Mapping a Patient-Reported Functional Outcome Measure to a Utility Measure for Comparative Effectiveness and Economic Evaluations in Older Adults with Low Back Pain

被引:7
作者
Rundell, Sean D. [1 ,2 ]
Bresnahan, Brian W. [1 ,2 ,3 ]
Heagerty, Patrick J. [4 ]
Comstock, Bryan A. [4 ]
Friedly, Janna L. [1 ,5 ]
Jarvik, Jeffrey G. [1 ,2 ,6 ,7 ,8 ,9 ]
Sullivan, Sean D. [3 ]
机构
[1] Univ Washington, Comparat Effectiveness Cost & Outcomes Res Ctr, Seattle, WA 98105 USA
[2] Univ Washington, Dept Radiol, Seattle, WA 98105 USA
[3] Univ Washington, Pharmaceut Outcomes Res & Policy Program, Seattle, WA 98105 USA
[4] Univ Washington, Ctr Biomed Stat, Seattle, WA 98105 USA
[5] Univ Washington, Dept Rehabil Med, Seattle, WA 98105 USA
[6] Univ Washington, Dept Neurol Surg, Seattle, WA 98105 USA
[7] Univ Washington, Dept Hlth Serv, Seattle, WA 98105 USA
[8] Univ Washington, Dept Pharm, Seattle, WA 98105 USA
[9] Univ Washington, Dept Orthoped & Sports Med, Seattle, WA 98105 USA
基金
美国医疗保健研究与质量局;
关键词
low back pain; older adults; health economic evaluations; Roland-Morris Disability Questionnaire; EQ-5D; QUALITY-OF-LIFE; DISEASE-SPECIFIC MEASURES; HEALTH-STATUS; LEG PAIN; DISABILITY; EQ-5D; RESPONSIVENESS; QUESTIONNAIRE; SCORES; INDEX;
D O I
10.1177/0272989X14533995
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background. Linking patient-reported back pain outcomes with health utility measures is valuable for informing economic evaluations. Methods. We used the Back pain Outcomes using Longitudinal Data (BOLD) registry to assess back pain and quality-of-life measures. The BOLD registry includes participants >= 65 years from 3 health systems. We used multiple baseline outcome measures: Roland-Morris Disability Questionnaire (RMDQ), Euroqol-5D (EQ-5D), and back and leg pain numerical rating scales (NRS). To develop and validate a model, we used a standard split-sample method and a novel multi-site validation approach. We applied linear regression to map RMDQ to EQ-5D, adjusting for age, sex, pain numerical rating scores, and nonlinear transformations of outcome measures. We computed R-2, root mean squared error, and mean absolute error (MAE) for purposes of model selection. The final model included EQ-5D as the dependent variable with independent variables of age, RMDQ, and back NRS. We used this model to predict EQ-5D scores in validation samples. Results. In total, 5224 participants had both baseline RMDQ and EQ-5D. Mean age was 74 years (65% female). Negative correlations (-0.72) were observed at baseline for RMDQ and EQ-5D. The selected model from all developmental samples had R-2>0.41 and MAE<0.119. Validation analyses indicated no differences in estimated v. observed mean EQ-5D scores in the split sample. Validation using the multisite validation approach identified prediction error variability, MAE of 0.081 to 0.119, when predicting EQ5D. Limitations. The statistical relationship may not generalize well to all study populations as we demonstrated in our multisite analysis. Conclusions. An empirical algorithm predicting EQ-5D weights from RMDQ scores provides a currently unavailable link for conducting economic evaluations in low back pain studies.
引用
收藏
页码:873 / 883
页数:11
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