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Where ’ s WALY? : A proof of concept study of the ‘ wellbeing adjusted life year ’ using secondary analysis of cross-sectional survey data

View Article: PubMed Central - PubMed

ABSTRACT

Background: The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE (https://www.nice.org.uk/process/pmg9/). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L.

Methods: Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson’s and Spearman’s correlations, linear regression, and receiver operating characteristic curves.

Results: Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R2 being 0.104 for the index and 0.141 for the visual analogue scale).

Conclusion: The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure – a Wellbeing Adjusted Life Year – is needed.

No MeSH data available.


Distribution of the WEMWBS scores for each level of each domain of EQ-5D-3L
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Fig2: Distribution of the WEMWBS scores for each level of each domain of EQ-5D-3L

Mentions: The joint distribution of WEMWBS with the EQ-5D-3L VAS score is shown in Table 2. The mean EQ-5D-3L VAS score was 77.5, with a standard deviation of 18.4. The median score was 80, with quartiles of 70 and 90. Correlations between the EQ-5D-3L VAS score and WEMWBS were r = 0.375 (95 % CI: 0.355, 0.396) and rs = 0.355 (95 % CI: 0.333, 0.376). The distributions of the WEMWBS scores for each level of each domain of EQ-5D-3L are illustrated in Fig. 2, showing there is a wide spread of WEMWBS scores within each EQ-5D-3L domain.Fig. 2


Where ’ s WALY? : A proof of concept study of the ‘ wellbeing adjusted life year ’ using secondary analysis of cross-sectional survey data
Distribution of the WEMWBS scores for each level of each domain of EQ-5D-3L
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5016960&req=5

Fig2: Distribution of the WEMWBS scores for each level of each domain of EQ-5D-3L
Mentions: The joint distribution of WEMWBS with the EQ-5D-3L VAS score is shown in Table 2. The mean EQ-5D-3L VAS score was 77.5, with a standard deviation of 18.4. The median score was 80, with quartiles of 70 and 90. Correlations between the EQ-5D-3L VAS score and WEMWBS were r = 0.375 (95 % CI: 0.355, 0.396) and rs = 0.355 (95 % CI: 0.333, 0.376). The distributions of the WEMWBS scores for each level of each domain of EQ-5D-3L are illustrated in Fig. 2, showing there is a wide spread of WEMWBS scores within each EQ-5D-3L domain.Fig. 2

View Article: PubMed Central - PubMed

ABSTRACT

Background: The Quality-Adjusted Life Year (QALY) is a measure that combines life extension and health improvement in a single score, reflecting preferences around different types of health gain. It can therefore be used to inform decision-making around allocation of health care resources to mutually exclusive options that would produce qualitatively different health benefits. A number of quality-of-life instruments can be used to calculate QALYs. The EQ-5D is one of the most commonly used, and is the preferred option for submissions to NICE (https://www.nice.org.uk/process/pmg9/). However, it has limitations that might make it unsuitable for use in areas such as public and mental health where interventions may aim to improve well-being. One alternative to the QALY is a Wellbeing-Adjusted Life Year. In this study we explore the need for a Wellbeing-Adjusted Life Year measure by examining the extent to which a measure of wellbeing (the Warwick-Edinburgh Mental Well-being Scale) maps onto the EQ-5D-3L.

Methods: Secondary analyses were conducted on data from the Coventry Household Survey in which 7469 participants completed the EQ-5D-3L, Warwick-Edinburgh Mental Well-being Scale, and a measure of self-rated health. Data were analysed using descriptive statistics, Pearson’s and Spearman’s correlations, linear regression, and receiver operating characteristic curves.

Results: Approximately 75 % of participants scored the maximum on the EQ-5D-3L. Those with maximum EQ-5D-3L scores reported a wide range of levels of mental wellbeing. Both the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were able to detect differences between those with higher and lower levels of self-reported health. Linear regression indicated that scores on the Warwick-Edinburgh Mental Well-being Scale and the EQ-5D-3L were weakly, positively correlated (with R2 being 0.104 for the index and 0.141 for the visual analogue scale).

Conclusion: The Warwick-Edinburgh Mental Well-being Scale maps onto the EQ-5D-3L to only a limited extent. Levels of mental wellbeing varied greatly amongst participants who had the maximum score on the EQ-5D-3L. To evaluate the relative effectiveness of interventions that impact on mental wellbeing, a new measure – a Wellbeing Adjusted Life Year – is needed.

No MeSH data available.