Departments of Dermatology and Dermatological Allergology, University of Debrecen, Nagyerdei krt. 98., Debrecen, 4032, Hungary.
Eur J Health Econ. 2014 May;15 Suppl 1:S111-9. doi: 10.1007/s10198-014-0600-x. Epub 2014 May 16.
There is a growing interest in policy making for using utility measures and identifying algorithms to convert disease-specific measures into utilities.
To analyse the relationship between EQ-5D, Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI) in psoriasis. To transform DLQI scores, and key clinical, demographic and health service utilisation variables into utilities.
A cross-sectional questionnaire survey of 200 consecutive adult patients with moderate to severe psoriasis was carried out in two Hungarian university clinics. The relationship between the outcome measures were analysed with correlations and with the known-groups method. Bivariate and multivariate regression algorithms on EQ-5D scores were formulated.
The mean age of respondents was 51 years (SD = 12.9), 68.5% were male, and 51.5% received biological therapy. Median EQ-5D, DLQI, and PASI scores were 0.73, 3.0, and 3.45, respectively. EQ-5D showed a moderate correlation with the DLQI and with the PASI (r s = -0.48 and -0.43, p < 0.05). Strong correlation was found between DLQI and PASI (r s = 0.81, p < 0.05). DLQI and PASI discriminated better among groups categorised by the localisation of the lesions than EQ-5D. Presence of psoriasis on the neck and/or décolletage was associated with the greatest health related quality of life (HRQOL) impairment. Ten variables were incorporated in a multivariate algorithm that accounted for 48.8% of EQ-5D variance (ANOVA p < 0.001).
This study provided the first evidence that patients with visible psoriatic lesions have significantly worse HRQOL compared to those with non-visible lesions, measured not only with DLQI but also with EQ-5D. In addition to demographic and clinical variables, our model included health service utilisation variables related to psoriasis, and explained higher proportion of EQ-5D variance than any previous findings in the literature.
利用效用测量和识别算法将疾病特异性测量值转换为效用值，这一做法在政策制定方面的兴趣日益浓厚。
分析银屑病患者的 EQ-5D、皮肤病生活质量指数（DLQI）和银屑病面积和严重程度指数（PASI）之间的关系。将 DLQI 评分以及关键临床、人口统计学和卫生服务利用变量转换为效用值。
在两家匈牙利大学诊所，对 200 例中重度银屑病成人患者进行横断面问卷调查。使用相关性和已知组方法分析结果测量之间的关系。制定了 EQ-5D 评分的双变量和多变量回归算法。
受访者的平均年龄为 51 岁（标准差=12.9），68.5%为男性，51.5%接受生物治疗。EQ-5D、DLQI 和 PASI 的中位数分别为 0.73、3.0 和 3.45。EQ-5D 与 DLQI 和 PASI 呈中度相关（rs=-0.48 和-0.43，p<0.05）。DLQI 和 PASI 之间存在很强的相关性（rs=0.81，p<0.05）。与 EQ-5D 相比，DLQI 和 PASI 能更好地区分按病变部位分类的组。颈部和/或颈部有银屑病与健康相关生活质量（HRQOL）受损最严重相关。10 个变量被纳入一个多变量算法中，该算法解释了 EQ-5D 变异的 48.8%（方差分析 p<0.001）。
本研究首次提供证据表明，与无可见皮损的患者相比，有可见皮损的银屑病患者的 HRQOL 显著更差，不仅通过 DLQI，而且通过 EQ-5D 进行测量。除了人口统计学和临床变量外，我们的模型还包括与银屑病相关的卫生服务利用变量，解释了 EQ-5D 变异的更高比例，超过了文献中以前的任何发现。
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