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Jumamyradov M, Craig BM, Jakubczyk M. Scale and rate heterogeneity in the EQ-5D-5L valuation. Health Qual Life Outcomes 2024; 22:55. [PMID: 39003479 DOI: 10.1186/s12955-024-02271-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: 03/29/2024] [Accepted: 06/30/2024] [Indexed: 07/15/2024] Open
Abstract
OBJECTIVES To estimate values on a quality-adjusted life year (QALY) scale using individual preference evidence, choice analyses typically include ancillary parameters, such as scale factors and discount rates. These parameters potentially differ among respondents. In this study, we investigated how allowing heterogeneity in scale and rate affects the estimation of EQ-5D-5L values. METHODS Using the first wave of the 2016 EQ-5D-5L valuation study (N = 1017), we estimated a conditional logit (CL) model and three mixed logit models: random scale, random rate, and bivariate. Prior to the exploratory study, we hypothesized that scale and rate are correlated and that allowing heterogeneity in both parameters decreases the number of insignificant incremental effects. We confirmed the exploratory findings by re-estimating these models using paired comparison responses from a second wave (N = 1229). RESULTS Scale and rate exhibited significant heterogeneity and were positively correlated. As hypothesized, allowing this heterogeneity improved the face validity of the EQ-5D-5L value set by reducing the number of insignificant incremental effects (from 6 to 2 p-values > 0.05; out of 20). Nevertheless, the CL and bivariate mixed logit estimates are highly correlated and concordant (Pearson correlation coefficient of 0.897, Spearman correlation coefficient of 0.888, Lin's concordance coefficient of 0.763). CONCLUSIONS Allowing this heterogeneity adds three parameters to the estimation (two variances and a correlation) and improves the face validity of the EQ-5D-5L values. This finding may influence experimental design and choice analysis in health valuation more generally.
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Affiliation(s)
| | - Benjamin M Craig
- Department of Economics, University of South Florida, Tampa, FL, USA
| | - Michał Jakubczyk
- Division of Decision Analysis and Support, SGH Warsaw School of Economics, Warsaw, Poland
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Martins F, Gonçalves FT, Imamura M, Barboza DS, Matheus D, Pereira MFB, Marques HHS, Correa-Silva S, Montenegro MM, Fink TT, Lindoso L, Bain V, Ferreira JCOA, Astley C, Matsuo OM, Suguita P, Trindade V, Paula CSY, Litvinov N, Palmeira P, Gualano B, Delgado AF, Carneiro-Sampaio M, Forsait S, Odone-Filho V, Antonangelo L, Battistella LR, Silva CA. Health-related quality of life and functionality in primary caregiver of surviving pediatric COVID-19. Front Public Health 2023; 11:1117854. [PMID: 37408752 PMCID: PMC10319046 DOI: 10.3389/fpubh.2023.1117854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/16/2023] [Indexed: 07/07/2023] Open
Abstract
Objectives To prospectively assess health-related quality of life (HRQoL), global functionality, and disability in primary caregivers of surviving children and adolescents after COVID-19. Methods A longitudinal observational study was carried out on primary caregivers of surviving pediatric post-COVID-19 patients (n = 51) and subjects without COVID-19 (n = 60). EuroQol five-dimension five-level questionnaire (EQ-5D-5L) and 12-question WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) were answered for both groups. The univariate regression analysis was carried out using SPSS (v 20) and significance was established at 5%. Results The median duration between COVID-19 diagnosis in children and adolescents and longitudinal follow-up visits was 4.4 months (0.8-10.7). The median age of children and adolescents caregivers with laboratory-confirmed COVID-19 was similar to primary caregivers of subjects without laboratory-confirmed COVID-19 [43.2 (31.6-60.9) vs. 41.5 (21.6-54.8) years, p = 0.08], as well as similar female sex (p = 1.00), level of schooling (p = 0.11), social assistance program (p = 0.28), family income/month U$ (p = 0.25) and the number of household's members in the residence (p = 0.68). The frequency of slight to extreme problems (level ≥ 2) of the pain/discomfort domain according to EQ-5D-5L score was significantly higher in the former group [74% vs. 52.5%, p = 0.03, OR = 2.57 (1.14-5.96)]. The frequency of disability according to WHODAS 2.0 total score was similar to those without disability and unknown (p = 0.79); however, with a very high disability in both groups (72.5% and 78.3%). Further analysis of primary caregivers of children and adolescents with post-COVID-19 condition (PCC) [n = 12/51 (23%)] compared to those without PCC [n = 39/51(77%)] revealed no differences between demographic data, EQ-5D-5L and WHODAS 2.0 scores in both groups (p > 0.05). Conclusion We longitudinally demonstrated that pain/discomfort were predominantly reported in approximately 75% of primary caregiver of COVID-19 patients, with high disability in approximately three-quarters of both caregiver groups. These data emphasized the prospective and systematic caregiver burden evaluation relevance of pediatric COVID-19.
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Affiliation(s)
- Fernanda Martins
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
- Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
| | - Fernanda T. Gonçalves
- Laboratorio de Imunohematologia e Hematologia Forense (LIM-40), Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marta Imamura
- Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Daniela S. Barboza
- Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
| | - Denise Matheus
- Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
| | - Maria Fernanda B. Pereira
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Heloisa H. S. Marques
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Simone Correa-Silva
- Laboratório de Pediatria Clínica (LIM-36), Departamento de Pediatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marilia M. Montenegro
- Laboratório de Pediatria Clínica (LIM-36), Departamento de Pediatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Thais T. Fink
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Livia Lindoso
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vera Bain
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Juliana C. O. A. Ferreira
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camilla Astley
- Faculdade de Medicina, Divisão de Reumatologia, Hospital das Clínicas, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Olivia M. Matsuo
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Priscila Suguita
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vitor Trindade
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Camila S. Y. Paula
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Nadia Litvinov
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Patricia Palmeira
- Laboratório de Pediatria Clínica (LIM-36), Departamento de Pediatria, Faculdade de Medicina, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Bruno Gualano
- Faculdade de Medicina, Divisão de Reumatologia, Hospital das Clínicas, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Artur F. Delgado
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Magda Carneiro-Sampaio
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Silvana Forsait
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vicente Odone-Filho
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Leila Antonangelo
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Linamara R. Battistella
- Instituto de Medicina Física e Reabilitação, Hospital das Clínicas HCFMUSP, São Paulo, SP, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Clovis A. Silva
- Faculdade de Medicina, Instituto da Criança e do Adolescente, Hospital das Clínicas HCFMUSP, Universidade de São Paulo, São Paulo, SP, Brazil
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Łaszewska A, Sajjad A, Busschbach J, Simon J, Hakkaart-van Roijen L. Conceptual Framework for Optimised Proxy Value Set Selection Through Supra-National Value Set Development for the EQ-5D Instruments. PHARMACOECONOMICS 2022; 40:1221-1234. [PMID: 36201130 PMCID: PMC9534733 DOI: 10.1007/s40273-022-01194-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/11/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Preference differences between countries and populations justify the use of country-specific value sets for the EQ-5D instruments. There are no clear criteria based on which the selection of value sets for countries without a national value set should be made. As part of the European PECUNIA project, this study aimed to identify factors contributing to differences in preference-based valuations and develop supra-national value sets for homogenous country clusters in Europe. METHODS A literature review was conducted to identify factors relevant to variations in the EQ-5D-3L/5L health state valuations across countries. Factors fulfilling the pre-specified criteria of validity, reliability, international feasibility and comparability were used to group 27 European Union member states, the European Free Trade Association countries and the UK. Clusters of countries were developed based on the frequency of their appearance in the same grouping. The supra-national value sets were estimated for these clusters from the coefficients of existing published valuation studies using the ordinary least-squares model. RESULTS Ten factors were identified from 69 studies. From these, five grouping variables: (1) culture and religion; (2) linguistics; (3) healthcare system typology; (4) healthcare system financing; and (5) sociodemographic aspects were derived to define the groups of homogenous countries. Frequency-based grouping revealed five cohesive clusters: English-speaking, Nordic, Central-Western, Southern and Eastern European. CONCLUSIONS European countries were clustered considering variables that may relate to differences in health state valuations. Supra-national value sets provide optimised proxy value set selection in the lack of a national value set and/or for regional decision making.
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Affiliation(s)
- Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria.
| | - Ayesha Sajjad
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Jan Busschbach
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Craig BM, Rand K, Hartman JD. Preference Paths and Their Kaizen Tasks for Small Samples. THE PATIENT 2022; 15:187-196. [PMID: 34327605 PMCID: PMC8321769 DOI: 10.1007/s40271-021-00541-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Stated preference research currently lacks a form of evidence that is well suited for small samples. A preference path is a sequence of two or more choices showing the evolution of an object following an adaptive process. OBJECTIVES The aims were to introduce preference paths and their kaizen tasks and to demonstrate how to analyze their evidence using a small sample. METHODS Twenty respondents were assigned the same 16 profiles generated from an orthogonal array based on the five attributes of the EQ-5D-5L descriptive system. Each kaizen task began with an opt-out paired comparison (i.e., choosing between the initial 10-year profile and the opt-out "dying immediately"), followed by choosing three changes, and ended with a second paired comparison (final profile versus opt-out) if the respondent chose opt-out initially. By maximum likelihood with respondent clusters, we estimated the 20 main effects using conditional logit and Zermelo-Bradley-Terry (ZBT) specifications. RESULTS Apart from demonstrating heterogeneity and profile effects, all main effect estimates were non-negative, and most were significant (15 for logit and all 20 for ZBT; p value < 0.05). Under the logit and ZBT specifications, the value of the worst EQ-5D-5L profile (55555) is - 0.920 quality-adjusted life years (QALYs) or - 1.478 QALYs, respectively. Furthermore, the findings illustrate a log-linear relationship between the logit and ZBT main effects. CONCLUSION This paper demonstrates the feasibility of a stated-preference study that estimates 20 main effects using path evidence from 20 respondents (16 kaizen tasks, 15-min interviews). This approach shows promise for future application in stated-preference research, particularly in small samples.
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Affiliation(s)
| | - Kim Rand
- Health Services Research Center, Akershus University Hospital, Lørenskog, Norway.,Maths in Health B.V., Rotterdam, The Netherlands
| | - John D Hartman
- Department of Health Science and Administration, University of West Florida, Pensacola, Florida, USA
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Cross-Cultural Adaptation of the Beta EQ-5D-Y-5L Into Chichewa (Malawi). Value Health Reg Issues 2021; 29:36-44. [PMID: 34801884 DOI: 10.1016/j.vhri.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/02/2021] [Accepted: 09/12/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The EuroQol Group is developing a new EQ-5D-Y-5L version with 5 severity levels for each of the 5 dimensions. The 5 severity levels describe different health severities and there is a potential for severity level inversion. This article aims to report the process of cross-cultural adaptation of the beta EQ-5D-Y-5L into Chichewa (Malawi) using the card ranking exercise, which has been added to the EQ-5D-Y-5L translation protocol. METHODS To assess the correct hierarchical ordering of severity levels, the adaptation followed the EQ-5D-Y-5L translation protocol. Cognitive interviews were undertaken to establish conceptual equivalence. Thereafter, 4 iterations of ranking exercises were conducted, leading to amendments of the translated Chichewa version to arrive at a final version. RESULTS The iterations were assessed by 18 participants aged 8 to 14 years. Health proved to be a difficult concept to translate as was "discomfort." Cognitive interviews identified further conceptual issues, particularly with the "looking after myself" dimension. Considerations about lack of soap or water indicated that some children did not fully comprehend this dimension as being about the ability to wash and dress themselves. The iterative card ranking exercise detected severity level inversion between "a little bit" and "some," and between "a lot" and "extreme" and alternative Chichewa words/phrases were then tested. Ultimately, the intended hierarchical severity ranking was achieved and an acceptable Chichewa version was produced. CONCLUSIONS Conceptual and linguistic equivalence to the English EQ-5D-Y-5L was established for the Chichewa EQ-5D-Y-5L version. The card ranking exercise was instrumental in correcting severity level inversion and supporting the comprehensible translation.
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de Almeida Tolentino G, Lima Florencio L, Ferreira Pinheiro C, Dach F, Fernández-de-Las-Peñas C, Bevilaqua-Grossi D. Effects of combining manual therapy, neck muscle exercises, and therapeutic pain neuroscience education in patients with migraine: a study protocol for a randomized clinical trial. BMC Neurol 2021; 21:249. [PMID: 34187384 PMCID: PMC8240357 DOI: 10.1186/s12883-021-02290-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: 05/06/2021] [Accepted: 06/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Non-pharmacological approaches for the management of migraine exhibit low to moderate effectiveness due to a lack of high-quality randomized clinical trials. In fact, previous studies applied isolated techniques, which were not representative of common clinical practice. A multimodal approach for migraine may benefit these patients more than isolated approaches. This randomized clinical trial aims to determine the effectiveness of a multimodal protocol combining manual therapy, exercise, and therapeutic pain neuroscience education versus the application of manual therapy or pain neuroscience education alone in patients with migraine. Methods This clinical trial will include 75 individuals of both sexes, aged between 18 and 55 years, with migraine. Participants will be randomized into three groups: the therapeutic pain neuroscience education (TPNE; n = 25) group, the manual therapy (MT; n = 25) group, and the multimodal (MM; n = 25) group. The TPNE group will receive one orientation session on migraine and pain self-management, and recommendations for daily active stretching and walking, with subsequent therapist monitoring. The MT group will receive manual therapies targeting musculoskeletal disorders of the cervical spine. The MM group will receive manual therapies targeting musculoskeletal disorders of the cervical spine, active neck exercises, and therapeutic pain neuroscience education. The treatment period will last 12 weeks. The primary outcome will be the headache impact, measured using the Headache Impact Test (HIT-6). Secondary outcomes will include migraine frequency and intensity, cervical mobility and strength parameters, neck pain-related disability, kinesiophobia, cutaneous allodynia, pain-related catastrophizing, quality of life, and self-perception of change. All outcomes will be evaluated at the fourth, eighth, and twelfth weeks of the treatment period. Primary and secondary clinical outcomes, such as headache impact, frequency, and intensity, will also be evaluated at the 1-, 2-, and 4-month follow-ups. Discussion The results of this randomized clinical trial may provide high-quality clinical evidence of the effects of non-pharmacological treatment options for the management of migraine. Trial registration This study was registered under the access code RBR-7s22c75 in the Registro Brasileiro de Ensaios Clínicos (ReBEC) in December 2020.
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Affiliation(s)
- Gabriella de Almeida Tolentino
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Lidiane Lima Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Carina Ferreira Pinheiro
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Fabíola Dach
- Department of Neurosciences and Behavioral Sciences - Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Débora Bevilaqua-Grossi
- Department of Health Sciences - Ribeirão Preto Medical School, University of São Paulo, 3900, Bandeirantes Avenue - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
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Derrett S, Herdman M, Ngwira LG, Moore EY, Jelsma J. A New Approach to Assessing Children's Interpretation of Severity Qualifiers in a Multi-Attribute Utility Instrument-The EQ-5D-Y-5L: Development and Testing. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 14:591-600. [PMID: 33650034 PMCID: PMC8357732 DOI: 10.1007/s40271-021-00496-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/23/2021] [Indexed: 11/28/2022]
Abstract
Introduction The beta EQ-5D-Y-5L is a new patient-reported outcome measure (PROM) for children aged 8–15 years that is currently under development by the EuroQol Group. The EQ-5D-Y-5L is similar to the EQ-5D-Y but has five levels of severity per dimension rather than three. The increased number of levels increases the granularity of the responses but possibly has also increased the difficulty of distinguishing between levels. The EuroQoL’s Version Management Committee (VMC) required a robust method to determine how well children distinguish between the five EQ-5D-Y-5L ordinal severity qualifiers (i.e. ‘no problems’ through to ‘extreme problems’), which are a critical aspect of both health measurement and the valuation of health states. Objective This paper describes the development, testing, selection, and piloting of such a method. Methods Following a literature review and consultation with the wider VMC and a Language Support Services agency, a range of exercises were developed to assess the ordering and comprehension of the five severity qualifiers. Three exercises were pre-tested with children in Spain and New Zealand. One exercise, preferred and understood by children, was then piloted. Results Five children in Spain and 11 in New Zealand tested the three exercises. In both countries, all children found the three exercises easy to understand and complete. Of the 12 children who expressed a preference, nine said they preferred the card ranking. Card ranking also allowed the interviewer to observe difficult choices being made as the children physically rearranged the card order until they settled on their final order. Following rigorous assessment of translatability and cultural portability by an independent Language Support Service, card ranking was piloted in South Africa (n = 9) and in Indonesia (n = 10), where it highlighted severity qualifier order inversions that would otherwise not have been detected. Conclusion The card ranking exercise was found to be a preferred and acceptable means of testing the ordering of translations of severity qualifiers among children. Additional formal testing of the exercise in other countries and languages is now underway. The approach developed and tested by the VMC for cognitive debriefing of beta EQ-5D-Y-5L language/country versions may also be useful in determining the adequacy of translated qualifiers in debriefing of adult EQ-5D-5L versions and other PROMs.
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Affiliation(s)
- Sarah Derrett
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand. .,The EuroQol Group, Version Management Committee, Rotterdam, Netherlands.
| | - Mike Herdman
- The EuroQol Group, Version Management Committee, Rotterdam, Netherlands.,Office of Health Economics, London, UK
| | - Lucky G Ngwira
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.,Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | | | - Jennifer Jelsma
- The EuroQol Group, Version Management Committee, Rotterdam, Netherlands.,Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
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Kao YH, Celestin MD, Yu Q, Moody-Thomas S, Jones-Winn K, Tseng TS. Racial and Income Disparities in Health-Related Quality of Life among Smokers with a Quit Attempt in Louisiana. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E48. [PMID: 30781893 PMCID: PMC6410197 DOI: 10.3390/medicina55020048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/27/2019] [Accepted: 02/10/2019] [Indexed: 12/25/2022]
Abstract
Background and objectives: Smoking is associated with a lower health-related quality of life (HRQOL). However, there is little information about the association between HRQOL in relation to race, income, and smoking status. The present study aimed to assess the association between HRQOL and smoking status for those of different races and income levels. Materials and Methods: This study applied a cross-sectional design using data from the 2017 patient survey of the Louisiana Tobacco Control Initiative. We obtained 1108 responses from patients at eight Louisiana public hospitals. The EuroQol (EQ-5D) US index score assessed HRQOL. Smoking status was classified into four groups: never smoked, former smoker, current smoker with a quit attempt, and current smoker without a quit attempt. Multivariate linear regression analyses were used to estimate the HRQOL for black or African Americans and whites. Results: The patients were predominantly black or African American (58.9%) with lower-income (71.2%). Bivariate analyses showed that there were differences in income levels between black or African Americans and whites (p = 0.006). Moreover, black or African Americans (median = 0.80) had a higher mean of HRQOL than whites (median = 0.76). Among lower-income black or African Americans, current smokers with a quit attempt had a lower HRQOL than current smokers (coefficient = -0.12; p < 0.01). Conclusions: Racial and income disparities were evident with regards to HRQOL, with lower-income black or African Americans who were current smokers with a quit attempt having a lower HRQOL. Intervention programs for smoking cessation should target lower-income black or African American smokers who have a prior quit attempt and provide effective cessation services to help them quit smoking and improve their HRQOL.
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Affiliation(s)
- Yu-Hsiang Kao
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | - Michael D Celestin
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | - Qingzhao Yu
- Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | - Sarah Moody-Thomas
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | - Krysten Jones-Winn
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
| | - Tung-Sung Tseng
- Behavioral and Community Health Sciences, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA.
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Abstract
BACKGROUND The 5-level version of the EQ-5D (EQ-5D-5L) was introduced as an improvement on the original 3-level version (EQ-5D-3L). To date, 6 country-specific value sets have been published for EQ-5D-5L and 9 US value sets have been published for other instruments. Our aims were to (1) produce EQ-5D-5L values on a quality-adjusted life year (QALY) scale from the perspective of US adults and (2) compare them with US EQ-5D-3L values and the other country-specific EQ-5D-5L values. METHODS In 2016, 8222 US respondents from all 50 states and Washington, DC completed an online survey including a discrete choice experiment with 20 paired comparisons. Each comparison asked respondents, "Which do you prefer?" regarding a pair of alternatives described using EQ-5D-5L and lifespan attributes. On the basis of more than 50 choices on each of the 3160 pairs, we estimated EQ-5D-5L values on a QALY scale and compared them with the US EQ-5D-3L values and the other country-specific EQ-5D-5L values. RESULTS Ranging from -0.287 (55555) to 0.992 (11121) on a QALY scale, the estimated EQ-5D-5L values were similar to the US EQ-5D-3L values. Compared with the US EQ-5D-3L values, the values exhibited greater sensitivity and specificity and higher correlation with the EQ-5D-5L values of other countries, particularly England. CONCLUSIONS Like previous US valuation studies, this study produced nationally representative EQ-5D-5L values on a QALY scale. The results further demonstrate the advantages of the EQ-5D-5L over its 3-level predecessor as a preference-based summary measure of health-related quality of life from the perspective of US adults.
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Mulhern B, Norman R, Shah K, Bansback N, Longworth L, Viney R. How Should Discrete Choice Experiments with Duration Choice Sets Be Presented for the Valuation of Health States? Med Decis Making 2017; 38:306-318. [PMID: 29084472 DOI: 10.1177/0272989x17738754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Discrete Choice Experiments including duration (DCETTO) can be used to generate utility values for health states from measures such as EQ-5D-5L. However, methodological issues concerning the optimum way to present choice sets remain. The aim of the present study was to test a range of task presentation approaches designed to support the DCETTO completion process. METHODS Four separate presentation approaches were developed to examine different task features including dimension level highlighting, and health state severity and duration level presentation. Choice sets included 2 EQ-5D-5L states paired with 1 of 4 duration levels, and a third "immediate death" option. The same design, including 120 choice sets (developed using optimal methods), was employed across all approaches. The online survey was administered to a sample of the Australian population who completed 20 choice sets across 2 approaches. Conditional logit regression was used to assess model consistency, and scale parameter testing investigated poolability. RESULTS Overall 1,565 respondents completed the survey. Three approaches, using different dimension level highlighting techniques, produced mainly monotonic coefficients that resulted in a larger disutility as the severity level increased (excepting usual activities levels 2/3). The fourth approach, using a level indicator to present the severity levels, has slightly more non-monotonicity and produced larger ordered differences for the more severe dimension levels. Scale parameter testing suggested that the data cannot be pooled. CONCLUSIONS The results provide information regarding how to present DCE tasks for health state valuation. The findings improve our understanding of the impact of different presentation approaches on valuation, and how DCE questions could be presented to be amenable to completion. However, it is unclear if the task presentation impacts online respondent engagement.
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Affiliation(s)
- Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
| | | | | | | | | | - Rosalie Viney
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, Australia
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