Craig Benjamin M, Pickard A Simon, Rand-Hendriksen Kim
Health Outcomes and Behavior, Moffitt Cancer Center, University of South Florida, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA,
Qual Life Res. 2015 Jul;24(7):1759-65. doi: 10.1007/s11136-014-0897-z. Epub 2014 Dec 18.
The aim of this study was to test whether the ordering of item labels in EQ-5D instruments disagrees with the preferences of US adults.
A preference inversion occurs when "worse" health along a scale or score is preferred. As a sub-study of the 2013 United States Measurement and Valuation of Health Study, we tested for 33 EQ-5D preference inversions using paired comparisons with unique samples of 50 or more US adults, aged 18 or older. Specifically, we tested whether health preferences contradicted ordering of EQ-5D labels.
The EQ-5D-3L and EQ-5D-Y item labels had no significant preference inversions. The EQ-5D-5L version had preference inversions between Levels 4 and 5. For example, 30 out of 59 respondents (51 %) preferred being "extremely" over "severely anxious or depressed," contrary to the ordering of labels for that item.
Preference inversions between Levels 4 and 5 on the EQ-5D-5L were tested and confirmed; therefore, valuation studies may find that Levels 4 and 5 have the same value. To mitigate such inversions, labels could be revised or a 4-level version could be considered.
本研究旨在测试EQ-5D量表中项目标签的排序是否与美国成年人的偏好不一致。
当在一个量表或分数上“更差”的健康状况被偏好时，就会出现偏好反转。作为2013年美国健康测量与评估研究的一项子研究，我们使用50名或更多18岁及以上美国成年人的独特样本进行配对比较，测试了33次EQ-5D偏好反转。具体而言，我们测试了健康偏好是否与EQ-5D标签的排序相矛盾。
EQ-5D-3L和EQ-5D-Y项目标签没有显著的偏好反转。EQ-5D-5L版本在第4级和第5级之间存在偏好反转。例如，59名受访者中有30名（51%）更喜欢“极度”而不是“严重焦虑或抑郁”，这与该项目标签的排序相反。
对EQ-5D-5L第4级和第5级之间的偏好反转进行了测试并得到证实；因此，估值研究可能会发现第4级和第5级具有相同的价值。为了减轻这种反转，可以修改标签或考虑采用4级版本。
