用 "螺栓 "评估多维健康状态:有捷径吗?

IF 4.9 2区 医学 Q1 ECONOMICS Value in Health Pub Date : 2024-11-01 DOI:10.1016/j.jval.2024.06.018
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引用次数: 0

摘要

目的:为了在经济评估研究中使用带有附加维度的 EQ-5D 问卷,需要新的价值集。在本研究中,我们探索了一种名为缩放因子模型的新方法的可行性,该方法利用估算的 EQ-5D 维度权重估算附加值集:方法:我们设计了一项双臂研究,邀请大学生使用综合时间权衡(cTTO)法对有无栓塞项目的健康状态进行估值。我们从正交阵列中选取了 25 种健康状态,并在设计中加入了 5 种最轻的 EQ-5D 状态。在第一组中,我们评估了不含自我护理的 EQ-5D 状态和标准 EQ-5D 状态;在第二组中,我们评估了标准 EQ-5D 状态和含视力的 EQ-5D 状态。我们按治疗组比较了有和没有附加项目的健康状况的平均观察值。接下来,我们按研究组使用标准模型和缩放因子模型估算了EQ-5D(含栓塞项目)状态的值集。从预测准确性和与基于似然法的平均值的相关性方面比较了模型的性能:结果:在 EQ-5D 中添加第五级附加项目会导致统计值降低。这种效应在两臂和附加项目中是一致的。缩放因子模型在所有统计数据中均优于标准模型:缩放因子模型为 EQ-5D 值集的生成提供了一种方法上可行且成本低廉的选择,并辅以附加项目。未来的研究应使用其他附加项目和相关研究人群进一步测试这种方法。
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Valuation of Multidimensional Health States With a Bolt-On: Is There a Shortcut?

Objectives

To use the EQ-5D questionnaire with bolt-on dimensions in economic evaluation studies, new value sets are needed. In this study, we explored the feasibility of a new approach called the scaling factor model, which estimates bolt-on value sets using estimated EQ-5D dimensional weights.

Methods

We designed a 2-arm study, inviting university students to value health states with and without bolt-on items using the composite time trade-off method. We selected 25 health states from an orthogonal array and added the 5 mildest EQ-5D states in the design. In arm 1, EQ-5D without self-care and standard EQ-5D states were valued, and in arm 2, standard EQ-5D states and EQ-5D with vision were valued. By arm, we compared the mean observed values of health states with and without bolt-on item. Next, by arm, we estimated value sets for the EQ-5D with bolt-on states using both standard model and scaling factor model. Model performances were compared in terms of prediction accuracy and correlation with likelihood-based mean values.

Results

Adding a five-level bolt-on to EQ-5D resulted in statistically lower values. This effect was consistent across 2 arms and bolt-on items. The scaling factor models outperformed the standard models in all statistics.

Conclusions

The scaling factor model offers a methodologically viable and low-cost option for producing value sets for EQ-5D supplemented with bolt-on items. Future studies should further test this method using other bolt-on items and more relevant study populations.
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来源期刊
Value in Health
Value in Health 医学-卫生保健
CiteScore
6.90
自引率
6.70%
发文量
3064
审稿时长
3-8 weeks
期刊介绍: Value in Health contains original research articles for pharmacoeconomics, health economics, and outcomes research (clinical, economic, and patient-reported outcomes/preference-based research), as well as conceptual and health policy articles that provide valuable information for health care decision-makers as well as the research community. As the official journal of ISPOR, Value in Health provides a forum for researchers, as well as health care decision-makers to translate outcomes research into health care decisions.
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