Dataset Information

Argentine valuation of the EQ-5D health states.

ABSTRACT: To develop a set of health state values based on EuroQol EQ-5D instrument for the Argentine general population.Consecutive subjects attending six primary care centers in Argentina were selected based on quota sampling and were interviewed using the EuroQol Group protocol for measurement and valuation of health studies. Initially, the respondents were randomly assigned a unique card set; however, to improve efficiency, the subjects were later randomly assigned to one of three fixed sets of EQ-5D states. Using the visual analog scale (VAS) and time-trade off (TTO) responses for these states, we estimated a valuation model using ordinary least squares regression clustered by respondent. Predicted values for EQ-5D health states are compared with published values for the United States.Six hundred eleven subjects were interviewed by 14 trained interviewers, rendering 6887 TTO and 6892 VAS responses. The model had an R(2) of 0.897 and 0.928 for TTO and VAS, respectively. The mean absolute difference between observed and predicted values was 0.039 for TTO and 0.020 for VAS, each showing a Lin's concordance coefficient more than 0.98. Argentine and US TTO-predicted values were highly correlated (Pearson's rho = 0.963), although the average absolute difference was clinically meaningful (0.06), rejecting the US values for nearly two-thirds of the states (62.8%). The Argentine population placed lower values on mild states and higher values on severe states.This study provides an Argentine value set that could be used locally or regionally, with meaningful and significant differences with that of the United States. Health policy in Latin America must incorporate local values for sovereignty and validity.

SUBMITTER: Augustovski FA

PROVIDER: S-EPMC3819816 | biostudies-literature | 2009 Jun

REPOSITORIES: biostudies-literature

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Argentine valuation of the EQ-5D health states.

Augustovski Federico Ariel FA Irazola Vilma Edit VE Velazquez Alberto Pascual AP Gibbons Luz L Craig Benjamin M BM

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research 20081112 4

<h4>Objective</h4>To develop a set of health state values based on EuroQol EQ-5D instrument for the Argentine general population.<h4>Methods</h4>Consecutive subjects attending six primary care centers in Argentina were selected based on quota sampling and were interviewed using the EuroQol Group protocol for measurement and valuation of health studies. Initially, the respondents were randomly assigned a unique card set; however, to improve efficiency, the subjects were later randomly assigned to ...[more]

PMID: 19900257

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Project description:IntroductionInconsistency in the time trade-off (TTO) task in EQ-5D-5L occurs when a respondent gives a higher value to a logically worse health state, the occurrence of inconsistency compromises the quality of the data. It is not yet clear which factors are associated with individual level inconsistency. Relating inconsistency to the characteristics of the respondent, interviewer, and the interview process could be helpful in understanding the causes of inconsistency. The objective of this paper is to discover the factors associated with individual level inconsistencies.MethodsTwenty interviewers interviewed 1,296 respondents and each respondent valued 10 health states using the EQ-VT platform in 5 cities in China. At the respondent level, inconsistency was identified in terms of severity and quantity and related to the respondent's background characteristics, the time and iterations spent on the wheelchair example task, and the formal TTO tasks, using multilevel multinomial regression analyses. Interviewers' impact on inconsistencies was analyzed using single level multinomial regression analyses.ResultsIn the full dataset, slight inconsistency was more related to the interview process (Time spent on TTO task: RRR = 1.246 with 95%CI: 1.076,1.441; time spent on Wheelchair example: RRR = 0.815 with 95%CI:0.699,0.952) while severe inconsistency was more related to respondent's gender (Gender: RRR = 2.347 with 95%CI:1.429,3.855). One Interviewer (Interviewer 7: RRR = 7.335 with 95%CI:1.908,28.195) and interviewer's experience (Sequence: RRR = 0.511 with 95%CI:0.385,0.678) in general showed strong influence over inconsistency in the TTO task.ConclusionIn conclusion, logical inconsistency in the valuation of EQ-5D-5L health states is associated not only with respondents' characteristics but also with interviewers' performance and the interview process. The role of interviewers and the importance of interviewer training may be more crucial than hitherto believed. This finding could be generalizable to other interviewer-administered health-state valuation study.

Project description:BACKGROUND:The objective of this study was to obtain utilities by means of EQ-5D-5L for different health states in patients with knee osteoarthritis (KOA) or hip osteoarthritis (HOA) in Spain, and to compare these values with those used in foreign studies with the aim of discussing their transferability for their use in economic evaluations conducted in Spain. METHODS:Primary study: Observational prospective study of KOA or HOA patients in Spain. Sociodemographic and clinical characteristics were collected to characterize the sample. Utilities were elicited using the EQ-5D-5L questionnaire. ANOVA and bivariable analyses were conducted to identify differences between health states. LITERATURE REVIEW:Using the bibliographic databases NSH EED and CEA Registry, we conducted searches of model-based cost utilities analyses of technologies in KOA or HOA patients. Health states and utilities were extracted and compared with values obtained from the Spanish sample. RESULTS:Three hundred ninety-seven subjects with KOA and 361 subjects with HOA were included, with average utilities of 0.544 and 0.520, respectively. In both samples, differences were found in utilities according to level of pain, stiffness and physical function (WOMAC) and severity of symptoms (Oxford scales), so that the worst the symptoms, the lower the utilities. The utilities after surgery were higher than before surgery. Due to limitations from our study related to sample size and observational design, it was not possible to estimate utilities for approximately half the health states included in the published models because they were directly related to specific technologies. For almost 100% of health states of the selected studies we obtained very different utilities from those reported in the literature. CONCLUSIONS:To our knowledge this is the first article with detailed utilities estimated using the EQ-5D-5L in Spain for KOA and HOA patients. In both populations, utilities are lower for worse health states in terms of level of pain, stiffness and physical function according to WOMAC, and according to the Oxford scales. Most utilities obtained from the Spanish sample are lower than those reported in the international literature. Further studies estimating utilities from local populations are required to avoid the use of foreign sources in economic evaluations.

Dataset Information

Argentine valuation of the EQ-5D health states.

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Argentine valuation of the EQ-5D health states.

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