(s)
- Stavros Petrou
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| | - Oliver Rivero-Arias
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Helen Dakin
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Louise Longworth
- Health Economics Research Group, Brunel University London, Uxbridge, UK
| | - Mark Oppe
- EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Robert Froud
- Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
- Norges Helsehøyskole, Campus Kristiania, Oslo, Norway
| | - Alastair Gray
- Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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25
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Vokó Z, Németh R, Nagyjánosi L, Jermendy G, Winkler G, Hídvégi T, Kalotai Z, Kaló Z. Mapping the Nottingham Health Profile onto the Preference-Based EuroQol-5D Instrument for Patients with Diabetes. Value Health Reg Issues 2014; 4:31-36. [PMID: 29702803 DOI: 10.1016/j.vhri.2014.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The aim of this study was to derive a function that can map the Nottingham Health Profile (NHP) questionnaire onto a utility measure, the EuroQol five-dimensional (EQ-5D) questionnaire index, for diabetic patients. METHODS A cross-sectional study was performed on diabetic patients in Hungary with different complications in which quality of life was measured by using both the NHP questionnaire and the EQ-5D questionnaire. Ordinary stepwise-backward least-squares regression was used to develop a mapping function. Adjusted R2, Akaike's information criterion, and root mean square error were used to assess the performance of the model. The robustness of the models was tested using 10-fold cross-validation and bootstrapping. RESULTS The best-fitting models were those that contained all the NHP statements as predictors and a stepwise reduced version that contained only 19 statements. The latter model, however, showed considerable variability in the selection of predictors. The adjusted R2 of the former model was 0.68, the root mean square error was 174, and the Akaike's information criterion was -559.9. CONCLUSIONS The expected value of the EQ-5D questionnaire can be reasonably predicted on the basis of results of the NHP in patients with diabetes mellitus. The mapping function of the NHP onto the EQ-5D questionnaire is capable of estimating the expected EQ-5D questionnaire utility values in a group of patients with diabetes. The function's applicability for individual-level predictions, however, is limited. Further research is needed to find out whether mapping functions developed in Central-Eastern European countries are transferable to Western European countries.
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Affiliation(s)
- Zoltán Vokó
- Faculty of Social Sciences, Department of Health Policy & Health Economics, Institute of Economics, Eötvös Loránd University; Syreon Research Institute.
| | - Renáta Németh
- Faculty of Social Sciences, Department of Statistics, Eötvös Loránd University
| | | | - György Jermendy
- 3rd Department of Internal Medicine, Bajcsy-Zsilinszky Hospital
| | - Gábor Winkler
- 2nd Department of Internal Medicine - Diabetology, Saint John Hospital, Budapest, Hungary; Faculty of Health Care, Institute of Theoretical Health Sciences, University of Miskolc, Miskolc, Hungary
| | - Tibor Hídvégi
- Department of Metabolic Disorders, Endocrinology and Diabetology, Petz Aladár County Teaching Hospital, Győr, Hungary
| | | | - Zoltán Kaló
- Faculty of Social Sciences, Department of Health Policy & Health Economics, Institute of Economics, Eötvös Loránd University; Syreon Research Institute
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Boye KS, Matza LS, Feeny DH, Johnston JA, Bowman L, Jordan JB. Challenges to time trade-off utility assessment methods: when should you consider alternative approaches? Expert Rev Pharmacoecon Outcomes Res 2014; 14:437-50. [DOI: 10.1586/14737167.2014.912562] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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