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多发性硬化症严重程度对健康状态效用值的影响:来自澳大利亚的证据。

The impact of multiple sclerosis severity on health state utility values: Evidence from Australia.

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia.

Covance Pty Ltd, North Ryde, NSW, Australia.

出版信息

Mult Scler. 2017 Jul;23(8):1157-1166. doi: 10.1177/1352458516672014. Epub 2016 Oct 3.

Abstract

BACKGROUND

The measurement of health state utility values (HSUVs) for a representative sample of Australian people with multiple sclerosis (MS) has not previously been performed.

OBJECTIVES

Our main aim was to quantify the HSUVs for different levels of disease severities in Australian people with MS.

METHOD

HSUVs were calculated by employing a 'judgement-based' method that essentially creates EQ-5D-3L profiles based on WHOQOL-100 responses and then applying utility weights to each level in each dimension. A stepwise linear regression was used to evaluate the relationship between HSUVs and disease severity, classified as mild (Expanded Disability Status Scale (EDSS) levels: 0-3.5), moderate (EDSS levels: 4-6) and severe (EDSS levels: 6.5-9.5).

RESULTS

Mean HSUV for all people with MS was 0.53 (95% confidence interval (CI): 0.52-0.54). Utility decreased with increasing disease severity: 0.61 (95% CI: 0.60-0.62), 0.51 (95% CI: 0.50-0.52) and 0.40 (95% CI: 0.38-0.43) for mild, moderate and severe disease, respectively. Adjusted differences in mean HSUV between the three severity groups were statistically significant.

CONCLUSION

For the first time in Australia, we have quantified the impact of increasing severity of MS on health utility of people with MS. The HSUVs we have generated will be useful in further health economic analyses of interventions that slow progression of MS.

摘要

背景

此前尚未对澳大利亚多发性硬化症(MS)患者的代表性样本进行健康状态效用值(HSUV)的测量。

目的

我们的主要目的是量化澳大利亚多发性硬化症患者不同疾病严重程度的 HSUV。

方法

通过采用“基于判断”的方法计算 HSUV,该方法实质上是根据 WHOQOL-100 回答创建 EQ-5D-3L 概况,然后为每个维度的每个级别应用效用权重。逐步线性回归用于评估 HSUV 与疾病严重程度之间的关系,将疾病严重程度分为轻度(扩展残疾状况量表(EDSS)水平:0-3.5)、中度(EDSS 水平:4-6)和重度(EDSS 水平:6.5-9.5)。

结果

所有多发性硬化症患者的平均 HSUV 为 0.53(95%置信区间(CI):0.52-0.54)。随着疾病严重程度的增加,效用降低:轻度疾病分别为 0.61(95%CI:0.60-0.62)、0.51(95%CI:0.50-0.52)和 0.40(95%CI:0.38-0.43),中度疾病和重度疾病分别为 0.51(95%CI:0.50-0.52)和 0.40(95%CI:0.38-0.43)。三组间平均 HSUV 的调整差异具有统计学意义。

结论

我们首次在澳大利亚量化了多发性硬化症严重程度增加对多发性硬化症患者健康效用的影响。我们生成的 HSUV 将有助于进一步对减缓多发性硬化症进展的干预措施进行健康经济学分析。

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