Does the correspondence between EQ-5D health state description and VAS score vary by medical condition?

Health and Quality of Life Outcomes

David K Whynes¹ 

[1] School of Economics, University of Nottingham, Nottingham NG7 2RD, UK

关键词: Patient-reported outcome measures;    Health-related quality of life;    Health state;    Visual analogue scale;    EQ-5D;   

Others  :  823205
DOI  :  10.1186/1477-7525-11-155

 received in 2013-03-05, accepted in 2013-09-09,  发布年份 2013

【 摘 要 】

Background

The EQ-5D health-related quality of life instrument comprises a health state classification (health problems by severity in five domains), followed by an evaluation using a visual analogue scale (VAS). Despite the EQ-5D’s use in health technology assessment and as a patient-reported outcome measure (PROM), the correspondence between the two parts of the instrument remains ill-understood. In this paper, we consider whether the association between health state classification and VAS score might vary by medical condition.

Methods

EQ-5D data collected for studies of patients in four different clinical conditions or circumstances (stroke, low back pain, colposcopic investigation or cytological surveillance) were pooled to generate a sample of 3,851 patient records. VAS scores were regressed on reported problem severities, with the inclusion of intercept and slope dummy variables specific to condition.

Results

The regression model achieved a goodness-of-fit of 0.54. Given its structure and the significance of the coefficients, the proportion of VAS scores which differed by condition for the same health state varied between 33.3 and 88.5 per cent of possible states.

Conclusions

Many of the patients with different medical conditions or in receipt of different interventions recorded different VAS valuations, in spite of ostensibly being in the same EQ-5D-defined health states. By implication, it is probable that the same state-to-state change would by valued differently by patients experiencing different conditions.

【 授权许可】

   
2013 Whynes; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Rabin R, Oemar M, Oppe M, on behalf of the EuroQoL Group: EQ-5D-3L user guide. 4th edition. Rotterdam: EuroQoL Group; 2011.
• [2]National Institute for Health and Clinical Excellence: Guide to the methods of technology appraisal. London: NICE; 2008.
• [3]Sorenson C, Drummond M, Kanavos P: Ensuring value for money in health care: the role of health technology assessment in the European Union. Copenhagen: World Health Organisation; 2008.
• [4]Benzer M: Independence in dependence: health technology assessment, quality of life, and the position of the patient. London: Centre for Analysis of Risk and Regulation, London School of Economics and Political Science; 2013.
• [5]Feng Y, Parkin D, Devlin NJ: Assessing the performance of the EQ-VAS in the NHS PROMs programme (Research Paper 12/01). London: Office of Health Economics; 2012.
• [6]Jelsma J, Ferguson G: The determinants of self-reported health-related quality of life in a culturally and socially diverse South African community. Bull World Health Organ 2004, 82:206-212.
• [7]Whynes DK: Correspondence between EQ-5D health state classifications and EQ VAS scores. Health Qual Life Outcomes 2008, 6:94. BioMed Central Full Text
• [8]Perneger TV, Courvoisier DS: Exploration of health dimensions to be included in multi-attribute health-utility assessment. Int J Qual Health Care 2011, 23:52-59.
• [9]Health & Social Care Information Centre: Provisional monthly patient reported outcome measures (PROMs) in England: a guide to PROMs methodology. 5th edition. Leeds: H&SCIC; 2013.
• [10]Browne J, Jamieson L, Lawsey J, van der Meulen J, Black N, Cairns J, Lamping D, Smith S, Copley L, Horrockes J: Patient Reported Outcome Measures (PROMs) in elective surgery: report to the Department of Health. London: Health Services Research Unit, London School of Hygiene & Tropical Medicine; 2007.
• [11]Department of Health: Equity and excellence: liberating the NHS (Cm 7881). Norwich: The Stationery Office; 2010.
• [12]Rolfson O, Kärrholm J, Dahlberg LE, Garellick G: Patient-reported outcomes in the Swedish hip arthroplasty register. J Bone Joint Surg 2011, 93-B:867-875.
• [13]Bryan S, Broesch J, Dalzell K, Davis J, Dawes M, Doyle-Waters MM, Lewis S, McGrail K, McGregor MJ, Murphy JM, Sawatzky R: What are the most effective ways to measure patient health outcomes of primary health care integration through PROM (Patient Reported Outcome Measurement) instruments?. Vancouver, BC: Centre for Clinical Epidemiology & Evaluation; 2013.
• [14]Rabin R, De Charro F: EQ-5D: a measure of health status from the EuroQol group. Ann Med 2001, 33:337-343.
• [15]Devlin NJ, Parkin D, Browne J: Patient-reported outcome measures in the NHS: new methods for analysing and reporting EQ-5D data. Health Econ 2010, 19:886-905.
• [16]Whynes DK, McCahon RA, Ravenscroft A, Hardman J: Cost effectiveness of epidural steroid injections to manage chronic lower back pain. BMC Anesthesiol 2012, 12:26. BioMed Central Full Text
• [17]Whynes DK, McCahon RA, Ravenscroft A, Hodgkinson V, Evley R, Hardman JG: Responsiveness of the EQ-5D health-related quality-of-life instrument in assessing low back pain. Value Health 2013, 16:124-132.
• [18]Whynes DK, Sprigg N, Selby J, Berge E, Bath PM, for the ENOS Investigators: Testing for differential item functioning within the EQ-5D. Med Decis Making 2013, 33:252-260.
• [19]TOMBOLA Group: Cytological surveillance compared with immediate referral for colposcopy in management of women with low grade cervical abnormalities: multicentre randomised controlled trial. Br Med J 2009, 339:b2546.
• [20]TOMBOLA Group: Options for managing low grade cervical abnormalities detected at screening: cost effectiveness study. Br Med J 2009, 339:b2549.
• [21]Bailey H, Kind P: Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets. Qual Life Res 2010, 19:1145-1154.
• [22]Potthoff RF: Statistical aspects of the problem of biases in psychological tests (Institute of Statistics Mimeo Series No 479). Chapel Hill, NC: Department of Statistics, University of North Carolina; 1966.
• [23]Greiner W, Weijnen T, Nieuwenhuizen M, Oppe S, Badia X, Busschbach J, Buxton M, Dolan P, Kind P, Krabbe P, et al.: A single European currency for EQ-5D health states. results from a six-country study. Eur J Health Econ 2003, 4:222-231.
• [24]Dolan P: The effect of experience of illness on health state valuations. J Clin Epidemiol 1996, 49:551-564.
• [25]McPherson K, Myers J, Taylor WJ, McNaughton HK, Weatherall M: Self-valuation and societal valuations of health state differ with disease severity in chronic and disabling conditions. Med Care 2004, 42:1143-1151.
• [26]Gandjour A: Theoretical foundation of patient v. population preferences in calculating QALYs. Med Decis Making 2010, 30:E57-E63.
• [27]Parkin D, Devlin N: Is there a case for using visual analogue scale valuations in cost-utility analysis? Health Econ 2006, 15:653-664.
• [28]Mann R, Brazier JE, Tsuchiya A: A comparison of patient and general population weightings of EQ-5D dimensions. Health Econ 2009, 18:363-372.
• [29]Rand-Hendriksen K, Augestad LA, Kristiansen IS, Stavem K: Comparison of hypothetical and experienced EQ-5D valuations: relative weights of the five dimensions. Qual Life Res 2012, 21:1005-1012.
• [30]Maher AJ, Kilmartin TE: An analysis of Euroqol EQ-5D and Manchester Oxford foot questionnaire scores six months following podiatric surgery. J Foot Ankle Res 2012, 5:17. BioMed Central Full Text
• [31]Goodwin R, Engstrom G: Personality and the perception of health in the general population. Psychol Med 2002, 32:325-332.
• [32]Kostka T, Jachimowicz V: Relationship of quality of life to dispositional optimism, health locus of control and self-efficacy in older subjects living in different environments. Qual Life Res 2010, 19:351-361.