Shrive Fiona M, Ghali William A, Johnson Jeffrey A, Donaldson Cam, Manns Braden J
Department of Community Health Sciences, Centre for Health and Policy Studies at the University of Calgary, Calgary, Alberta, Canada.
Med Care. 2007 Mar;45(3):269-73. doi: 10.1097/01.mlr.0000250480.55578.45.
Most studies that have used the EuroQol-5D instrument (EQ-5D) have used a scoring algorithm based on preferences solicited from the U.K. population. An algorithm recently was developed for the U.S. population, with studies showing meaningful differences in the results obtained using the 2 algorithms. We recently published an economic evaluation assessing the use of drug-eluting stents in patients undergoing percutaneous coronary intervention (PCI).
Using the aforementioned economic evaluation, we describe the EQ-5D utility scores resulting from use of U.S. and U.K. algorithms and explore the differences in the incremental cost-utility ratio (ICER) resulting from use of the different EQ-5D estimates.
EQ-5D data were obtained from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart (APPROACH) disease registry. Individual responses were scored once with each algorithm. The within-individual difference was calculated (U.S. score-U.K. score). The mean, SD, and range were compared using paired t tests. The resulting ICERs were compared using probabilistic sensitivity analysis.
The U.K. mean was statistically different from the U.S. mean (0.83, SD 0.20 vs. 0.87, SD 0.15, P<0.001). The mean within individual difference was 0.04 with a wide range (-0.02 to +0.41). The resulting ICER are CAN $58,635 (95% confidence interval $198,248-$34,406) per quality-adjusted life year and CAN $58,229 (95% confidence interval $116,818-$38,779) per quality-adjusted life year for the U.K. and U.S. algorithms, respectively (P value: 0.07).
The algorithms produce quite notable differences within individuals. The effect on the mean score is less pronounced. In the context of our economic evaluation, however, the impact of using the U.S. algorithm on the ICER is negligible.
大多数使用欧洲五维健康量表（EQ - 5D）的研究采用的评分算法是基于从英国人群中征集的偏好。最近为美国人群开发了一种算法，研究表明使用这两种算法得出的结果存在显著差异。我们最近发表了一项经济评估，评估了药物洗脱支架在接受经皮冠状动脉介入治疗（PCI）患者中的应用。
利用上述经济评估，我们描述了使用美国和英国算法得出的EQ - 5D效用评分，并探讨使用不同EQ - 5D估计值导致的增量成本 - 效用比（ICER）的差异。
EQ - 5D数据来自艾伯塔省冠心病结局评估省级项目（APPROACH）疾病登记处。每个个体的回答分别用两种算法进行评分。计算个体内差异（美国评分 - 英国评分）。使用配对t检验比较均值、标准差和范围。使用概率敏感性分析比较得出的ICER。
英国的均值与美国的均值在统计学上存在差异（0.83，标准差0.20对0.87，标准差0.15，P<0.001）。个体内平均差异为0.04，范围较宽（-0.02至+0.41）。对于英国和美国的算法，得出的ICER分别为每质量调整生命年58,635加元（95%置信区间198,248 - 34,406加元）和每质量调整生命年58,229加元（95%置信区间116,818 - 38,779加元）（P值：0.07）。
两种算法在个体内产生了相当显著的差异。对平均分的影响不太明显。然而，在我们的经济评估背景下，使用美国算法对ICER的影响可以忽略不计。
