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Mapping and direct valuation: do they give equivalent EQ-5D-5L index scores?

Luo N, Cheung YB, Ng R, Lee CF - Health Qual Life Outcomes (2015)

Bottom Line: Whenever appropriate, the 90% confidence intervals (90% CI) were compared to predefined equivalence margins.However, the mapping-derived index score was lower than the valuation-derived index score in patients experiencing extreme health problems, and the test-retest reliability of the former was lower than the latter, for example, their ICCs differed by 0.121 (90% CI = 0.051 to 0.198) in patients who reported no change in performance status in the follow-up survey.This study provided the first evidence supporting the validity of the mapping function for converting EQ-5D-5L profile data into a utility-based index score.

View Article: PubMed Central - PubMed

Affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

ABSTRACT

Objective: Utility values of health states defined by health-related quality of life instruments can be derived from either direct valuation ('valuation-derived') or mapping ('mapping-derived'). This study aimed to compare the utility-based EQ-5D-5L index scores derived from the two approaches as a means to validating the mapping function developed by van Hout et al for the EQ-5D-5L instrument.

Methods: This was an observational study of 269 breast cancer patients whose EQ-5D-5L index scores were derived from both methods. For comparing discriminatory ability and responsiveness to change, multivariable regression models were used to estimate the effect sizes of various health indicators on the index scores. Agreement and test-retest reliability were examined using intraclass correlation coefficient (ICC). Whenever appropriate, the 90% confidence intervals (90% CI) were compared to predefined equivalence margins.

Results: The mean difference in and ICC between the valuation- and mapping-derived EQ-5D-5L index scores were 0.015 (90% CI = 0.006 to 0.024) and 0.915, respectively. Discriminatory ability and responsiveness of the two indices were equivalent in 13 of 15 regression analyses. However, the mapping-derived index score was lower than the valuation-derived index score in patients experiencing extreme health problems, and the test-retest reliability of the former was lower than the latter, for example, their ICCs differed by 0.121 (90% CI = 0.051 to 0.198) in patients who reported no change in performance status in the follow-up survey.

Conclusion: This study provided the first evidence supporting the validity of the mapping function for converting EQ-5D-5L profile data into a utility-based index score.

No MeSH data available.


Related in: MedlinePlus

Bland-Altman plots of the baseline and follow-up EQ-5D-5L index derived from direct valuation and mapping in patients who reported no change in a self-assessed performance status and b health status
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Fig2: Bland-Altman plots of the baseline and follow-up EQ-5D-5L index derived from direct valuation and mapping in patients who reported no change in a self-assessed performance status and b health status

Mentions: In patients who reported no change in performance status (N = 138), the ICC was 0.832 and 0.710 for the valuation- and mapping-derived index score, respectively, resulting in a difference of 0.121 (90 % CI = 0.051 to 0.198). In patients reporting no change in health status (N = 92), the respective ICCs were 0.793 and 0.607; the difference was 0.186 (90 % CI = 0.078 to 0.307). There was no overlap between the CIs and the equivalence margin of −0.05 to 0.05, indicating non-equivalence. Bland-Altman plots confirm the better test-retest reliability of the valuation-derived index score than the mapping-derived score in both groups of patients (Fig. 2). Take patients who reported no change in performance status for example, the 95 % limits of agreement for the mapping-derived score were wider and 2 patients (1.4 %) in relatively poor health status had dramatically different baseline and follow-up scores based on the mapping approach. One of these two patients improved from ‘unable to walk about’ at baseline to ‘moderate problems in walking about’ at follow-up, with the corresponding change in score being 0.717 for the mapping-derived index and 0.221 for the valuation-derived index; the other patient deteriorated from ‘slight problems in performing usual activities’ at baseline to ‘unable to perform usual activities’ at follow-up, with the corresponding score change being −0.709 and −0.141 for the mapping- and valuation-derived indices, respectively.Fig. 2


Mapping and direct valuation: do they give equivalent EQ-5D-5L index scores?

Luo N, Cheung YB, Ng R, Lee CF - Health Qual Life Outcomes (2015)

Bland-Altman plots of the baseline and follow-up EQ-5D-5L index derived from direct valuation and mapping in patients who reported no change in a self-assessed performance status and b health status
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4595246&req=5

Fig2: Bland-Altman plots of the baseline and follow-up EQ-5D-5L index derived from direct valuation and mapping in patients who reported no change in a self-assessed performance status and b health status
Mentions: In patients who reported no change in performance status (N = 138), the ICC was 0.832 and 0.710 for the valuation- and mapping-derived index score, respectively, resulting in a difference of 0.121 (90 % CI = 0.051 to 0.198). In patients reporting no change in health status (N = 92), the respective ICCs were 0.793 and 0.607; the difference was 0.186 (90 % CI = 0.078 to 0.307). There was no overlap between the CIs and the equivalence margin of −0.05 to 0.05, indicating non-equivalence. Bland-Altman plots confirm the better test-retest reliability of the valuation-derived index score than the mapping-derived score in both groups of patients (Fig. 2). Take patients who reported no change in performance status for example, the 95 % limits of agreement for the mapping-derived score were wider and 2 patients (1.4 %) in relatively poor health status had dramatically different baseline and follow-up scores based on the mapping approach. One of these two patients improved from ‘unable to walk about’ at baseline to ‘moderate problems in walking about’ at follow-up, with the corresponding change in score being 0.717 for the mapping-derived index and 0.221 for the valuation-derived index; the other patient deteriorated from ‘slight problems in performing usual activities’ at baseline to ‘unable to perform usual activities’ at follow-up, with the corresponding score change being −0.709 and −0.141 for the mapping- and valuation-derived indices, respectively.Fig. 2

Bottom Line: Whenever appropriate, the 90% confidence intervals (90% CI) were compared to predefined equivalence margins.However, the mapping-derived index score was lower than the valuation-derived index score in patients experiencing extreme health problems, and the test-retest reliability of the former was lower than the latter, for example, their ICCs differed by 0.121 (90% CI = 0.051 to 0.198) in patients who reported no change in performance status in the follow-up survey.This study provided the first evidence supporting the validity of the mapping function for converting EQ-5D-5L profile data into a utility-based index score.

View Article: PubMed Central - PubMed

Affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.

ABSTRACT

Objective: Utility values of health states defined by health-related quality of life instruments can be derived from either direct valuation ('valuation-derived') or mapping ('mapping-derived'). This study aimed to compare the utility-based EQ-5D-5L index scores derived from the two approaches as a means to validating the mapping function developed by van Hout et al for the EQ-5D-5L instrument.

Methods: This was an observational study of 269 breast cancer patients whose EQ-5D-5L index scores were derived from both methods. For comparing discriminatory ability and responsiveness to change, multivariable regression models were used to estimate the effect sizes of various health indicators on the index scores. Agreement and test-retest reliability were examined using intraclass correlation coefficient (ICC). Whenever appropriate, the 90% confidence intervals (90% CI) were compared to predefined equivalence margins.

Results: The mean difference in and ICC between the valuation- and mapping-derived EQ-5D-5L index scores were 0.015 (90% CI = 0.006 to 0.024) and 0.915, respectively. Discriminatory ability and responsiveness of the two indices were equivalent in 13 of 15 regression analyses. However, the mapping-derived index score was lower than the valuation-derived index score in patients experiencing extreme health problems, and the test-retest reliability of the former was lower than the latter, for example, their ICCs differed by 0.121 (90% CI = 0.051 to 0.198) in patients who reported no change in performance status in the follow-up survey.

Conclusion: This study provided the first evidence supporting the validity of the mapping function for converting EQ-5D-5L profile data into a utility-based index score.

No MeSH data available.


Related in: MedlinePlus