Badia X, Roset M, Herdman M, Kind P
Catalan Institute of Public Health, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain.
Med Decis Making. 2001 Jan-Feb;21(1):7-16. doi: 10.1177/0272989X0102100102.
Few studies have compared preference values for health states obtained in different countries. The present study compared Spanish and United Kingdom (UK) time trade-off values for EuroQol-5D health states. The same preference elicitation protocol was followed in both countries. Differences in values for 43 health states rated directly were analyzed using t tests, and regression coefficients generated by random effects modeling were compared by aggregating the 2 value sets and using dummy variables to analyze country effect by dimension and level of severity. For the milder health states, Spanish and UK value assignation was similar; for intermediate health states, Spanish values were both higher and lower than UK values, whereas for health states worse than death, UK values were generally higher than Spanish values. There were statistically significant differences (P < 0.01) in values for 34.9% of health states rated directly, and some preference reversals between countries. UK raters ascribed greater importance to dimensions of pain/discomfort and anxiety/depression, whereas Spanish raters placed more importance on functional dimensions of mobility and self-care. Further analysis is required to determine how these differences affect cost-effectiveness and cost-utility analyses.
很少有研究比较过不同国家获得的健康状态偏好值。本研究比较了西班牙和英国（UK）对欧洲五维健康量表（EuroQol-5D）健康状态的时间权衡值。两国都遵循相同的偏好诱导方案。使用t检验分析了43个直接评定的健康状态值的差异，并通过汇总两组值并使用虚拟变量按维度和严重程度水平分析国家效应，比较了随机效应模型生成的回归系数。对于较轻的健康状态，西班牙和英国的赋值相似；对于中度健康状态，西班牙的值高于和低于英国的值，而对于比死亡更差的健康状态，英国的值通常高于西班牙的值。在直接评定的健康状态中，34.9% 的值存在统计学显著差异（P < 0.01），并且两国之间存在一些偏好逆转。英国评分者认为疼痛/不适和焦虑/抑郁维度更为重要，而西班牙评分者更重视行动能力和自我护理的功能维度。需要进一步分析以确定这些差异如何影响成本效益分析和成本效用分析。
