Goodwin Elizabeth, Green Colin, Spencer Anne
Health Economics Group, University of Exeter Medical School, University of Exeter, Exeter, UK.
Health Economics Group, University of Exeter Medical School, University of Exeter, Exeter, UK; UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.
Value Health. 2015 Dec;18(8):1025-36. doi: 10.1016/j.jval.2015.10.004. Epub 2015 Nov 17.
Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis (MS). Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality-adjusted life-year because they are not based on preferences.
To report the estimation of a preference-based single index for an eight-dimensional instrument for MS, the Multiple Sclerosis Impact Scale - Eight Dimensions (MSIS-8D), derived from an MS-specific measure of health-related quality of life, the 29-item Multiple Sclerosis Impact Scale (MSIS-29).
We elicited preferences for a sample of MSIS-8D states (n = 169) from a sample (n = 1702) of the UK general population. Preferences were elicited using the time trade-off technique via an Internet-based survey. We fitted regression models to these data to estimate values for all health states described by the MSIS-8D. Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large, representative sample of people with MS.
Participants reported that the time trade-off questions were easy to understand. Observed health state values ranged from 0.08 to 0.89. The best-performing model was a main effects, random effects model (mean absolute error = 0.04). Validation analyses support the performance of the MSIS-8D index: it correlated more strongly than did generic measures with MSIS-29 scores, and it discriminated effectively between subgroups of people with MS.
The MSIS-8D enables health state values to be estimated from the MSIS-29, adding to the methods available to assess health outcomes and to estimate quality-adjusted life-years for MS for use in health technology assessment and decision-making contexts.
特定疾病的测量方法经常用于评估多发性硬化症(MS)患者与健康相关的生活质量。由于这些测量方法并非基于偏好,因此不适用于需要估计每质量调整生命年成本的经济评估。
报告一种基于偏好的单一指数的估计值,该指数用于一种针对MS的八维度工具,即多发性硬化症影响量表 - 八维度(MSIS-8D),它源自一种针对MS的与健康相关生活质量的特定测量方法,即29项多发性硬化症影响量表(MSIS-29)。
我们从英国普通人群样本(n = 1702)中获取了对MSIS-8D状态样本(n = 169)的偏好。通过基于互联网的调查,使用时间权衡技术获取偏好。我们对这些数据拟合回归模型,以估计MSIS-8D所描述的所有健康状态的值。在一个大型、具有代表性的MS患者样本中,将估计值与MSIS-29得分以及从基于偏好的通用测量方法得出的值进行比较评估。
参与者表示时间权衡问题易于理解。观察到的健康状态值范围为0.08至0.89。表现最佳的模型是主效应随机效应模型(平均绝对误差 = 0.04)。验证分析支持MSIS-8D指数的性能:它与MSIS-29得分的相关性比通用测量方法更强,并且能够有效地区分MS患者亚组。
MSIS-8D能够从MSIS-29估计健康状态值,为评估健康结果以及估计MS的质量调整生命年增添了方法,可用于卫生技术评估和决策制定背景。