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.

scholarly journals Selecting Bolt-on Dimensions for the EQ-5D: Testing the Impact of Hearing, Sleep, Cognition, Energy, and Relationships on Preferences Using Pairwise Choices

2020 ◽  
Vol 41 (1) ◽  
pp. 89-99
Author(s):  
Aureliano Paolo Finch ◽  
John Brazier ◽  
Clara Mukuria
Keyword(s):  
Online Survey ◽  
Logistic Models ◽  
Cost Effective ◽  
Health State ◽  
Health States ◽  
Cost Effective Approach ◽  
Level 3 ◽  
Severity Levels ◽  
The Impact ◽  
Selection Of

Background Generic preference-based measures (GPBMs) such as the EQ-5D are valid across many conditions, but in some cases, “bolting on” additional dimensions may improve validity. The selection of “bolt-ons” has been based on the psychometric impact of individual dimensions, but preferences provide another important way to select them. This study aims to test the potential of using pairwise choices to inform the selection of bolt-ons for the EQ-5D-5L. Methods General population preferences were collected using an online survey of 1040 UK residents. Three EQ-5D-5L health state pairs were selected based on pairs that had a 50:50 split in respondent preferences from a previous pairwise survey. Participants were presented with pairwise choices of EQ-5D-5L health states without and with bolt-ons of hearing, sleep, cognition, energy, and relationships, each added individually. Logistic models were used to assess the impact of bolt-ons, as well as bolt-ons at different severity levels, on the log odds of responders choosing between health states. Results Preferences varied according to the bolt-ons and their severity level (only levels 1, 3, and 5 were used). Additions of bolt-ons at level 1 generally resulted in nonstatistically significant differences while additions of bolt-ons at level 3 and level 5 produced a negative and statistically significant impact on preferences for the health state with the bolt-on. At level 5, hearing had the largest impact, followed by cognition, relationships, energy, and sleep. At level 3, cognition produced the largest impact, followed by hearing and sleep with similar impacts, energy, and relationships. This ordering offers information for bolt-on selection, with hearing and cognition appearing as the most important. The weight placed on the different health problems is not constant across severity levels between bolt-ons. Conclusions Pairwise choices provide a cost-effective approach of generating information on preferences to support bolt-on selection.

scholarly journals Utility Values for Advanced Soft Tissue Sarcoma Health States from the General Public in the United Kingdom

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Julian F. Guest ◽  
Erikas Sladkevicius ◽  
Nicholas Gough ◽  
Mark Linch ◽  
Robert Grimer
Keyword(s):  
Soft Tissue ◽  
Partial Response ◽  
Stable Disease ◽  
General Public ◽  
Progressive Disease ◽  
Locally Advanced ◽  
Complete Response ◽  
Health State ◽  
Health States ◽  
The Impact

Soft tissue sarcomas are a rare type of cancer generally treated with palliative chemotherapy when in the advanced stage. There is a lack of published health utility data for locally advanced “inoperable”/metastatic disease (ASTS), essential for calculating the cost-effectiveness of current and future treatments. This study estimated time trade-off (TTO) and standard gamble (SG) preference values associated with four ASTS health states (progressive disease, stable disease, partial response, complete response) among members of the general public in the UK (n=207). The four health states were associated with decreases in preference values from full health. Complete response was the most preferred health state (mean utility of 0.60 using TTO). The second most preferred health state was partial response followed by stable disease (mean utilities were 0.51 and 0.43, respectively, using TTO). The least preferred health state was progressive disease (mean utility of 0.30 using TTO). The utility value for each state was significantly different from one another (P<0.001). This study demonstrated and quantified the impact that different treatment responses may have on the health-related quality of life of patients with ASTS.

scholarly journals Crosswalk EQ-5D-5L Value Set for Slovenia

2020 ◽  
Vol 59 (3) ◽  
pp. 189-194 ◽  
Author(s):  
Valentina Prevolnik Rupel ◽  
Marko Ogorevc
Keyword(s):  
General Population ◽  
Health State ◽  
Health States ◽  
Value Set ◽  
Euroqol Group ◽  
A Value ◽  
Distribution Of Values ◽  
Severe Health State ◽  
The Mean ◽  
Informational Value

AbstractIntroductionDue to the availability of the EQ-5D-5L instrument official translation into Slovenian its use is widespread in Slovenia. However, the health profiles obtained in many studies cannot be ascribed their appropriate values as the EQ-5D-5L value set does not yet exist in Slovenia. Our aim was to estimate an interim EQ-5D-5L value set for Slovenia using the crosswalk methodology developed by the EuroQol Group on the basis of the EQ-5D-3L Slovenian TTO value set. Our secondary aim was to compare the interim values obtained with the EQ-5D-3L Slovenian values.MethodsTo obtain a Slovenian interim EQ-5D-5L value set, we applied the crosswalk methodology developed by the EuroQol Group to the Slovenian EQ-5D-3L TTO value set. We examined the differences between values by comparing the mean 3L and 5L value scores and the distribution of values across all respondents.ResultsBy definition, 3-level and 5-level versions have the same range (from 1 to −0.495) and a health state coded 22222 in the 3-level version corresponds to 33333 in the 5-level version. While the addition of a “slight” severity level (22222) in the 5-level version has a low informational value, the addition of a “severe” health state (44444) covers larger range of the scale. The 5-level version results in fewer health states being valued below 0 and above 0.8.ConclusionThe EQ-5D-5L value set, based on the crosswalk methodology, should be used until a value set for the EQ-5D-5L is derived from preferences elicited directly from a representative sample of the Slovenian general population.

scholarly journals LIVES WORSE THAN DEATH: ADULT CHILDREN ARE POOR AT ESTIMATING PARENTS’ QUALITY-OF-LIFE VALUATIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S636-S636
Author(s):  
Matthew Pichiello ◽  
Meghan McDarby ◽  
Elissa K Kozlov ◽  
Brian Carpenter
Keyword(s):  
Quality Of Life ◽  
Adult Children ◽  
Adult Child ◽  
Feeding Tube ◽  
Health State ◽  
Worth Living ◽  
Health States ◽  
Older Parents ◽  
The Impact

Abstract Adult children often help older parents make medical decisions when their health is compromised. To do so in a way that respects parent values requires children to know how their parent views health states and consequent quality of life. The current study compared older parent and adult child valuations of quality of life in different health contexts. Families consisted of older parents (n = 37) and their adult children (n = 66). Parents rated perceived quality of life in 14 compromised health states on a scale from 1 (difficult but acceptable) to 5 (not worth living). Children estimated how their parent responded to each health state, yielding an index of their knowledge of parent perceptions. Overall, parents described all compromised health states as less acceptable than adult children thought they would, t(99) = 2.19, p &lt; .05. Notably, parents believed situations that caused financial or emotional burden to their family were much less acceptable than their children estimated. Children were more knowledgeable about parent valuations for more extreme circumstances, such as living with a feeding tube. Within families, children demonstrated only slight knowledge about parent quality of life valuations (kappa = .081). Across the entire sample of families, there was a broad range of knowledge (kappas = -.181 – .351), but at best, knowledge was still only fair. Results from this study suggest that adult children may underestimate the impact of compromised health states on parent estimations of quality of life, which could affect collaborations on healthcare decisions.

scholarly journals Characterizing health state utilities associated with Duchenne muscular dystrophy: a systematic review

2019 ◽  
Vol 29 (3) ◽  
pp. 593-605 ◽  
Author(s):  
Shelagh M. Szabo ◽  
Ivana F. Audhya ◽  
Daniel C. Malone ◽  
David Feeny ◽  
Katherine L. Gooch
Keyword(s):  
Systematic Review ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Patient Characteristics ◽  
Included Study ◽  
Health State ◽  
Health States ◽  
Published Evidence ◽  
Health State Utilities ◽  
The Impact

Abstract Background Preferences for health states for Duchenne muscular dystrophy (DMD) are necessary to assess costs and benefits of novel therapies. Because DMD progression begins in childhood, the impact of DMD on health-related quality-of-life (HRQoL) affects preferences of both DMD patients and their families. The objective of this review was to synthesize published evidence for health state utility from the DMD patient and caregiver perspectives. Methods A systematic review was performed using MEDLINE and Embase, according to best practices. Data were extracted from studies reporting DMD patient or caregiver utilities; these included study and patient characteristics, health states considered, and utility estimates. Quality appraisal of studies was performed. Results From 888 abstracts, eight publications describing five studies were identified. DMD utility estimates were from preference-based measures presented stratified by ambulatory status, ventilation, and age. Patient (or patient–proxy) utility estimates ranged from 0.75 (early ambulatory DMD) to 0.05 (day-and-night ventilation). Caregiver utilities ranged from 0.87 (for caregivers of adults with DMD) to 0.71 (for caregivers of predominantly childhood patients). Both patient and caregiver utilities trended lower with higher disease severity. Variability in utilities was observed based on instrument, respondent type, and country. Utility estimates for health states within non-ambulatory DMD are under reported; nor were utilities for DMD-related health states such as scoliosis or preserved upper limb function identified. Conclusion Published health state utilities document the substantial HRQoL impacts of DMD, particularly with disease progression. Additional research in patient utilities for additional health states, particularly in non-ambulatory DMD patients, is warranted.

L'effetto dell'esperienza della malattia sulla valutazione degli stati di salute

2009 ◽  
pp. 19-42
Author(s):  
Carmela Di Mauro ◽  
Daniela Giammanco ◽  
Eleonora Miano
Keyword(s):  
Standard Gamble ◽  
Rating Scale ◽  
Adaptive Behaviour ◽  
Health State ◽  
Health States ◽  
Current Health ◽  
Duration Of Illness ◽  
Experience Of Illness ◽  
The Impact ◽  
Health Valuation

- The issue of how respondents' characteristics influence preference-based valuations of health states has been addressed by the literature with a particular emphasis on the analysis of the effects of experience of illness. This study investigates the impact of experience of illness and of current health state on valuations provided by patients through three techniques, Standard Gamble, Rating Scale, and Time Trade-Off. This analysis complements the existing literature on the duration of illness and on adaptive behaviour, and sheds light on the way experience may affect health valuation according to the technique adopted. We use responses from 130 interviews administered to consecutively admitted patients of two cardiology units. Results show that the impact of the time elapsed since diagnosis is technique-specific: only in Standard Gamble estimates we find evidence that, the further away in time is the diagnosis, the lower the utility of the state.

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 Systematic review of health state utility values used in pharmacoeconomic evaluations for chronic hepatitis C: impact on cost-effectiveness results

2020 ◽  
Author(s):  
Ru Han ◽  
Clément François ◽  
Mondher Toumi
Keyword(s):  
Liver Transplant ◽  
Cost Effective ◽  
Decompensated Cirrhosis ◽  
Health State ◽  
Health States ◽  
Utility Elicitation ◽  
Compensated Cirrhosis ◽  
The Difference ◽  
Elicitation Studies ◽  
The Impact

AbstractBackgroundHealth state utility values (HSUVs) identified from utility elicitation studies are widely used in pharmacoeconomic evaluations for chronic hepatitis C (CHC) and are particularly instrumental in health technology assessment (HTA) evaluation like the National Institute for Health and Clinical Excellence (NICE).ObjectiveThe objective of this study is to identify HSUVs used in cost-utility analyses (CUAs) for CHC in Europe and evaluate the impact of HSUVs selection on cost-effectiveness results in terms of incremental cost per quality-adjusted life-year (QALY) gained (ICER).MethodsA systematic search of pharmacoeconomic evaluations for CHC was updated in Medline and Embase from the period of 2012-2017 to the period of 2017-2020. Data on health states, HSUVs and utility elicitation studies were extracted. The difference in HSUVs of the same health state in different CUAs and the difference between HSUVs of one health state and of the interlink health state in the same CUAs were calculated. A quality assessment was performed to evaluate the selection of HSUVs in CUAs. Sets of HSUVs identified were used in a re-constructed CUA model to assess the impact on ICER.ResultsTwenty-six CUAs conducted in European countries and referring to 17 utility elicitation studies were included. The difference in HSUVs of the same health states in different CUAs ranged from 0.021 (liver transplant) to 0.468 (decompensated cirrhosis). The difference between HSUVs of one health state and of the interlink health state of next disease severity level was calculated between health state of F0-F1/mild and F2-F3/moderate (n=11, 0.040 to 0.110), F2-F3/moderate and F4/compensated cirrhosis (n=18, 0.027 to 0.130), compensated cirrhosis and decompensated cirrhosis (n=22, 0.020 to 0.100), decompensated cirrhosis and hepatocellular carcinoma (n=24, 0.000 to 0.200), hepatocellular carcinoma and liver transplant in the first year (n=17, −0.329 to 0.170) and liver transplant in the first year and in subsequent years (n=17, −0.340 to 0.000). The utility elicitation study selected by most CUAs (n=11)was recommended as the source of HSUVs, as least for the CUAs conducted in the UK, based on the results of quality assessment. Seven sets of HSUVs were generated to fit the re-constructed model and changed the results of incremental analysis from being cost-effective to not cost-effective (ICER raging from £2,460 to £24,954 per QALY gained), and to dominated in the UK setting.ConclusionsThe CUAs for CHC were found to apply various HSUVs from different utility elicitation studies in the same health state. This variability of HSUVs has the potential to significantly affect ICER and ICER-based reimbursement decision. A rigorous selection of HSUVs in CUAs to inform healthcare resource allocation is suggested for future studies of CUAs and guideline development.

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.

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