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Nikl A, Janssen MF, Jenei B, Brodszky V, Rencz F. Population Norms for the EQ-5D-5L, PROPr and SF-6D in Hungary. PHARMACOECONOMICS 2024; 42:583-603. [PMID: 38416366 DOI: 10.1007/s40273-024-01360-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES This study aimed to develop population norms for three preference-accompanied measures [EQ-5D-5L, Patient-Reported Outcomes Measurement Information System (PROMIS)-preference scoring system (PROPr) and Short-Form Six-Dimension (SF-6D)] in Hungary. METHODS In November 2020, an online cross-sectional survey was conducted among a representative sample of the Hungarian adult general population (n = 1631). Respondents completed the Hungarian versions of the EQ-5D-5L, PROMIS-29+2 version 2.1 and 36-item Short Form Survey version 1 (SF-36v1). The association of utilities with sociodemographic and health-related characteristics of respondents was analysed using multivariate regressions. RESULTS The proportion of respondents reporting problems ranged from 8 to 44% (self-care to pain/discomfort) on the EQ-5D-5L, 39-94% (physical function to sleep) on PROPr and 38-87% (role limitations to vitality) on the SF-6D. Problems related to physical function, self-care, usual activities/role limitations and pain increased with age, while mental health problems decreased in all three measures. In almost all corresponding domains, respondents indicated the fewest problems on the EQ-5D-5L and the most problems on the SF-6D. The mean EQ-5D-5L, PROPr and SF-6D utilities were 0.900, 0.535 and 0.755, respectively. Female gender (PROPr, SF-6D), a lower level of education (EQ-5D-5L, PROPr), being unemployed or a disability pensioner (EQ-5D-5L), being underweight or obese (SF-6D), lack of physical exercise (all) and polypharmacy (all) were associated with significantly lower utilities. PROPr yielded the lowest and EQ-5D-5L the highest mean utilities in 28 of 30 chronic health conditions. CONCLUSIONS This study presents the first set of Hungarian population norms for the EQ-5D-5L, PROPr and SF-6D. Our findings can serve as reference values in clinical trials and observational studies and contribute to the monitoring of population health and the assessment of disease burden in Hungary.
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Affiliation(s)
- Anna Nikl
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
- Semmelweis University Doctoral School, Budapest, Hungary
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Balázs Jenei
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary
| | - Fanni Rencz
- Department of Health Policy, Corvinus University of Budapest, 8 Fővám tér, 1093, Budapest, Hungary.
- Semmelweis University Doctoral School, Budapest, Hungary.
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Xie S, Wu J, Chen G. Comparative performance and mapping algorithms between EQ-5D-5L and SF-6Dv2 among the Chinese general population. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024; 25:7-19. [PMID: 36709458 DOI: 10.1007/s10198-023-01566-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 01/11/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To explore the comparative performance and develop the mapping algorithms between EQ-5D-5L and SF-6Dv2 in China. METHODS Respondents recruited from the Chinese general population completed both EQ-5D-5L and SF-6Dv2 during face-to-face interviews. Ceiling/floor effects were reported. Discriminative validity in self-reported chronic conditions was investigated using the effect sizes (ES). Test-retest reliability was evaluated using intra-class correlation coefficient (ICC) and Bland-Altman plots in a subsample. Correlation and absolute agreements between the two measures were estimated with Spearman's rank correlation coefficient and ICC, respectively. Ordinary least squares (OLS), generalized linear model, Tobit model, and robust MM-estimator were explored to estimate mapping equations between EQ-5D-5L and SF-6Dv2. RESULTS 3320 respondents (50.3% males; age 18-90 years) were recruited. 51.1% and 12.2% of respondents reported no problems on all EQ-5D-5L and SF-6Dv2 dimensions, respectively. The mean EQ-5D-5L utility was higher than SF-6Dv2 (0.947 vs. 0.827, p < 0.001). Utilities were significantly different across all chronic conditions groups for both measures. The mean absolute difference of utilities between the two tests for EQ-5D-5L was smaller (0.033 vs. 0.043) than SF-6Dv2, with a slightly higher ICC (0.859 vs. 0.827). Fair agreement (ICC = 0.582) was observed in the utilities between the two measures. Mapping algorithms generated by the OLS models performed the best according to the goodness-of-fit indicators. CONCLUSIONS Both measures showed comparable discriminative validity. Systematic differences in utilities were found, and on average, the EQ-5D-5L generates higher values than the SF-6Dv2. Mapping algorithms between the EQ-5D-5L and SF-6Dv2 are reported to enable transformations between these two measures in China.
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Affiliation(s)
- Shitong Xie
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China.
- Center for Social Science Survey and Data, Tianjin University, Tianjin, China.
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia.
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Ben ÂJ, van Dongen JM, Finch AP, Alili ME, Bosmans JE. To what extent does the use of crosswalks instead of EQ-5D value sets impact reimbursement decisions?: a simulation study. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:1253-1270. [PMID: 36371791 PMCID: PMC10533624 DOI: 10.1007/s10198-022-01539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Inconsistent results have been found on the impact of using crosswalks versus EQ-5D value sets on reimbursement decisions. We sought to further investigate this issue in a simulation study. METHODS Trial-based economic evaluation data were simulated for different conditions (depression, low back pain, osteoarthritis, cancer), severity levels (mild, moderate, severe), and effect sizes (small, medium, large). For all 36 scenarios, utilities were calculated using 3L and 5L value sets and crosswalks (3L to 5L and 5L to 3L crosswalks) for the Netherlands, the United States, and Japan. Utilities, quality-adjusted life years (QALYs), incremental QALYs, incremental cost-effectiveness ratios (ICERs), and probabilities of cost-effectiveness (pCE) obtained from values sets and crosswalks were compared. RESULTS Differences between value sets and crosswalks ranged from -0.33 to 0.13 for utilities, from -0.18 to 0.13 for QALYs, and from -0.01 to 0.08 for incremental QALYs, resulting in different ICERs. For small effect sizes, at a willingness-to-pay of €20,000/QALY, the largest pCE difference was found for moderate cancer between the Japanese 5L value set and 5L to 3L crosswalk (difference = 0.63). For medium effect sizes, the largest difference was found for mild cancer between the Japanese 3L value set and 3L to 5L crosswalk (difference = 0.06). For large effect sizes, the largest difference was found for mild osteoarthritis between the Japanese 3L value set and 3L to 5L crosswalk (difference = 0.08). CONCLUSION The use of crosswalks instead of EQ-5D value sets can impact cost-utility outcomes to such an extent that this may influence reimbursement decisions.
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Affiliation(s)
- Ângela Jornada Ben
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
| | - Johanna M van Dongen
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Aureliano Paolo Finch
- EuroQol Office, EuroQol Research Foundation, Marten Meesweg 107, 3068 AV, Rotterdam, The Netherlands
| | - Mohamed El Alili
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | - Judith E Bosmans
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
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Yang Z, Zeng X, Huang W, Chai Q, Zhao A, Chuang LH, Wu B, Luo N. Characteristics of health-state utilities used in cost-effectiveness analyses: a systematic review of published studies in Asia. Health Qual Life Outcomes 2023; 21:59. [PMID: 37340446 DOI: 10.1186/s12955-023-02131-z] [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: 10/19/2022] [Accepted: 05/11/2023] [Indexed: 06/22/2023] Open
Abstract
INTRODUCTION Cost-utility analysis (CUA) is the preferred form of economic evaluation in many countries. As one of the key data inputs in cost-utility models, health state utility (HSU) has a crucial impact on CUA results. In the past decades, health technology assessment has been expanding rapidly in Asia, yet research examining the methodology and process used to generate cost-effectiveness evidence is scarce. The aim of this study was to examine the reporting of the characteristics of HSU data used in CUAs in Asia and how the characteristics have changed over time. METHODS A systematic literature search was performed to identify published CUA studies targeting Asian populations. Information was extracted for both the general characteristics of selected studies and the characteristics of reported HSU data. For each HSU value identified, we extracted data for four key characteristics, including 1) estimation method; 2) source of health-related quality of life (HRQoL) data; 3) source of preference data; and 4) sample size. The percentage of nonreporting was calculated and compared over two time periods (1990-2010 vs 2011-2020). RESULTS A total of 789 studies were included and 4,052 HSUs were identified. Of these HSUs, 3,351 (82.7%) were from published literature and 656 (16.2%) were from unpublished empirical data. Overall, the characteristics of HSU data were not reported in more than 80% of the studies. Of HSUs whose characteristics were reported, most of them were estimated using the EQ-5D (55.7%), Asian HRQoL data (91.9%), and Asian health preferences (87.7%); 45.7% of the HSUs was estimated with a sample of 100 or more individuals. All four characteristics showed improvements after 2010. CONCLUSION Over the past two decades, there has been a significant increase in CUA studies targeting Asian populations. However, HSU's characteristics were not reported in most of the CUA studies, making it difficult to evaluate the quality and appropriateness of the HSUs used in those cost-effectiveness studies.
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Affiliation(s)
- Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Gui'an, China
- Center of Medicine Economics and Management Research, Guizhou Medical University, Gui'an, China
| | - Xueyun Zeng
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- School of Health Management, Harbin Medical University, Harbin, China
| | - Weidong Huang
- School of Health Management, Harbin Medical University, Harbin, China.
| | - Qingqing Chai
- Department of Pharmacy, School of Medicine, Huangpu Branch, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | | | - Ling-Hsiang Chuang
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- GongJing Healthcare (Nanjing) Co. Ltd, Nanjing, China
| | - Bin Wu
- School of Medicine, Ren Ji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
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Yang Z, Rand K, Luo N. Censoring Time Trade-off Values at 0 Versus at -1: How Does the Assumption for Worse-Than-Dead Time Trade-off Values Affect the Modeling of EQ-5D-5L Valuation Data? VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2023; 26:685-693. [PMID: 36375679 DOI: 10.1016/j.jval.2022.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 10/25/2022] [Accepted: 11/02/2022] [Indexed: 05/03/2023]
Abstract
OBJECTIVES A recent study found that negative utility values elicited using composite time trade-off (TTO) were barely associated with the severity of EQ-5D-5L health states, suggesting poor discriminative ability. Assuming negative values provide limited information, this study aimed to explore the usefulness of censoring negative TTO values at 0 in modeling EQ-5D-5L valuation data. METHODS We analyzed EQ-5D-5L valuation data from China, The Netherlands, Canada, Singapore, and Thailand. For each data set, we estimated value sets using 2 Tobit models, one left-censored at -1 (current practice) and one left-censored at 0 (our proposed method), and compared the model performances. We hypothesized that censoring at 0 and censoring at -1 would produce similar values, though on slightly different scales. RESULTS When censoring at 0, logical inconsistencies and statistical significance were improved but the value range was compressed. In the cross-attribute level effects model, the 3-level parameters were similar between the models censored at 0 and -1, but the rank order of some dimension parameters was altered. Health state values predicted by the 2 censoring models approximated a perfect agreement after rescaling. CONCLUSIONS Censoring TTO values at 0 improved model estimation and fit but produced higher utility values than models censoring at -1. Investigators of future EQ-5D value set studies using the composite TTO method are advised to examine the validity of negative TTO values before choosing modeling strategies.
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Affiliation(s)
- Zhihao Yang
- Health Services Management Department, Guizhou Medical University, Guiyang, China; College of Pharmacy, Jinan University, Guangzhou, China.
| | - Kim Rand
- Health Services Research Center, Akershus University Hospital, Lørenskog, Norway; Maths in Health B.V., Rotterdam, The Netherlands
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Zhang A, Mao Z, Wang Z, Wu J, Luo N, Wang P. Comparing measurement properties of EQ-5D and SF-6D in East and South-East Asian populations: a scoping review. Expert Rev Pharmacoecon Outcomes Res 2023; 23:449-468. [PMID: 36889006 DOI: 10.1080/14737167.2023.2189590] [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: 03/10/2023]
Abstract
INTRODUCTION Euro-Qol-5 Dimension (EQ-5D) and Short-Form 6-Dimension (SF-6D) are the most commonly used generic multi-attribute utility instruments (MAUI) to calculate quality-adjusted life-years (QALYs) in East and South-East Asia. This study aims to systematically review and summarize current evidence on comparing measurement properties of EQ-5D and SF-6D in East and South-East Asian populations. AREAS COVERED Guided by the PRISMA systematic review and meta-analysis guidelines, a systematic literature search was conducted in databases of PubMed, Web of Science, MEDLINE, EMBASE and CINAHL (until June 2022) to obtain studies which compared measurement properties (feasibility, reliability, validity, responsiveness, and sensitivity) and agreement of EQ-5D and SF-6D in the populations. EXPERT OPINION In general, both EQ-5D and SF-6D had good measurement properties in East and South-East Asian populations; but their utility scores cannot be used interchangeably. Compared to the 3-level EQ-5D, SF-6D had better sensitivity and lower ceiling effects, but the comparison results between the 5-level EQ-5D and SF-6D were inconsistent across populations. This scoping review found that most studies did not consider order effects, did not specify the versions of SF-6D, and ignored certain measurement properties (reliability, content validity, and responsiveness). These aspects need to be further explored in future studies.
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Affiliation(s)
- Aixue Zhang
- School of Public Health, Fudan University, Shanghai, Hong Kong, China.,KeyLaboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, Hong Kong, China
| | - Zhuxin Mao
- Centre for Health Economics Research and Modelling Infectious Diseases (CHERMID), University of Antwerp, Antwerp, Belgium
| | - Zitong Wang
- School of Public Health, Fudan University, Shanghai, Hong Kong, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, Beijing, China
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Pei Wang
- School of Public Health, Fudan University, Shanghai, Hong Kong, China.,KeyLaboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, Hong Kong, China
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Tan RLY, Soh SZY, Chen LA, Herdman M, Luo N. Psychometric Properties of Generic Preference-Weighted Measures for Children and Adolescents: A Systematic Review. PHARMACOECONOMICS 2023; 41:155-174. [PMID: 36404365 DOI: 10.1007/s40273-022-01205-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Preference-weighted measures (PWMs)-also referred to as preference-based measures in the literature-of health status/health-related quality of life plays an essential role in estimating quality-adjusted life-years (QALY) for use in economic evaluations of healthcare products and interventions. However, as PWMs are first and foremost intended to accurately reflect respondent health status, they should ideally demonstrate good psychometric properties for the population in question. This study aimed to systematically review published evidence on the measurement properties of commonly used PWMs for children and adolescents. METHODS Three electronic databases (PubMed, Medline, and PsycINFO) were searched for articles assessing the psychometric properties (content validity, construct validity-including convergent validity and known-group validity, test-retest reliability, and responsiveness) of the PWMs of interest (AQoL-6D, CHU9D, HUI2, HUI3, and EQ-5D-Y). The COsensus-based Standards for the selection of health Measurement INstruments methodology (COSMIN) guidelines were used to assess (a) the methodological quality of the studies included and (b) the psychometric performance of the instruments covered. Data were analysed overall as well as by population (country and disease group) and perspective (self-report or proxy-report). The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021277296). RESULTS In total, 53 articles were included in this systematic review. Health Utilities Index (HUI) was tested only in patient populations, CHU9D was most frequently tested in general population samples, while EQ-5D-Y was tested in both populations. Overall, there was high-quality evidence supporting sufficient construct validity for all instruments except AQoL-6D. Evidence supporting test-retest and responsiveness was scarce. There was high-quality evidence supporting sufficient responsiveness of HUI2 and HUI3, and inconsistent test-retest reliability of CHU9D and EQ-5D-Y. Evidence for content validity was minimal and therefore not extracted and synthesized for any PWMs. CONCLUSION This review provides updated evidence on the measurement properties of existing generic PWMs for children and adolescents. High-quality evidence for all relevant psychometric properties and across a range of populations was not available for any of the instruments included, indicating that further work is needed in this direction. This study has identified some of the most noticeable evidence gaps for each of the individual measures. Users can use this information to guide their decision on the choice of PWM to administer.
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Affiliation(s)
- Rachel Lee-Yin Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Sonia Zhi Yi Soh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Le Ann Chen
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Michael Herdman
- Office of Health Economics, 105 Victoria Street, London, SW1E 6QT, UK
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
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Emmert-Fees KM, Laxy M, Patel SA, Singh K, Poongothai S, Mohan V, Chwastiak L, Narayan KV, Sagar R, Sosale AR, Anjana RM, Sridhar GR, Tandon N, Ali MK. Cost-Effectiveness of a Collaborative Care Model Among Patients With Type 2 Diabetes and Depression in India. Diabetes Care 2023; 46:11-19. [PMID: 36383487 PMCID: PMC9797643 DOI: 10.2337/dc21-2533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 10/10/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the cost-effectiveness of collaborative versus usual care in adults with poorly controlled type 2 diabetes and depression in India. RESEARCH DESIGN AND METHODS We performed a within-trial cost-effectiveness analysis of a 24-month parallel, open-label, pragmatic randomized clinical trial at four urban clinics in India from multipayer and societal perspectives. The trial randomly assigned 404 patients with poorly controlled type 2 diabetes (HbA1c ≥8.0%, systolic blood pressure ≥140 mmHg, or LDL cholesterol ≥130 mg/dL) and depressive symptoms (9-item Patient Health Questionnaire score ≥10) to collaborative care (support from nonphysician care coordinators, electronic registers, and specialist-supported case review) for 12 months, followed by 12 months of usual care or 24 months of usual care. We calculated incremental cost-effectiveness ratios (ICERs) in Indian rupees (INR) and international dollars (Int'l-$) and the probability of cost-effectiveness using quality-adjusted life-years (QALYs) and depression-free days (DFDs). RESULTS From a multipayer perspective, collaborative care costed an additional INR309,558 (Int'l-$15,344) per QALY and an additional INR290.2 (Int'l-$14.4) per DFD gained compared with usual care. The probability of cost-effectiveness was 56.4% using a willingness to pay of INR336,000 (Int'l-$16,654) per QALY (approximately three times per-capita gross domestic product). The willingness to pay per DFD to achieve a probability of cost-effectiveness >95% was INR401.6 (Int'l-$19.9). From a societal perspective, cost-effectiveness was marginally lower. In sensitivity analyses, integrating collaborative care in clinical workflows reduced incremental costs by ∼47% (ICER 162,689 per QALY, cost-effectiveness probability 89.4%), but cost-effectiveness decreased when adjusting for baseline values. CONCLUSIONS Collaborative care for patients with type 2 diabetes and depression in urban India can be cost-effective, especially when integrated in clinical workflows. Long-term cost-effectiveness might be more favorable. Scalability across lower- and middle-income country settings depends on heterogeneous contextual factors.
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Affiliation(s)
- Karl M.F. Emmert-Fees
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Michael Laxy
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Shivani A. Patel
- Hubert Department of Global Health, Emory University, Atlanta, GA
| | - Kavita Singh
- Centre for Chronic Conditions and Injuries, Public Health Foundation of India and Centre for Chronic Disease Control, New Delhi, India
| | - Subramani Poongothai
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | - Lydia Chwastiak
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
| | | | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Aravind R. Sosale
- Diabetes Care and Research Center, DIACON Hospital, Bangalore, Karnataka, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation and Dr. Mohan’s Diabetes Specialities Centre, Chennai, Tamil Nadu, India
| | | | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi
| | - Mohammed K. Ali
- Hubert Department of Global Health, Emory University, Atlanta, GA
- Department of Family and Preventive Medicine, Emory University, Atlanta, GA, United States
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Phua G, Tan GP, Phua HP, Lim WY, Neo HY, Chai GT. Health-related quality of life in a multiracial Asian interstitial lung disease cohort. J Thorac Dis 2022; 14:4713-4724. [PMID: 36647495 PMCID: PMC9840018 DOI: 10.21037/jtd-22-906] [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: 07/15/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022]
Abstract
Background Understanding health-related quality of life (HRQL) in patients with interstitial lung disease (ILD) provides insight into disease burden and treatment effects on patients' well-being. We examined HRQL in a multiracial Asian ILD cohort using the King's brief ILD (K-BILD) and EuroQol 5-dimension-3-level (EQ5D-3L) questionnaires and their associations with several clinical variables. Methods This was a single-centre cross-sectional study of ILD patients in a university-affiliated tertiary public hospital in Singapore. All patients completed two self-administered HRQL questionnaires upon study entry, and their clinical information was retrieved from electronic medical records. Results Ninety-nine patients (56% male, 75% Chinese) were included. The median (interquartile range) age was 63 (54-72) years. The most common ILD diagnosis was connective tissue disease-related ILD (n=51, 52%), followed by idiopathic pulmonary fibrosis (n=27, 27%). The mean (standard deviation) scores for the EQ5D-3L utility value, EQ5D Visual Analogue Scale (VAS) and K-BILD total were 0.806 (0.284), 75.1 (12.8) and 63.9 (14.3), respectively. A moderate correlation was found between the EQ5D-3L and K-BILD total and domain scores. The HRQL scores also correlate moderately with the modified Medical Research Council dyspnoea scale (mMRC) scores. There was a weak-to-moderate correlation between HRQL and forced vital capacity (FVC), carbon monoxide diffusing capacity (DLCO) and Charlson comorbidity index. Multiple linear regression showed a significant association of K-BILD total [beta coefficient 0.244, 95% confidence interval (CI): 0.075-0.414; P=0.005], K-BILD 'breathlessness and activities' (beta coefficient 0.448, 95% CI: 0.192-0.703; P=0.001), and the 'psychological' domain (beta coefficient 0.256, 95% CI: 0.024-0.488; P=0.031) with DLCO %pred after adjustment for age, sex, BMI, race, smoking history, comorbidities, FVC %pred and ILD diagnosis. Non-Chinese race was a predictor of better K-BILD 'psychological' domain (beta coefficient 8.680, 95% CI: 0.656-16.704; P=0.034) after adjustment. Conclusions HRQL is significantly impaired in ILD patients, and low DLCO is a strong predictor of this impairment.
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Affiliation(s)
- Grace Phua
- Lee Kong Chian School of Medicine, National Technological University, Singapore, Singapore
| | - Geak Poh Tan
- Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Hwee Pin Phua
- Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore
| | - Wei-Yen Lim
- Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore, Singapore
| | - Han-Yee Neo
- Lee Kong Chian School of Medicine, National Technological University, Singapore, Singapore;,Department of Palliative Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Gin Tsen Chai
- Lee Kong Chian School of Medicine, National Technological University, Singapore, Singapore;,Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore
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Shiroiwa T, Murata T, Ahn J, Li X, Nakamura R, Teerawattananon Y, Kun Z, Shafie AA, Valverde H, Lam H, Ng K, Nadjib M, Pwu RF, Nugraha RR, Chen YC, Fukuda T. Developing a New Region-Specific Preference-Based Measure in East and Southeast Asia. Value Health Reg Issues 2022; 32:62-69. [PMID: 36099801 DOI: 10.1016/j.vhri.2022.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/31/2022] [Accepted: 07/25/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Almost all preference-based measures (PBMs) have been developed in Western countries, with none having been formulated in Asian countries. In this study, we construct a new generic PBM based on concept elicitation using interview surveys in East and Southeast Asian countries and qualitative analysis. METHODS This cross-sectional study included 225 adults recruited from 9 East and Southeast Asian countries or regions (Indonesia, Japan, Korea, mainland China, Malaysia, the Philippines, Singapore, Taiwan, and Thailand). Trained interviewers conducted semistructured interviews with 25 participants from the general population of each country/region. Qualitative data were analyzed using a content analysis approach. The selection of items was determined based on interview surveys and team member discussions. The description of items was considered based on a detailed qualitative analysis of the interview survey. RESULTS A new region-specific PBM-the Asia PBM 7 dimensions instrument-was designed. It reflects East and Southeast Asian values and comprises 7 items: pain, mental health, energy, mobility, work/school, interpersonal interactions, and burden to others. CONCLUSIONS The new region-specific instrument is one of the first PBMs developed in the context of non-Western countries. The Asia PBM 7 dimensions contains 7 items that address the core concepts of health-related quality of life that are deemed important based on East and Southeast Asian health concepts.
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Affiliation(s)
- Takeru Shiroiwa
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan.
| | | | - Jeonghoon Ahn
- Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea
| | - Xue Li
- China National Health Development Research Center, Beijing, China
| | - Ryota Nakamura
- Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Kunitachi, Japan
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand; Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Zhao Kun
- China National Health Development Research Center, Beijing, China
| | - Asrul Akmal Shafie
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Haidee Valverde
- Institute of Health Policy and Development Studies, University of the Philippines Manila, National Institutes of Health, Manila, Philippines
| | - Hilton Lam
- Institute of Health Policy and Development Studies, University of the Philippines Manila, National Institutes of Health, Manila, Philippines
| | - Kwong Ng
- Agency for Care Effectiveness, Ministry of Health Singapore, Singapore
| | - Mardiati Nadjib
- ThinkWell, Jakarta, Indonesia; Department of Health Policy and Administration, University of Indonesia, Depok, Indonesia
| | - Raoh-Fang Pwu
- National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ryan Rachmad Nugraha
- Center for Health Economics and Policy Studies, School of Public Health University of Indonesia, Depok, Indonesia
| | - Yong-Chen Chen
- Master Program of Big Data in Biomedicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Takashi Fukuda
- Center for Outcomes Research and Economic Evaluation for Health, National Institute of Public Health, Wako, Japan
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Golicki D, Młyńczak K. Measurement Properties of the EQ-5D-Y: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:S1098-3015(22)02001-0. [PMID: 35752534 DOI: 10.1016/j.jval.2022.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/16/2022] [Accepted: 05/09/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study aimed to perform a systematic review of published evidence on the psychometric properties of 3-level version of EQ-5D-Y and 5-level version of EQ-5D-Y (EQ-5D-Y-5L). METHODS A literature search on the MEDLINE, Embase, and EuroQol website (until June 2021) was conducted. Original studies on EQ-5D-Y psychometric properties such as feasibility, distribution properties (ceiling and floor effects), reliability (test-retest, interrater, intermodal), validity (known-groups, convergent), and responsiveness, published as full-text articles in English, were included. Studies on experimental EQ-5D-Y versions were excluded. The following data were pooled using random effects models: missing values, the ceiling effect, and correlations coefficients with other measures. RESULTS A total of 47 studies (inclusive of 7 on EQ-5D-Y-5L) containing data from 45 310 children and 2690 proxy respondents representing 15 countries were included. These studies were characterized as being high quality according to the quality index. The most represented areas were school populations and musculoskeletal diseases and orthopedics. The EQ-5D-Y dimensions, EQ visual analog scale, and EQ index were reported in 89%, 77%, and 26% of studies, respectively. Most articles addressed validity (known-groups, n = 27; convergent, n = 21) and reliability (test-retest and interrater, n = 10 each). Convergent validity studies showed that, where the assessment of the child's functioning at school is required, EQ-5D-Y should be supplemented with other school-specific measures. CONCLUSIONS This systematic review provides a summary of measurement properties and the psychometric performance of 3-level version of EQ-5D-Y and EQ-5D-Y-5L. The existing evidence supports using the EQ-5D-Y descriptive system and EQ visual analog scale in children and adolescent populations. Further research on test-retest reliability and the responsiveness of the EQ-5D-Y index obtained with child-specific value sets is needed.
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Affiliation(s)
- Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
| | - Katarzyna Młyńczak
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland
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12
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Al Shabasy S, Abbassi M, Finch A, Roudijk B, Baines D, Farid S. The EQ-5D-5L Valuation Study in Egypt. PHARMACOECONOMICS 2022; 40:433-447. [PMID: 34786590 PMCID: PMC8595057 DOI: 10.1007/s40273-021-01100-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 05/19/2023]
Abstract
INTRODUCTION No value sets exist for either the EQ-5D-3L or the EQ-5D-5L in Egypt, despite local pharmacoeconomic guidelines recommending the use of the EQ-5D to derive utility. Most published Egyptian economic evaluation studies have used utility values from other published studies and systematic reviews. OBJECTIVE Our objective was to develop an Egyptian EQ-5D-5L value set using the international EuroQol standardized protocol (EQ-VT-2.1). This study is a revision of a previous EQ-5D-5L value set for Egypt retracted by the authors. METHODS Adult Egyptian participants were recruited from public places using multi-stratified quota sampling based on age, sex, and geographical distribution. Two elicitation techniques were applied: the composite time trade-off (cTTO) and discrete-choice experiments (DCEs). Before actual data collection, interviewers' performance was assessed in a pilot phase. Data were modelled using generalized least squares, Tobit, heteroskedastic, logit, and hybrid models, and the best fitting model was selected based on logical consistency of the parameters, significance level, prediction accuracy, and model parsimony. RESULTS A total of 1378 interviews were conducted, of which 188 were excluded because they were incomplete and did not comply with the protocol, 216 were pilot interviews, and 974 were included in the final analysis. The heteroskedastic model with constraints (model 4) based on the cTTO data was selected as the preferred model to generate the value set. Values ranged from - 0.964 for the worst health state (55555) to 1 for full health (11111) and 0.948 for 11211, with 1123 of all predicted health states (35.94%) being worse than dead. Mobility had the largest impact on health state preference values. CONCLUSION This is the first value set for the EQ-5D-5L based on social preferences obtained from a nationally representative sample in Egypt or any Arabic-speaking country. The value set can be used as a scoring system for economic evaluation and to improve the quality of health technology assessment in the Egyptian healthcare system.
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Affiliation(s)
- Sahar Al Shabasy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt
| | - Maggie Abbassi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt
| | | | - Bram Roudijk
- EuroQol Group Office, Rotterdam, The Netherlands
| | | | - Samar Farid
- Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt.
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13
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Barrenetxea J, Pan A, Feng Q, Koh WP. Factors associated with depression across age groups of older adults: The Singapore Chinese health study. Int J Geriatr Psychiatry 2022; 37. [PMID: 34816486 DOI: 10.1002/gps.5666] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES We studied sociodemographic and health factors associated with depression across three age groups of community-dwelling older adults. METHODS/DESIGN We used data from 16,785 participants from the third follow-up of the Singapore Chinese Health Study (mean age: 73, range: 61-96 years). We defined depression as having a score of ≥5 using the 15-item Geriatric Depression Scale. We used regression splines to examine the pattern of depression risk with age and applied multivariable logistic regression to study factors associated with depression. RESULTS Increasing age was associated with depression in an inverted J-shape relationship with the highest odds ratio (OR) at age 75. Compared to the youngest-old (<70 years), the middle-old (70-80 years) had higher odds of depression [OR = 1.20, 95% confidence interval (CI) = 1.09-1.31], while the oldest-old (>80 years) had no increased risk (OR = 1.01, 95% CI = 0.89-1.15). We also found demographic (men, lower education, unemployment), social (living alone, poor social support, no social activity) and health factors (instrumental limitations, poor physical function, function-limiting pain, chronic diseases, cognitive impairment, poor sleep quality, poor self-rated health) associated with depression. In stratified analysis by age groups, the OR estimates for lower education level, instrumental limitations and cognitive impairment decreased with age, whereas the risk of depression for men increased with age (all p-values for interaction<0.03). CONCLUSIONS Compared to the youngest-old, the likelihood of depression was highest among middle-old adults and decreased to null in the oldest-old. The associations between some factors and depression were attenuated with age, suggesting a coping mechanism among oldest-old survivors.
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Affiliation(s)
- Jon Barrenetxea
- Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
| | - An Pan
- Department of Epidemiology and Biostatistics, MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiushi Feng
- Department of Sociology & Centre for Family and Population Research, National University of Singapore, Singapore
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore
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Hong J, Bae EY. A Review of Utility Measurement Methods Used in Pharmacoeconomic Submissions to HIRA in South Korea: Methodological Consistency and Areas for Improvement. PHARMACOECONOMICS 2021; 39:1109-1121. [PMID: 34318442 DOI: 10.1007/s40273-021-01066-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
Pharmacoeconomic (PE) guidelines, first published in 2006 and later updated in 2011, were developed to guide the preparation and submission of PE data to the Health Insurance Review and Assessment Service (HIRA) for drug reimbursement decision making in South Korea. This study, which was conducted as part of a project for revision of the PE guideline, reviewed utility values used in the PE submissions processed at HIRA during 2014-2018 to identify aspects of the current guidelines that may need to be revisited. A total of 50 PE submissions were processed at HIRA over the 5 years. Of these, 47 submissions that used quality-adjusted life-years as an outcome measure were included in this review. Data were extracted from full copies of the manufacturer's initial submissions and committee documents provided by HIRA. Of the 47 submissions, nearly half (n = 23, 48.9%) used published sources to obtain health state utility values, followed by direct methods using time trade-off (n = 7) or standard gamble (n = 2) and indirect methods with patient-level data using the EQ-5D-3L (n = 4) or the EQ-5D-5L (n = 2). Mapping, using the EQ-5D-3L as a target measure, was also adopted in six submissions, although it was somewhat unfavourably described in the guideline. Notably, 52.2% of the submissions with published sources took utility values from different sources for different health states defined in a single model. In addition, details of utility measurement methods or mapping functions taken from published sources were relatively poorly reported. Moreover, the preferences of the Korean general public, preferred by the guideline, were rarely reflected in the utility values used in submissions relying on published sources (95.7% for foreign values only/mixed) and mapping (66.7%). While most submissions with direct and indirect methods used domestic preference values, the former was occasionally criticised by assessment committees because of health state descriptions. This review highlights a considerable amount of inconsistency in the measurement of utility values used in the PE submissions during 2014-2018, indicating a strong need for methodological standardisation.
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Affiliation(s)
- Jihyung Hong
- Department of Healthcare Management, College of Social Science, Gachon University, Seongnam, 13120, South Korea.
| | - Eun-Young Bae
- College of Pharmacy, Gyeongsang National University, Jinju, South Korea
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Zhou YF, Song XY, Pan XF, Feng L, Luo N, Yuan JM, Pan A, Koh WP. Association Between Combined Lifestyle Factors and Healthy Ageing in Chinese Adults: The Singapore Chinese Health Study. J Gerontol A Biol Sci Med Sci 2021; 76:1796-1805. [PMID: 33522576 DOI: 10.1093/gerona/glab033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The aim of the study was to examine the relations of individual lifestyle factors and its composite score with healthy ageing among Chinese adults. METHOD We included 14 159 participants aged 45-74 years at baseline from the Singapore Chinese Health Study, a population-based prospective cohort. A protective lifestyle score (0-5 scale) was calculated at baseline (1993-1998) and updated at the second follow-up visit (2006-2010) on the basis of optimal body mass index (18.5-22.9 kg/m2), healthy diet (upper 40% of the Alternative Healthy Eating Index score), being physically active (≥2 h/wk of moderate activity or ≥0.5 h/wk of strenuous activity), nonsmoking (never smoking), and low-to-moderate alcohol drinking (>0 to ≤14 drinks/wk for men and >0 to ≤7 drinks/wk for women). Healthy ageing was assessed at the third follow-up visit (2014-2016) and was defined as absence of specific chronic diseases, absence of cognitive impairment and limitations in instrumental activities of daily living, good mental and overall self-perceived health, good physical functioning, and no function-limiting pain. RESULTS About 20.0% (2834) of the participants met the criteria of healthy ageing after a median follow-up of 20 years. Each 1-point increase in the protective lifestyle score computed at baseline and second follow-up visits was associated with higher likelihood of healthy ageing by 25% (95% CI: 20%-30%) and 24% (18%-29%), respectively. The population-attributable risk percent of adherence to 4-5 protective lifestyle factors was 34.3% (95% CI: 25.3%-42.3%) at baseline and 31.3% (23.0%-38.7%) at second follow-up visits for healthy ageing. In addition, positive increase in lifestyle scores from baseline to second follow-up visits was also significantly associated with a higher likelihood of healthy ageing with an odds ratio of 1.18 (95% CI: 1.12%-1.24%) for each increment in protective lifestyle score. CONCLUSIONS Our findings confirmed that adopting healthy lifestyle factors, even after midlife, was associated with healthy ageing at old age.
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Affiliation(s)
- Yan-Feng Zhou
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xing-Yue Song
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.,Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pennsylvania, USA.,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore
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Finch AP, Gamper E, Norman R, Viney R, Holzner B, King M, Kemmler G. Estimation of an EORTC QLU-C10 Value Set for Spain Using a Discrete Choice Experiment. PHARMACOECONOMICS 2021; 39:1085-1098. [PMID: 34216380 PMCID: PMC8352836 DOI: 10.1007/s40273-021-01058-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND The EORTC QLU-C10D is a preference-based measure derived from the EORTC QLQ-C30. For use in economic evaluations, country-specific value sets are needed. This study aimed to generate an EORTC QLU-C10 value set for Spain. METHODS A sample of the Spanish general population completed an online discrete choice experiment. An attribute-balanced incomplete block design was used to select 960 choice tasks, with a total of 1920 health states. Each participant was randomly assigned 16 choice sets without replacement. Data were modelled using generalized estimating equations and mixed logistic regressions. RESULTS A total of 1625 panel members were invited to participate, 1010 of whom were included in the study. Dimension decrements were generally monotonic with larger disutilities at increased severity levels. Dimensions associated with larger decrements were physical functioning and pain, while the dimension with the smallest decrement was sleep disturbances. The PITS state (i.e. worst attainable health) for the Spanish population is - 0.043. CONCLUSIONS This study generated the first Spanish value set for the QLU-C10D. This can facilitate cost-utility analyses when applied to data collected with the EORTC QLQ-C30.
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Affiliation(s)
- Aureliano Paolo Finch
- Research Centre on Health and Social Care Management (CERGAS), Bocconi University, Via Sarfatti 25, S1 4DT, Milan, Italy.
- Health Values Research and Consultancy, Amsterdam, The Netherlands.
| | - Eva Gamper
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Richard Norman
- School of Public Health, Curtin University, Perth, Australia
| | - Rosalie Viney
- Centre for Health Economics Research and Evaluation (CHERE), UTS Business School, University of Technology Sydney (UTS), Sydney, NSW, Australia
| | - Bernhard Holzner
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
- Division of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - Madeleine King
- School of Psychology, University of Sydney, Sydney, Australia
| | - Georg Kemmler
- Division of Psychiatry II, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
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Cheng LJ, Tan RLY, Luo N. Measurement Properties of the EQ VAS Around the Globe: A Systematic Review and Meta-Regression Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1223-1233. [PMID: 34372988 DOI: 10.1016/j.jval.2021.02.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 01/21/2021] [Accepted: 02/19/2021] [Indexed: 05/26/2023]
Abstract
OBJECTIVES This study aimed to synthesize and evaluate published evidence on the measurement properties of the EQ VAS, a component of all EQ-5D questionnaires. METHODS This systematic review followed the Consensus-Based Standards for the Selection of Health Measurement Instruments guidelines. Five electronic databases were searched for EQ-5D-3L and EQ-5D-5L validation articles published from January 1, 2009, to November 5, 2019. Evidence for construct validity, test-retest reliability, and responsiveness was extracted from individual studies before being aggregated for evaluation of the populations represented by the studied samples. Multivariable logistic meta-regression was conducted to explore the effects of potential covariates on construct validity. RESULTS A total of 50 articles containing 488 studies, using samples drawn from 12 different populations, were identified. Generally, the quality of evidence was high for construct validity studies (n = 397) but only moderate for both test-retest reliability studies (n = 21) and responsiveness studies (n = 70). "Sufficient" construct validity of EQ VAS was found in 8 of 12 populations, "sufficient" test-retest reliability was found in 3 of 11 populations, and "sufficient" responsiveness was found in 5 of 12 populations. Meta-regression analyses suggested that construct validity studies from the Asian-Pacific region were more likely to show a negative rating compared with studies from Europe and North America. CONCLUSION The EQ VAS exhibits "sufficient" construct validity, "inconsistent" test-retest reliability, and "inconsistent" responsiveness across a broad range of populations. Additional studies are needed to explore the suboptimal validity of the EQ VAS in the Asian-Pacific region, whereas more high-quality validation studies are needed to assess its reliability and responsiveness.
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Affiliation(s)
- Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore; Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rachel Lee-Yin Tan
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Health Systems & Behavioral Sciences, Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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18
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Geraerds AJLM, Bonsel GJ, Janssen MF, Finch AP, Polinder S, Haagsma JA. Methods Used to Identify, Test, and Assess Impact on Preferences of Bolt-Ons: A Systematic Review. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:901-916. [PMID: 34119088 DOI: 10.1016/j.jval.2020.12.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES The question of whether additional dimensions should be added to the EQ-5D, so-called bolt-ons, has been researched since the 1990s. Several candidate bolt-ons have been tested. The aim of this systematic review was to provide an overview of EQ-5D bolt-on studies, including the origin of possible suitable bolt-ons, their format, and methods that were used to examine their value. METHODS Studies were identified through database search and reference screening and assessed based on a set of inclusion criteria. All studies that investigated bolt-ons for the EQ-5D were eligible for inclusion. Two reviewers independently extracted information from all included studies on objectives, study design, EQ-5D version used, the investigated bolt-ons, methods used to achieve objectives, and outcomes. RESULTS Of 308 initially identified studies, 28 studies met the inclusion criteria. Of these studies, 3 identified potentially suitable bolt-on dimensions, 13 investigated the psychometric performance of EQ-5D + bolt-on(s), and 6 investigated the impact of the bolt-on on health state preferences. In total, 26 bolt-ons were identified, of which cognition was the most frequently mentioned. A wide variety of bolt-on identification methods, psychometric performance tests, and health state valuation methods were used in the included studies. CONCLUSION A range of bolt-on dimensions has been investigated using diverse methods. Guidelines are needed to standardize the wording of the bolt-on dimension and response options, evaluate minimal important gain of the bolt-on, and facilitate quality assessment of bolt-on studies. Subsequently, guidelines will facilitate decision making on whether or not to implement a bolt-on dimension to the EQ-5D.
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Affiliation(s)
| | - Gouke J Bonsel
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, The Netherlands; EuroQol Research Foundation, Rotterdam, The Netherlands
| | - Mathieu F Janssen
- Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands; EuroQol Research Foundation, Rotterdam, The Netherlands
| | | | - Suzanne Polinder
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, The Netherlands
| | - Juanita A Haagsma
- Erasmus MC, University Medical Center Rotterdam, Department of Public Health, The Netherlands
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Park HY, Cheon HB, Choi SH, Kwon JW. Health-Related Quality of Life Based on EQ-5D Utility Score in Patients With Tuberculosis: A Systematic Review. Front Pharmacol 2021; 12:659675. [PMID: 33935781 PMCID: PMC8080025 DOI: 10.3389/fphar.2021.659675] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Tuberculosis (TB) has significant effects on patients' health-related quality of life (HRQOL) and this study was conducted to evaluate the HRQOL based on EQ-5D utility score according to various health statuses of TB patients. Methods: A systematic literature review was conducted to select articles on HRQOLs outcomes of TB patients since 2000. A total of 1,710 articles were searched for primary screening and seven studies that directly assessed all types of TB patients using the EQ-5D were finally selected. Results: The EQ-5D scores of TB patients were in the ranges of 0.43-0.70. After the completion of TB treatment, the utility weights increased to the ranges of 0.88-0.98 and the EQ VAS values showed similar trend as the results of the EQ-5D. The EQ-5D score for multi-drug-resistant TB was very low at 0.51 during treatment but increased to 0.88 after the treatment was completed. The utility weights of latent TB were not significantly different from those of the general population. Conclusion: This study showed that the HRQOL based on the EQ-5D utility score of TB patients has significantly decreased, and the TB treatment has a significantly positive effect on the quality of life of patients.
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Affiliation(s)
- Hae-Young Park
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Hyo-Bin Cheon
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
| | - Sun Ha Choi
- Lung Cancer Center, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Jin-Won Kwon
- BK21 FOUR Community-Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, South Korea
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McKenna SP, Heaney A. Setting and maintaining standards for patient-reported outcome measures: can we rely on the COSMIN checklists? J Med Econ 2021; 24:502-511. [PMID: 33759686 DOI: 10.1080/13696998.2021.1907092] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
As test-developers we have often been troubled by published reviews of patient-reported outcome measures (PROMs). Too often minor issues are judged important while other reviews exclude the best measures available. Perhaps this led several groups to make recommendations for evaluating the quality of PROMs. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist is the latest set of recommendations. While reviewing the COSMIN literature and reviews conducted using their recommendations several concerns became apparent. The checklist is not evidence-based, relying on the opinion of researchers experienced in health-related quality of life. PROMs measuring other types of outcomes are inadequately covered by the checklist. COSMIN choose to focus on Classical Test Theory and the checklists are not appropriate for use with PROMs developed using modern measurement. Such an approach only obstructs progress in the field of outcome measurement. The retrospective nature of the evaluations also penalizes new PROMs. While the checklists imply that composite, ordinal level measurement is acceptable, crucial aspects of instrument development and quality are excluded. Reviews based on the COSMIN checklist produce contradictory conclusions and fail to provide evidence to support the recommendations. These problems suggest that the checklists themselves lack reliability and validity. It is also clear that several reviewers lack the expertise to apply the checklists. Researchers require a good grounding in instrument development and psychometrics to produce quality reviews. The science of modern PROM development is still in an early phase. Few available PROMs have sufficient quality, limiting the need for complex reviews. Standards need to be agreed for high quality outcome measurement. The issue is who should set these standards? Most published reviews merely scratch the surface and lack essential detail. All reviews of PROMs should be treated with caution, irrespective of whether the COSMIN checklist was employed.
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Affiliation(s)
- Stephen P McKenna
- Galen Research, Manchester, UK
- School of Health Sciences, University of Manchester, Manchester, UK
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Xu RH, Zhou LM, Wong EL, Wang D, Chang JH. Psychometric Evaluation of the Chinese Version of the Decision Regret Scale. Front Psychol 2020; 11:583574. [PMID: 33424697 PMCID: PMC7793926 DOI: 10.3389/fpsyg.2020.583574] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Objective The objective of this study was to evaluate the psychometric properties of the Chinese version of the decision regret scale (DRSc). Methods The data of 704 patients who completed the DRSc were used for the analyses. We evaluated the construct, convergent/discriminant, and known-group validity; internal consistency and test-retest reliability; and the item invariance of the DRSc. A receiver operating characteristic (ROC) curve was employed to confirm the optimal cutoff point of the scale. Results A confirmatory factor analysis (CFA) indicated that a one-factor model fits the data. The internal consistency (α = 0.74) and test-retest reliability [intraclass correlation coefficient (ICC) = 0.71] of the DRSc were acceptable. The DRSc demonstrated unidimensionality and invariance for use across the sexes. It was confirmed that an optimal cutoff point of 25 could discriminate between patients with high and low decisional regret during clinical practice. Conclusion The DRSc is a parsimonious instrument that can be used to measure the uncertainty inherent in medical decisions. It can be employed to provide knowledge, offer support, and elicit patient preferences in an attempt to promote shared decision-making.
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Affiliation(s)
- Richard Huan Xu
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ling Ming Zhou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Eliza Laiyi Wong
- Centre for Health Systems and Policy Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jing Hui Chang
- School of Health Management, Southern Medical University, Guangzhou, China
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22
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How Do Respondents Interpret and View the EQ-VAS? A Qualitative Study of Three Asian Populations. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:283-293. [DOI: 10.1007/s40271-020-00452-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Measurement properties of preference-based measures for economic evaluation in COPD: a systematic review. Qual Life Res 2020; 29:2875-2885. [PMID: 32617890 DOI: 10.1007/s11136-020-02569-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Preference-based measures can provide measurements of health-related quality of life and be utilized for cost-effectiveness analyses of interventions in individuals with chronic obstructive pulmonary disease (COPD). The purpose of this study is to evaluate whether generic preference-based measures are reliable, valid, and responsive in COPD. METHODS A systematic review was performed using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. Three databases were searched: MEDLINE, EMBASE, and CINAHL. Studies were included if the sample represented individuals with COPD and the aim was to evaluate one or more psychometric properties or the interpretability of generic preference-based measures. RESULTS Six hundred and sixty-seven abstracts were screened, 65 full-text articles were reviewed and 24 articles met the inclusion criteria. Measures which emerged from the search were the EQ-5D, the SF-6D, the Quality of Well-being scale, the 15D, and the Health Utilities Index 3. Evidence for the test-retest reliability of these measures was limited. Construct validity of the measures was well supported with correlations with generic health profiles being 0.37-0.68, and correlations with COPD-specific health profiles being 0.53-0.75. Evidence for known-groups validity of these measures was poor and data on responsiveness were mixed. CONCLUSION Generic preference-based measures' sensitivity to change and ability to discriminate between different disease severities in COPD was poorly supported. Future research may consider examining the development of COPD-specific preference-based measures that may allow for a more accurate detection of change and discrimination among disease severities to facilitate cost-effectiveness evaluations.
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