Estimating Utility Values for Health States of DFU Patients Using EQ-5D-5L and cTTO

2021 ◽  
pp. 153473462110143
Author(s):  
Morteza Arab-Zozani ◽  
Hossein Safari ◽  
Zoha Dori ◽  
Somayeh Afshari ◽  
Hosein Ameri ◽  
...  
Keyword(s):  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Economic Modeling ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
The Mean ◽  
The Difference ◽  
Diabetes Center ◽  
Health State Utility Values

Health-state utility values of diabetic foot ulcer (DFU) patients are necessary for clinical praxis and economic modeling. The purpose of this study was to estimate utility values in DFU patients using the EuroQol-5-dimension-5-level (EQ-5D-5L) and composite time trade-off (cTTO). The EQ-5D-5L and cTTO were used for estimating utility values. Data were collected from 228 patients referred to the largest governmental diabetes center in the South of Iran, Yazd province. When appropriate, independent sample t-test or analysis of variance test was used to test the difference in the utility values in each of the demographic and clinical characteristics of the patients. Finally, the BetaMix was used to identify predictors of the utility values. The means of EQ-5D-5L and cTTO values were 0.55( SD 0.21) and 0.67( SD 0.23), respectively. Anxiety and pain were the most common problems reported by the patients. The difference between the mean EQ-5D-5L values was significant for age, grade of ulcer, number of comorbidities, and having complications. In addition, variables of gender, age, grade of ulcer, and having complications were significant predictors of the EQ-5D-5L. The difference between the mean cTTO values was significant for age, employment status, grade of ulcer, number of comorbidities, and having complications. Moreover, variables of gender, age, grade of ulcer, number of comorbidities, and developing complications were significant predictors of cTTO. The current study provided estimates of utility values for DFU patients for clinical praxis and economic modeling. These estimates, similar to utilities reported in other studies, were low. Identifying strategies to decrease anxiety/depression and pain in patients is important to improve the utility values.

Methods for obtaining health state utility values: generic preference-based measures of health

2016 ◽  
Author(s):  
John Brazier ◽  
Julie Ratcliffe ◽  
Joshua A. Salomon ◽  
Aki Tsuchiya
Keyword(s):  
Health State Utility ◽  
Health State ◽  
Multiattribute Utility ◽  
Health States ◽  
Utility Values ◽  
Published Evidence ◽  
State Classification ◽  
Health State Utility Values ◽  
Generic Measures ◽  
Health State Classification

This chapter describes the six most widely used generic preference-based measures of health (GPBMs) (also known as multiattribute utility scales): EQ-5D, SF-6D, HUI, AQoL, 15D, and QWB. GPBMs have become the most widely used method for obtaining health state utility values. They contain a health state classification with multilevel dimensions that together describe a universe of health states and a set of values (where full health = 1 and dead = 0) for each health state obtained by eliciting the preferences (typically) of members of the general population. These measures are reviewed in terms of their content, methods of valuation, the scores they generate, and the possible reasons for the differences found. Their performance is reviewed using published evidence on their validity across conditions, and the implications for their use in policy making discussed. The chapter also reviews the generic measures available for use in populations of children and adolescents.

scholarly journals The estimation of health state utility values in rare diseases: overview of existing techniques

2020 ◽  
Vol 36 (5) ◽  
pp. 469-473
Author(s):  
Michela Meregaglia ◽  
Elena Nicod ◽  
Michael Drummond
Keyword(s):  
Rare Diseases ◽  
Ethical Issues ◽  
Health State Utility ◽  
Health State ◽  
Health States ◽  
Promising Alternative ◽  
Utility Values ◽  
Life Threatening ◽  
Pros And Cons ◽  
Health State Utility Values

There are several techniques for estimating health state utility values, each of which presents pros and cons in the context of rare diseases (RDs). Direct approaches (e.g. standard gamble and time trade-off) may be too demanding for patients with RDs, since most of them affect young children or cause cognitive impairment. The alternatives are using “vignettes” that describe hypothetical health states for the general public, which may not reflect the heterogeneous manifestations of RDs, or multi-attribute utility instruments (i.e. indirect techniques), such as EQ-5D, which may be less sensitive in capturing the specificities of RDs. The “rule of rescue” approach is a promising alternative in RDs, since it prioritizes identifiable patients with life-threatening or disabling conditions. However, it raises measurement challenges and ethical issues. Furthermore, the literature reports on relevant implications of choosing a technique over others for health technology assessment, which should be considered in relation to individual RDs.

scholarly journals A systematic review of health state utility values for thyroid cancer

2020 ◽  
Author(s):  
Rachel Houten ◽  
Nigel Fleeman ◽  
Eleanor Kotas ◽  
Angela Boland ◽  
Tosin Lambe ◽  
...  
Keyword(s):  
Systematic Review ◽  
Thyroid Cancer ◽  
Cost Effectiveness ◽  
Differentiated Thyroid Cancer ◽  
Health State ◽  
Health States ◽  
Utility Values ◽  
Sf 36 ◽  
Health State Utility Values ◽  
Eortc Qlq

Abstract Purpose Health state utility values are commonly used to inform economic evaluations and determine the cost-effectiveness of an intervention. The aim of this systematic review is to summarise the utility values available to represent the health-related quality of life (HRQoL) of patients with thyroid cancer. Methods Eight electronic databases were searched from January 1999 to April 2019 for studies which included assessment of HRQoL for patients with thyroid cancer. Utility estimates derived from multiple sources (EuroQol questionnaire 5-dimension (EQ-5D), time trade-off [TTO] and standard gamble [SG] methods) were extracted. In addition, utility estimates were generated by mapping from SF-36 and EORTC QLQ-30 to the EQ-5D-3L UK value set using published mapping algorithms. Results Searches identified 33 eligible studies. Twenty-six studies reported HRQoL for patients with differentiated thyroid cancer and seven studies for patients with general thyroid cancer. We identified studies which used different methods and tools to quantify the HRQoL in patients with thyroid cancer, such as the EQ-5D-3L, SF-36, EORTC QLQ-30 and SG and TTO techniques to estimate utility values. Utility estimates range from 0.205 (patients with low-risk differentiated thyroid cancer) to utility values approximate to the average UK population (following successful thyroidectomy surgery and radioiodine treatment). Utility estimates for different health states, across thyroid cancer sub-types and interventions are presented. Conclusion A catalogue of utility values is provided for use when carrying out economic modelling of thyroid cancer; by including mapped values, this approach broadens the scope of health states that can be considered within cost-effectiveness modelling.

scholarly journals Differences in the Selection of Health State Utility Values by Sponsorship in Published Cost-Effectiveness Analyses

2021 ◽  
pp. 0272989X2098582
Author(s):  
Nathaniel Hendrix ◽  
David D. Kim ◽  
Krishna S. Patel ◽  
Beth Devine
Keyword(s):  
Cost Effectiveness ◽  
The United States ◽  
Health State Utility ◽  
Free Text ◽  
Health State ◽  
Industry Funding ◽  
Health States ◽  
Utility Values ◽  
Health State Utility Values ◽  
Selection Of

Background Health state utility values (HSUVs) are among the most influential attributes of cost-effectiveness analyses (CEAs). Our objective was to evaluate whether industry-funded studies select systematically different HSUVs as compared with studies without industry funding. Methods Among 10 diseases with high disease burden in the United States, we further identified 31 progressive health states. We then searched the Tufts Medical Center’s CEA Registry to identify studies that included HSUVs and were submitted to the registry between 2002 and 2019. Two reviewers mapped the free-text descriptions of health states onto the 31 predefined health states. We analyzed the effect of industry funding on the point estimates of these HSUVs with a beta regression. We also analyzed the difference between related health states within studies by funding source with a linear regression. Results After identifying 26,222 HSUVs from 4198 CEAs, we matched 2573 HSUVs to the 31 predefined health states. We observed large variations within each health state: 12 of 31 health states included a range of HSUVs greater than 0.5. The point estimate model showed 1 statistically significant difference of 31 comparisons between studies with any industry funding and those without. The utility difference model found 3 significant differences out of 39 comparisons between CEAs with any industry funding and those without. Limitations Inclusion of unpublished CEAs may have affected our conclusions about the effect of industry funding on selection of HSUVs. We also relied on free-text descriptions of health states available in the CEA Registry and did not include adjustment for multiple comparisons. Conclusion Limited evidence exists that industry-funded studies select different HSUVs compared to non-industry-funded studies for the health states we considered.

The impact of acute pneumococcal disease on health state utility values: a systematic review

2021 ◽  
Author(s):  
Ryan O’Reilly ◽  
Sayako Yokoyama ◽  
Justin Boyle ◽  
Jeffrey C. Kwong ◽  
Allison McGeer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pneumococcal Disease ◽  
Health State Utility ◽  
Health State ◽  
Utility Values ◽  
Health State Utility Values ◽  
The Impact

The impact of multiple sclerosis severity on health state utility values: Evidence from Australia

2016 ◽  
Vol 23 (8) ◽  
pp. 1157-1166 ◽  
Author(s):  
Hasnat Ahmad ◽  
Bruce V Taylor ◽  
Ingrid van der Mei ◽  
Sam Colman ◽  
Beth A O’Leary ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Severity ◽  
Severe Disease ◽  
Health Utility ◽  
Health State Utility ◽  
Health State ◽  
Utility Values ◽  
Health State Utility Values ◽  
Economic Analyses ◽  
The Impact

Background: The measurement of health state utility values (HSUVs) for a representative sample of Australian people with multiple sclerosis (MS) has not previously been performed. Objectives: Our main aim was to quantify the HSUVs for different levels of disease severities in Australian people with MS. Method: HSUVs were calculated by employing a ‘judgement-based’ method that essentially creates EQ-5D-3L profiles based on WHOQOL-100 responses and then applying utility weights to each level in each dimension. A stepwise linear regression was used to evaluate the relationship between HSUVs and disease severity, classified as mild (Expanded Disability Status Scale (EDSS) levels: 0–3.5), moderate (EDSS levels: 4–6) and severe (EDSS levels: 6.5–9.5). Results: Mean HSUV for all people with MS was 0.53 (95% confidence interval (CI): 0.52–0.54). Utility decreased with increasing disease severity: 0.61 (95% CI: 0.60–0.62), 0.51 (95% CI: 0.50–0.52) and 0.40 (95% CI: 0.38–0.43) for mild, moderate and severe disease, respectively. Adjusted differences in mean HSUV between the three severity groups were statistically significant. Conclusion: For the first time in Australia, we have quantified the impact of increasing severity of MS on health utility of people with MS. The HSUVs we have generated will be useful in further health economic analyses of interventions that slow progression of MS.

Health-state utility values in breast cancer

2010 ◽  
Vol 10 (5) ◽  
pp. 553-566 ◽  
Author(s):  
Tessa Peasgood ◽  
Sue E Ward ◽  
John Brazier
Keyword(s):  
Breast Cancer ◽  
Health State Utility ◽  
Health State ◽  
Utility Values ◽  
Health State Utility Values
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