Institute of Clinical Effectiveness and Health Policy, Ciudad Autónoma de Buenos Aires, Argentina.
Value Health. 2011 Jul-Aug;14(5 Suppl 1):S60-4. doi: 10.1016/j.jval.2011.05.007.
To estimate and compare EuroQol instrument (EQ-5D) health states' values for pneumococcal and human papillomavirus (HPV) diseases in Argentina, Chile, and the United Kingdom.
Twelve vignettes were designed, pilot-tested, and administered to a convenience sample in a cross-sectional design to elicit descriptive EQ-5D state data. Country-specific EQ-5D time-trade-off-based weights were used to map these descriptive health states into local country preference weights. Descriptive analysis is reported and intercountry differences for each condition were compared using repeated measures analysis of variance.
Seventy-three subjects completed the survey. Pneumococcal disease-related health states mean values ranged from -0.331 (sepsis, Chile) to 0.727 (auditive sequelae, Argentina). HPV-related conditions ranged from 0.152 (cervical cancer, United Kingdom) to 0.848 (cervical intraepithelial neoplasia 1, Argentina). Chile had consistently the lowest mean values in pneumococcal states and in one HPV state, whereas those of the United Kingdom were the lowest in most HPV states. Argentina had the highest mean values in both diseases. Differences in country-specific values for each health state were statistically (P < 0.001) significant except for six health states in which differences between Chilean and United Kingdom weights were nonsignificant.
Utility values for most conditions differed statistically relevantly among analyzed countries, even though the same health states' descriptive set was valued for each. These results reflect the difference in social weights among different countries, which could be attributed to either different population values or valuation study methodologies. They stress the importance of using local preference weights for context-specific decision making.
估算并比较阿根廷、智利和英国的肺炎球菌和人乳头瘤病毒(HPV)疾病的欧洲五维健康量表(EQ-5D)健康状况值。
设计了 12 个情景模拟,进行了试点测试,并采用横断面设计对方便样本进行了管理,以获取描述性 EQ-5D 状态数据。使用国家特异性 EQ-5D 时间权衡法权重将这些描述性健康状态映射到当地国家偏好权重。报告了描述性分析,并使用重复测量方差分析比较了每种情况的国家间差异。
73 名受试者完成了调查。肺炎球菌疾病相关健康状况的平均值范围为-0.331(败血症,智利)至 0.727(听觉后遗症,阿根廷)。HPV 相关病症的范围为 0.152(宫颈癌,英国)至 0.848(阿根廷的宫颈上皮内瘤变 1 级)。智利在肺炎球菌状态和一种 HPV 状态下的平均值始终最低,而英国在大多数 HPV 状态下的平均值最低。阿根廷在两种疾病中都有最高的平均值。除了智利和英国权重之间的六个健康状态差异不显著外,每个健康状态的国家特异性值差异在统计学上(P <0.001)均具有显著性。
即使对每个国家的相同健康状态描述集进行了评估,但分析国家之间的效用值在统计学上存在显著差异。这些结果反映了不同国家之间社会权重的差异,这可能归因于不同的人口价值观或评估研究方法。它们强调了使用当地偏好权重进行特定于上下文的决策的重要性。