Santos Marisa, Cintra Monica A C T, Monteiro Andrea L, Santos Braulio, Gusmão-Filho Fernando, Andrade Mônica Viegas, Noronha Kenya, Cruz Luciane N, Camey Suzi, Tura Bernardo, Kind Paul
Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil (MS, MACTC, ALM, BS, BT)
Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil (FG-f)
Med Decis Making. 2016 Feb;36(2):253-63. doi: 10.1177/0272989X15613521. Epub 2015 Oct 22.
Most EQ-5D-3L valuation studies include the same sample of health states that was used in the protocol of the original UK Measurement and Valuation of Health (MVH) study. Thus far, no studies using a time tradeoff utility elicitation method have been carried out using all 243 EQ-5D health states. Because the values and preferences regarding health outcomes differ among countries, it is essential to have country-specific data to enable local high-level decisions regarding resource allocation. This study developed a country-specific set of values for EQ-5D-3L health states.
A multicentric study was conducted in 4 Brazilian areas. A probabilistic sample of the general population, aged 18 to 64 y, stratified by age and gender, was surveyed. The interview followed a revised version of the MVH protocol, in which all 243 health states were valued. Each respondent ranked and valued 7 health states using the TTO in a home interview.
Data were collected from 9148 subjects. The best-fitting regression model was an individual-level mixed-effects model without any interaction terms. The dimensions "Mobility" and "Usual Activities" were associated with higher losses in health state utility value. The "Anxiety/Depression" dimension was the domain that contributed to lower losses in health state utility value.
This study generated significant insight into the Brazilian population's health preferences that can be applied to health technology assessment and economic analyses in Brazil. This information represents an important new tool that can be used in Brazilian health policy creation and evaluation.
大多数EQ-5D-3L评估研究纳入的健康状态样本与英国原始健康测量与估值(MVH)研究方案中所使用的相同。迄今为止,尚未有研究使用时间权衡效用诱导法对所有243种EQ-5D健康状态进行评估。由于不同国家对于健康结果的价值观和偏好存在差异,因此拥有特定国家的数据对于做出有关资源分配的地方高层决策至关重要。本研究针对EQ-5D-3L健康状态制定了一套特定于巴西的价值标准。
在巴西4个地区开展了一项多中心研究。对年龄在18至64岁之间、按年龄和性别分层的一般人群进行概率抽样调查。访谈遵循MVH方案的修订版,其中对所有243种健康状态进行了估值。每位受访者在家庭访谈中使用时间权衡法对7种健康状态进行排序和估值。
收集了9148名受试者的数据。拟合度最佳的回归模型是一个无任何交互项的个体水平混合效应模型。“行动能力”和“日常活动”维度与健康状态效用值的较高损失相关。“焦虑/抑郁”维度是导致健康状态效用值损失较低的领域。
本研究对巴西人群的健康偏好产生了重要见解,可应用于巴西的卫生技术评估和经济分析。这些信息是一种重要的新工具,可用于巴西卫生政策的制定和评估。