Parallel Valuation: A Direct Comparison of EQ-5D-3L and EQ-5D-5L Societal Value Sets

2018 ◽  
Vol 38 (8) ◽  
pp. 968-982 ◽  
Author(s):  
Ernest H. Law ◽  
A. Simon Pickard ◽  
Feng Xie ◽  
Surrey M. Walton ◽  
Todd A. Lee ◽  
...  
Keyword(s):  
Model Specification ◽  
Measurement Properties ◽  
Parameter Estimates ◽  
Health State ◽  
Health States ◽  
Valuation Study ◽  
Descriptive System ◽  
Level Transition ◽  
Value Sets ◽  
Main Effects

Objective. To compare and contrast EQ-5D-5L (5L) and EQ-5D-3L (3L) health state values derived from a common sample. Methods. Data from the 2017 US EQ-5D valuation study were analyzed. Value sets were estimated with random-effects linear regression based on composite time trade-off (cTTO) valuations for 3L and 5L health states with 2 approaches to model specification: main effects only and additional N3/N45 terms. Properties of the descriptive system and value set characteristics were compared by examining distributions of predicted index scores, ceiling effects, and single-level transition values from adjacent corner health states. Mean transition values were calculated for all predicted 3L and 5L health states and plotted against baseline index scores. Results. A total of 1062 respondents were included in the analysis. The observed mean cTTO values for the worst possible 3L and 5L health states were −0.423 and −0.343, respectively. The range of scale was larger with the 3L, compared to the 5L, for both main effects and N term models. Values for the mildest 5L health states (range, 0.857−0.924) were similar to 11111 for the 3L. Parameter estimates for matched dimension levels differed by <|0.07| except for the most severe level of Mobility. For the main effects model, 3L mean transition values were greater for more severe baseline 3L index scores, whereas 5L mean transition values remained constant irrespective of the baseline index score. Conclusions. Compared to the 3L, the 5L exhibited a lower ceiling effect and improved measurement properties. There was a larger range of scale for the 3L compared to 5L; however, this difference was driven by differences in preference for the most severe level of problems in Mobility.

How Significant Are “High” Correlations Between EQ-5D Value Sets?

2018 ◽  
Vol 38 (6) ◽  
pp. 635-645 ◽  
Author(s):  
Franz Ombler ◽  
Michael Albert ◽  
Paul Hansen
Keyword(s):  
Correlation Coefficients ◽  
Cost Utility ◽  
Health State ◽  
Health States ◽  
Life Years ◽  
Significance Levels ◽  
Related Quality ◽  
Health Related ◽  
Descriptive System ◽  
Value Sets

The calculation of quality-adjusted life years, as used for cost–utility analysis, depends on the availability of value sets representing people’s preferences with respect to health-related quality of life (HRQoL). A value set consists of HRQoL index values for all health states representable by the particular descriptive system used, of which the EQ-5D (EuroQoL, 5 Dimensions) is by far the most widely used. High correlation coefficients for EQ-5D value sets derived from different samples—across countries and/or using different valuation techniques—are conventionally interpreted as evidence that the people in the respective samples have similar HRQoL preferences. However, EQ-5D value sets—for both versions of the system (EQ-5D-3L and EQ-5D-5L)—contain many inherent rankings of health state values by design. By calculating correlation coefficients for value sets created from random data, we demonstrate that “high” coefficients are artifacts of these inherent rankings, such as median Pearson’s r = 0.783 for the EQ-5D-3L and 0.850 for the EQ-5D-5L instead of zero. Therefore, high correlation coefficients do not necessarily constitute evidence of meaningful associations in terms of similar HRQoL preferences. After calculating significance levels based on our simulations—available as an online resource for other researchers—we find that many high coefficients are not as significant as conventionally interpreted, whereas other coefficients are not significant. These “high” but insignificant correlations are in fact spurious.

scholarly journals The Online Elicitation of Personal Utility Functions (OPUF) tool: a new method for valuing health states

2022 ◽  
Vol 7 ◽  
pp. 14
Author(s):  
Paul Schneider ◽  
Ben van Hout ◽  
Marike Heisen ◽  
John Brazier ◽  
Nancy Devlin
Keyword(s):  
Utility Functions ◽  
Health State ◽  
Group Level ◽  
Health States ◽  
Online Tool ◽  
Value Set ◽  
Individual Level ◽  
Personal Utility ◽  
Value Sets ◽  
The Individual

Introduction Standard valuation methods, such as TTO and DCE are inefficient. They require data from hundreds if not thousands of participants to generate value sets. Here, we present the Online elicitation of Personal Utility Functions (OPUF) tool; a new type of online survey for valuing EQ-5D-5L health states using more efficient, compositional elicitation methods, which even allow estimating value sets on the individual level. The aims of this study are to report on the development of the tool, and to test the feasibility of using it to obtain individual-level value sets for the EQ-5D-5L. Methods We applied an iterative design approach to adapt the PUF method, previously developed by Devlin et al., for use as a standalone online tool. Five rounds of qualitative interviews, and one quantitative pre-pilot were conducted to get feedback on the different tasks. After each round, the tool was refined and re-evaluated. The final version was piloted in a sample of 50 participants from the UK. A demo of the EQ-5D-5L OPUF survey is available at: https://eq5d5l.me Results On average, it took participants about seven minutes to complete the OPUF Tool. Based on the responses, we were able to construct a personal EQ-5D-5L value set for each of the 50 participants. These value sets predicted a participants' choices in a discrete choice experiment with an accuracy of 80%. Overall, the results revealed that health state preferences vary considerably on the individual-level. Nevertheless, we were able to estimate a group-level value set for all 50 participants with reasonable precision. Discussion We successfully piloted the OPUF Tool and showed that it can be used to derive a group-level as well as personal value sets for the EQ-5D-5L. Although the development of the online tool is still in an early stage, there are multiple potential avenues for further research.

scholarly journals Variations in Patients’ Overall Assessment of Their Health Across and Within Disease Groups Using the EQ-5D Questionnaire: Protocol for a Longitudinal Study in the Swedish National Quality Registers

10.2196/27669 ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. e27669
Author(s):  
Fitsum Sebsibe Teni ◽  
Ola Rolfson ◽  
Nancy Devlin ◽  
David Parkin ◽  
Emma Nauclér ◽  
...  
Keyword(s):  
General Population ◽  
Data Retrieval ◽  
Health State ◽  
Health States ◽  
National Quality ◽  
Patient Reported ◽  
Patient Groups ◽  
Value Sets ◽  
Eq Vas

Background EQ-5D is one of the most commonly used questionnaires to measure health-related quality of life. It is included in many of the Swedish National Quality Registers (NQRs). EQ-5D health states are usually summarized using “values” obtained from members of the general public, a majority of whom are healthy. However, an alternative, which remains to be studied in detail, is the potential to use patients’ self-reported overall health on the visual analog scale (VAS) as a means of capturing experience-based perspective. Objective The aim of this study is to assess EQ VAS as a valuation method with an experience-based perspective through comparison of its performance across and within patient groups, and with that of the general population in Sweden. Methods Data on nearly 700,000 patients from 12 NQRs covering a variety of diseases/conditions and nearly 50,000 individuals from the general population will be analyzed. The EQ-5D-3L data from the 12 registers and EQ-5D-5L data from 2 registers will be used in the analyses. Longitudinal studies of patient-reported outcomes among different patient groups will be conducted in the period from baseline to 1-year follow-up. Descriptive statistics and analyses comparing EQ-5D dimensions and observed self-assessed EQ VAS values across and within patient groups will be performed. Comparisons of the change in health state and observed EQ VAS values at 1-year follow-up will also be undertaken. Regression models will be used to assess whether EQ-5D dimensions predict observed EQ VAS values to investigate patient value sets in each patient group. These will be compared across the patient groups and with the existing Swedish experience-based VAS and time trade-off value sets obtained from the general population. Results Data retrieval started in May 2019 and data of patients in the 12 NQRs and from the survey conducted among the general population have been retrieved. Data analysis is ongoing on the retrieved data. Conclusions This research project will provide information on the differences across and within patient groups in terms of self-reported health status through EQ VAS and comparison with the general population. The findings of the study will contribute to the literature by exploring the potential of self-assessed EQ VAS values to develop value sets using an experience-based perspective. Trial Registration ClinicalTrials.gov NCT04359628; https://clinicaltrials.gov/ct2/show/NCT04359628. International Registered Report Identifier (IRRID) DERR1-10.2196/27669

scholarly journals Comparison of online and face-to-face valuation of the EQ-5D-5L using composite time trade-off

2020 ◽  
Author(s):  
Ruixuan Jiang ◽  
James Shaw ◽  
Axel Mühlbacher ◽  
Todd A. Lee ◽  
Surrey Walton ◽  
...  
Keyword(s):  
Task Engagement ◽  
Health State ◽  
Health States ◽  
Trade Off ◽  
Face To Face ◽  
Random Intercept ◽  
Trade Offs ◽  
Trading Patterns ◽  
Value Sets ◽  
Better Than

Abstract Objective The aim of this study was to compare online, unsupervised and face-to-face (F2F), supervised valuation of EQ-5D-5L health states using composite time trade-off (cTTO) tasks. Methods The official EuroQol experimental design and valuation protocol for the EQ-5D-5L of 86 health states were implemented in interviewer-assisted, F2F and unsupervised, online studies. Validity of preferences was assessed using prevalence of inconsistent valuations and expected patterns of TTO values. Respondent task engagement was measured using number of trade-offs and time per task. Trading patterns such as better-than-dead only was compared between modes. Value sets were generated using linear regression with a random intercept (RILR). Value set characteristics such as range of scale and dimension ranking were evaluated between modes. Results Five hundred one online and 1,134 F2F respondents completed the surveys. Mean elicited TTO values were higher online than F2F when compared by health state severity. Compared to F2F, a larger proportion of online respondents did not assign the poorest EQ-5D-5L health state (i.e., 55555) the lowest TTO value ([Online] 41.3% [F2F] 12.2%) (p < 0.001). A higher percentage of online cTTO tasks were completed in 3 trade-offs or fewer ([Online] 15.8% [F2F] 3.7%), (p < 0.001). When modeled using the RILR, the F2F range of scale was larger than online ([Online] 0.600 [F2F] 1.307) and the respective dimension rankings differed. Conclusions Compared to F2F data, TTO tasks conducted online had more inconsistencies and decreased engagement, which contributed to compromised data quality. This study illustrates the challenges of conducting online valuation studies using the TTO approach.

Aggregating Health State Valuations

1997 ◽  
Vol 2 (3) ◽  
pp. 160-165 ◽  
Author(s):  
Paul Dolan
Keyword(s):  
Ethical Issues ◽  
Health State ◽  
Health States ◽  
Mean Values ◽  
Descriptive System ◽  
Health State Valuations ◽  
The Mean ◽  
Allocation Decisions ◽  
Priorities In Health Care ◽  
Resource Allocation Decisions

It is now recognized that preference-based measures of health status have an important role to play in determining priorities in health care. A number of methodological and ethical issues have been raised, but one that has as yet received little attention is the question of how individual responses should be aggregated when attempting to express the valuations of a given group. In a recent study of over 3000 members of the British general public, valuations were elicited for health states defined in terms of the EuroQol Descriptive System using the time trade-off method. A EuroQol ‘tariff’ of valuations has been generated which, because of the methodology employed, provides a good approximation of mean values. The purpose of this paper is to present a tariff based on median values. The nature of the distributions of values results in a median-based tariff which, compared to the mean-based one, has higher values for less severe states and lower values for more severe states. This is likely to have important implications for resource allocation decisions.

scholarly journals Exploring the Impact of Adding a Respiratory Dimension to the EQ-5D-5L

2019 ◽  
Vol 39 (4) ◽  
pp. 393-404 ◽  
Author(s):  
Martine Hoogendoorn ◽  
Mark Oppe ◽  
Melinde R. S. Boland ◽  
Lucas M. A. Goossens ◽  
Elly A. Stolk ◽  
...  
Keyword(s):  
Principal Component ◽  
Hybrid Models ◽  
Physical Activities ◽  
Health State ◽  
Health States ◽  
Euroqol Group ◽  
Standardized Interview ◽  
Valuation Study ◽  
Level 3 ◽  
The Impact

Objectives. To evaluate the impact of adding a respiratory dimension (a bolt-on dimension) to the EQ-5D-5L health state valuations. Methods. Based on extensive regression and principal component analyses, 2 respiratory bolt-on candidates were formulated: R1, limitations in physical activities due to shortness of breath, and R2, breathing problems. Valuation interviews for the selected bolt-ons were performed with a representative sample from the Dutch general public using the standardized interview protocol and software of the EuroQol group. Hybrid models based on the combined time-tradeoff (TTO) and discrete choice experiment (DCE) data were estimated to assess whether the 5 levels of the respiratory bolt-on led to significant changes in utility values. Results. For each bolt-on candidate, slightly more than 200 valuation interviews were conducted. Mean TTO values and DCE choice probabilities for health states with a level 4 or 5 for the respiratory dimension were significantly lower compared with the same health states in the Dutch EQ-5D-5L valuation study without the respiratory dimension. Results of hybrid models showed that for the bolt-on “limitations in physical activities,” the utility decrements were significant for level 3 (–0.055), level 4 (–0.087), and level 5 (–0.135). For “breathing problems,” the utility decrements for the same levels were greater (–0.086, –0.219, and –0.327, respectively). Conclusions. The addition of each of the 2 respiratory bolt-ons to the EQ-5D-5L had a significant effect on the valuation of health states with severe levels for the bolt-on. The bolt-on dimension “breathing problems” showed the greatest utility decrements and therefore seems the most appropriate respiratory bolt-on dimension.

Modelling health state valuation data

2016 ◽  
Author(s):  
John Brazier ◽  
Julie Ratcliffe ◽  
Joshua A. Salomon ◽  
Aki Tsuchiya
Keyword(s):  
Hybrid Approach ◽  
Statistical Modelling ◽  
Ordinary Least Squares ◽  
Health State Valuation ◽  
Model Specification ◽  
Health State ◽  
Paired Data ◽  
Health States ◽  
Preference Data ◽  
Technical Issues

This chapter examines the technical issues in modelling health state valuation data. Most measures of health define too many states to directly value all of them (e.g. SF-6D defines 18,000 health states). The solution has been to value a subset and by using modelling to predict the values of all states. This chapter reviews two approaches to modelling: one using multiattribute utility theory to determine health values given an assumed functional form; and the other is using statistical modelling of SF-6D preference data that are skewed, bimodal, and clustered by respondents. This chapter examines the selection of health states for valuation, data preparation, model specification, and techniques for modelling the data starting with ordinary least squares (OLS) and moving on to more complex techniques including Bayesian non-parametric and semi-parametric approaches, and a hybrid approach that combines cardinal preference data with the results of paired data from a discrete choice experiment.

scholarly journals Valuation study for a preference-based quality of life measure for dental caries (Dental Caries Utility Index - DCUI) among Australian adolescents - study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038626
Author(s):  
Ruvini Hettiarachchi ◽  
Sanjeewa Kularatna ◽  
Joshua Byrnes ◽  
Brendan Mulhern ◽  
Gang Chen ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Classification System ◽  
Health Interventions ◽  
Health State ◽  
Health States ◽  
Pilot Studies ◽  
Utility Index ◽  
Valuation Study

IntroductionA new health state classification system has been developed for dental caries - Dental Caries Utility Index (DCUI) to facilitate the assessment of oral health interventions in the cost-utility analysis (CUA). This paper reports the protocol for a valuation study, which aims to generate a preference-based algorithm for the classification system for the DCUI.Methods and analysisDiscrete choice experiments (DCEs) will be conducted to value health states generated by the DCUI classification system and preferences for these health states will be modelled to develop a utility algorithm. DCEs produce utility values on a latent scale and these values will be anchored into the full health-dead scale to calculate the quality-adjusted life years in CUA. There is no previous evidence for the most suitable anchoring method for dental caries health state valuation. Hence, we will first conduct pilot studies with two anchoring approaches; DCE including duration attribute and DCE anchoring to worst heath state in Visual Analogue Scale. Based on the pilot studies, the most suitable anchoring method among two approaches will be used in the main valuation survey, which will be conducted as an online survey among a representative sample of 2000 adults from the Australian general population. Participants will be asked to complete a set of DCE choice tasks along with anchoring tasks, basic social-demographic questions, DCUI, a generic preference-based measure and oral health quality of life instrument.Ethics and disseminationEthical approval for this study was obtained from the Human Research Ethics Committee, Griffith University (reference number HREC/2019/550). The generated algorithm will facilitate the use of the new dental caries preference-based measure in economic evaluations of oral health interventions. The results will be disseminated through journal articles and professional conferences.

scholarly journals Time trade-off with someone to live for: impact of having significant others on time trade-off valuations of hypothetical health states

2021 ◽  
Author(s):  
Tonya Moen Hansen ◽  
Knut Stavem ◽  
Kim Rand
Keyword(s):  
Significant Others ◽  
Health State ◽  
Health States ◽  
Trade Off ◽  
Life Years ◽  
Health State Preference ◽  
Valuation Study ◽  
State Preference ◽  
Health State Utilities ◽  
Health State Preference Values

Abstract Background The TTO task involves giving up life years, i.e. living a shorter life, to avoid an undesirable health state. Despite being a hypothetical task, some respondents take other life factors into account when completing the task. This study explored the effect of having children and/or a partner on TTO valuations of hypothetical EQ-5D-5L health states in a valuation study of the general population. Methods The study used TTO data collected in a Norwegian EQ-5D-5L valuation study in 2019–2020, by one-to-one pc-assisted interviews following the EQ-VT protocol. We used regression modelling to determine the effect of significant others (having children or a partner) on disutility per health state from the TTO valuations. Results 430 respondents were included [mean age 43.8 (SD 15.9) years, 58% female, 48% with children, 68% with a partner, 25% with neither children nor partner]. Having children and/or a partner was associated with lowered willingness to trade life years translating to higher elicited health state utilities (p < 0.01). Conclusion Having significant others, or the lack of having significant others, was associated with respondents’ valuation of hypothetical health states using TTO, more so than traditional sampling variables such as age and sex. Inadequate representativeness in terms of having significant others could bias health state preference values in valuation studies.

scholarly journals Variations in Patients’ Overall Assessment of Their Health Across and Within Disease Groups Using the EQ-5D Questionnaire: Protocol for a Longitudinal Study in the Swedish National Quality Registers (Preprint)

2021 ◽  
Author(s):  
Fitsum Sebsibe Teni ◽  
Ola Rolfson ◽  
Nancy Devlin ◽  
David Parkin ◽  
Emma Nauclér ◽  
...  
Keyword(s):  
General Population ◽  
Data Retrieval ◽  
Health State ◽  
Health States ◽  
National Quality ◽  
Patient Reported ◽  
Patient Groups ◽  
Value Sets ◽  
Eq Vas

BACKGROUND EQ-5D is one of the most commonly used questionnaires to measure health-related quality of life. It is included in many of the Swedish National Quality Registers (NQRs). EQ-5D health states are usually summarized using “values” obtained from members of the general public, a majority of whom are healthy. However, an alternative, which remains to be studied in detail, is the potential to use patients’ self-reported overall health on the visual analog scale (VAS) as a means of capturing experience-based perspective. OBJECTIVE The aim of this study is to assess EQ VAS as a valuation method with an experience-based perspective through comparison of its performance across and within patient groups, and with that of the general population in Sweden. METHODS Data on nearly 700,000 patients from 12 NQRs covering a variety of diseases/conditions and nearly 50,000 individuals from the general population will be analyzed. The EQ-5D-3L data from the 12 registers and EQ-5D-5L data from 2 registers will be used in the analyses. Longitudinal studies of patient-reported outcomes among different patient groups will be conducted in the period from baseline to 1-year follow-up. Descriptive statistics and analyses comparing EQ-5D dimensions and observed self-assessed EQ VAS values across and within patient groups will be performed. Comparisons of the change in health state and observed EQ VAS values at 1-year follow-up will also be undertaken. Regression models will be used to assess whether EQ-5D dimensions predict observed EQ VAS values to investigate patient value sets in each patient group. These will be compared across the patient groups and with the existing Swedish experience-based VAS and time trade-off value sets obtained from the general population. RESULTS Data retrieval started in May 2019 and data of patients in the 12 NQRs and from the survey conducted among the general population have been retrieved. Data analysis is ongoing on the retrieved data. CONCLUSIONS This research project will provide information on the differences across and within patient groups in terms of self-reported health status through EQ VAS and comparison with the general population. The findings of the study will contribute to the literature by exploring the potential of self-assessed EQ VAS values to develop value sets using an experience-based perspective. CLINICALTRIAL ClinicalTrials.gov NCT04359628; https://clinicaltrials.gov/ct2/show/NCT04359628. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/27669

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