Rutten-van Mölken Maureen P M H, Hoogendoorn Martine, Lamers Leida M
Erasmus MC, Institute for Medical Technology Assessment (iMTA), Rotterdam, the Netherlands.
Pharmacoeconomics. 2009;27(6):465-77. doi: 10.2165/00019053-200927060-00003.
There are few empirical studies on the valuation of health profiles that describe the short-term fluctuations of chronic diseases.
This study aimed to value chronic obstructive pulmonary disease (COPD) health profiles, which describe the health of these patients over the course of 1 year from a societal perspective.
We developed 16 COPD health profiles. Each profile combined a description of the severity of COPD during the stable phase with a description of the exacerbation profile in terms of severity, frequency and duration. These profiles were valued by a representative sample of 239 Dutch adults using the visual analogue scale (VAS) and time trade-off (TTO) methods. Value functions were estimated using random effects regression analysis.
Both VAS and TTO values consistently decreased as severity of the COPD profiles increased. Estimated TTO values ranged from 0.97 for mild COPD without exacerbations to 0.43 for very severe COPD with one non-serious and one serious exacerbation per year. The estimated decrements in TTO values ranged from 0.010 for having one non-serious exacerbation to 0.088 for having one non-serious plus one serious exacerbation per year.
The value function may be an alternative way to model the joint impact of COPD severity and exacerbations on utility values in health economic modelling studies.
关于描述慢性病短期波动的健康状况评估的实证研究较少。
本研究旨在评估慢性阻塞性肺疾病（COPD）的健康状况，从社会角度描述这些患者一年中的健康状况。
我们制定了16种COPD健康状况。每种状况都结合了稳定期COPD严重程度的描述以及急性加重状况在严重程度、频率和持续时间方面的描述。这些状况由239名荷兰成年人组成的代表性样本使用视觉模拟量表（VAS）和时间权衡（TTO）方法进行评估。使用随机效应回归分析估计价值函数。
随着COPD状况严重程度的增加，VAS和TTO值均持续下降。估计的TTO值范围从无急性加重的轻度COPD的0.97到每年有一次非严重和一次严重急性加重的极重度COPD的0.43。TTO值的估计下降幅度范围从每年有一次非严重急性加重的0.010到每年有一次非严重加一次严重急性加重的0.088。
在健康经济建模研究中，价值函数可能是一种模拟COPD严重程度和急性加重对效用值联合影响的替代方法。
