Yang Yaling, Brazier John, Longworth Louise
Nuffield Department of Primary Care Health Sciences, University of Oxford, New Radcliffe House, Walton Street, Oxford, OX2 6NW, UK.
Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, UK.
Eur J Health Econ. 2015 Dec;16(9):927-39. doi: 10.1007/s10198-014-0638-9. Epub 2014 Oct 31.
This systematic literature review aims to assess the reliability, validity and responsiveness of three widely used generic preference-based measures of health-related quality of life (HRQL), i.e., EQ-5D, Health Utility Index 3 (HUI3) and SF-6D in patients with skin conditions.
A systematic search was conducted to identify studies reporting health state utility values obtained using EQ-5D, SF-6D, or HUI3 alongside other HRQL measures or clinical indices for patients with skin conditions. Data on test-retest analysis for reliability, known group differences or correlation and regression analyses for validity, and change over time or responsiveness indices analysis were extracted and reviewed.
A total of 16 papers reporting EQ-5D utilities in people with skin conditions were included in the final review. No papers for SF-6D and HUI3 were found. Evidence of reliability was not found for any of these measures. The majority of studies included in the review (12 out of 16) examined patients with plaque psoriasis or psoriatic arthritis and the remaining four studies examined patients with either acne, hidradenitis suppurativa, hand eczema, or venous leg ulcers. The findings were generally positive in terms of performance of EQ-5D. Six studies showed that EQ-5D was able to reflect differences between severity groups and only one reported differences that were not statistically significant. Four studies found that EQ-5D detected differences between patients and the general population, and differences were statistically different for three of them. Further, moderate-to-strong correlation coefficients were found between EQ-5D and other skin-specific HRQL measures in four studies. Eight studies showed that EQ-5D was able to detect change in HRQL appropriately over time and the changes were statistically significant in seven studies.
Overall, the validity and responsiveness of the EQ-5D was found to be good in people with skin diseases, especially plaque psoriasis or psoriatic arthritis. No evidence on SF-6D and HUI3 was available to enable any judgments to be made on their performance.
本系统文献综述旨在评估三种广泛使用的基于偏好的健康相关生活质量（HRQL）通用测量工具，即EQ-5D、健康效用指数3（HUI3）和SF-6D在皮肤病患者中的可靠性、有效性和反应性。
进行系统检索，以识别报告使用EQ-5D、SF-6D或HUI3获得的健康状态效用值以及其他HRQL测量工具或临床指标的皮肤病患者研究。提取并审查关于可靠性的重测分析数据、关于有效性的已知组差异或相关性及回归分析数据，以及随时间变化或反应性指标分析数据。
最终综述纳入了16篇报告皮肤病患者EQ-5D效用值的论文。未找到关于SF-6D和HUI3的论文。未发现这些测量工具中任何一种的可靠性证据。综述纳入的大多数研究（16篇中的12篇）研究了斑块状银屑病或银屑病关节炎患者，其余4项研究研究了痤疮、化脓性汗腺炎、手部湿疹或下肢静脉溃疡患者。就EQ-5D的表现而言，研究结果总体呈阳性。6项研究表明EQ-5D能够反映严重程度组之间的差异，只有1项报告的差异无统计学意义。4项研究发现EQ-5D检测出患者与一般人群之间的差异，其中3项差异具有统计学意义。此外，4项研究发现EQ-5D与其他皮肤特异性HRQL测量工具之间存在中度至强的相关系数。8项研究表明EQ-5D能够随时间适当地检测HRQL的变化，7项研究中的变化具有统计学意义。
总体而言，发现EQ-5D在皮肤病患者，尤其是斑块状银屑病或银屑病关节炎患者中具有良好的有效性和反应性。没有关于SF-6D和HUI3的证据可用于对其表现做出任何判断。
