What is the value of social values? The uselessness of assessing health-related quality of life through preference measures

被引:38
作者
Prieto L. [1 ]
Sacristán J.A. [1 ]
机构
[1] Health Outcomes Research Unit, Eli Lilly and Co. Spain, 28108 Alcobendas, Av. de la Industria
关键词
Social Preference; Utility Score; Standard Gamble; Preference Measure; Utility Measure;
D O I
10.1186/1471-2288-4-10
中图分类号
学科分类号
摘要
Background: The use of preference-based measures in the evaluation of health outcomes has extended considerably over the last decade. Their alleged advantage over other types of general instruments in the evaluation of health related quality of life (HRQOL), supposedly lies in the fact that preference measures incorporate values or utilities that reflects the value of social preferences through health states. The objective of this study was to determine whether the use of social preference weights or utilities makes any real difference when calculating scores for the Euroqol (EQ5-D) questionnaire, a HRQOL preference-based measure. Methods: Responses to the EQ5-D of a sample of 10,972 patients from 10 countries enrolled in an observational study of the treatment of schizophrenia in Europe were used for this purpose. Two different methods of scoring the EQ-5D where compared: 'weighting the items' of the questionnaire through the UK official weight coefficients, and 'non-weighting the items'. Pearson's, Spearman's, and two-way mixed parametric intraclass correlation coefficients were used to estimate the association of the scores obtained in both ways. Results: The association between weighted and unweighted Euroqol scores was extremely high (Pearson's r = 0.91), as was the association between their ranks (Spearman's ρ = 0.93). The intraclass correlation coefficient obtained (0.89) also suggested that the concordance between the score distributions was prominent. Conclusions: A non-weighted approach to score the EQ5-D is enough to explain a high proportion of variance in scores obtained through the use of utilities. The differential contribution of weights based on population preference values is therefore minimal and, in our opinion, negligible.
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页码:1 / 9
页数:8
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共 28 条
[1]  
Neumann P.J., Goldie S.J., Weinstein M.C., Preference-based measures in economic evaluation in health care, Annu Rev Public Health, 21, pp. 587-611, (2000)
[2]  
Garrat A., Schmidt L., Mackintosh A., Fitzpatrick R., Quality of life measurement: Bibliographic study of patient assessed health outcomes, BMJ, 324, (2002)
[3]  
Sanders C., Egger M., Donovan J., Tallon D., Frankel S., Reporting on quality of life in randomized controlled trials: Bibliographic study, BMJ, 317, pp. 1191-1194, (1998)
[4]  
Kind P., Dolan P., Gudex C., Williams A., Variations in population health status: Results from a United Kingdom national questionnaire survey, BMJ, 316, pp. 736-741, (1998)
[5]  
Ware Jr. J.E., Gandek B., Overview of the SF-36 health survey and the International Quality of Life Assessment (IQOLA) project, J Clin Epidemiol, 51, pp. 903-912, (1998)
[6]  
Bergner M., Bobbitt R.A., Carter W.B., Gilson B.S., The sickness impact profile: Development and final revision of a health status measure, Med Care, 19, pp. 787-805, (1981)
[7]  
Hunt S.M., McKenna S.P., McEwen J., Williams J., Papp E., The Nottingham health profile: Subjective health status and medical consultations, Soc Sci Med, 15, pp. 221-229, (1981)
[8]  
Feeny D., A utility approach to the assessment of health-related quality of life, Med Care, 38, 9 SUPPL., (2000)
[9]  
Rosser R., From health indicators to quality adjusted life years: Technical and ethical issues, Measuring the Outcomes of Medical Care, pp. 1-17, (1990)
[10]  
Greenberg D., Pliskin J.S., Preference-based outcome measures in cost-utility analyses. A 20-year overview, Int J Technol Assess Health Care, 18, pp. 461-466, (2002)