Lamers L M, Bouwmans C A M, van Straten A, Donker M C H, Hakkaart L
Institute for Medical Technology Assessment bv, Erasmus University Medical Center, Rotterdam, The Netherlands.
Health Econ. 2006 Nov;15(11):1229-36. doi: 10.1002/hec.1125.
Various preference-based measures of health are available for use as an outcome measure in cost-utility analysis. The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients. Baseline data from a Dutch multi-centre randomised trial of 616 patients with mood and/or anxiety disorders were used. Mean and median EQ-5D and SF-6D utilities were compared, both in the total sample and between severity subgroups based on quartiles of SCL-90 scores. Utilities were expected to decline with increased severity. Both EQ-5D and SF-6D utilities differed significantly between patients of adjacent severity groups. Mean utilities increased from 0.51 at baseline to 0.68 at 1.5 years follow-up for EQ-5D and from 0.58 to 0.70 for SF-6D. For all severity subgroups, the mean change in EQ-5D utilities as well as in SF-6D utilities was statistically significant. Standardised response means were higher for SF-6D utilities. We concluded that both EQ-5D and SF-6D discriminated between severity subgroups and captured improvements in health over time. However, the use of EQ-5D resulted in larger health gains and consequent lower cost-utility ratios, especially for the subgroup with the highest severity of mental health problems.
在成本效用分析中，有多种基于偏好的健康测量方法可作为结果指标使用。本研究的目的是比较心理健康患者中两种此类测量方法EQ-5D和SF-6D。使用了来自荷兰一项针对616名患有情绪和/或焦虑症患者的多中心随机试验的基线数据。比较了总样本以及基于SCL-90分数四分位数的严重程度亚组之间EQ-5D和SF-6D效用的均值和中位数。预计效用会随着严重程度的增加而下降。相邻严重程度组的患者之间，EQ-5D和SF-6D效用均存在显著差异。EQ-5D的平均效用从基线时的0.51增加到1.5年随访时的0.68，SF-6D的平均效用从0.58增加到0.70。对于所有严重程度亚组，EQ-5D效用以及SF-6D效用的平均变化均具有统计学意义。SF-6D效用的标准化反应均值更高。我们得出结论，EQ-5D和SF-6D都能区分严重程度亚组，并随着时间推移反映出健康状况的改善。然而，使用EQ-5D带来了更大的健康收益，从而降低了成本效用比，尤其是对于心理健康问题最严重的亚组。
