Luo Nan, Liu Gordon, Li Minghui, Guan Haijing, Jin Xuejing, Rand-Hendriksen Kim
Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
China Center for Health Economic Research, Peking University, Beijing, China; National School of Development, Peking University, Beijing, China.
Value Health. 2017 Apr;20(4):662-669. doi: 10.1016/j.jval.2016.11.016. Epub 2017 Feb 9.
To estimate a five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) value set for China using the health preferences of residents living in the urban areas of the country.
The values of a subset of the EQ-5D-5L-defined health states (n = 86) were elicited using the time trade-off (TTO) technique from a sample of urban residents (n = 1271) recruited from five Chinese cities. In computer-assisted personal interviews, participants each completed 10 TTO tasks. Two additive and two multiplicative regression models were evaluated for their performance in describing the relationship between TTO values and health state characteristics using a cross-validation approach. Final values were generated using the best-performed model and a rescaling method.
The 8- and 9-parameter multiplicative models unanimously outperformed the 20-parameter additive model using a random or fixed intercept in predicting values for out-of-sample health states in the cross-validation analysis and their coefficients were estimated with lower standard errors. The prediction accuracies of the two multiplicative models measured by the mean absolute error and the intraclass correlation coefficient were very similar, thus favoring the more parsimonious model.
The 8-parameter multiplicative model performed the best in the study and therefore was used to generate the EQ-5D-5L value set for China. We recommend using rescaled values whereby 1 represents the value of instrument-defined full health in economic evaluation of health technologies in China whenever the EQ-5D-5L data are available.
利用中国城市居民的健康偏好,估算中国的五级欧洲五维健康量表(EQ - 5D - 5L)价值集。
采用时间权衡(TTO)技术,从中国五个城市招募的1271名城市居民样本中,获取EQ - 5D - 5L定义的部分健康状态(n = 86)的价值。在计算机辅助个人访谈中,参与者每人完成10项TTO任务。使用交叉验证方法,评估了两个加法回归模型和两个乘法回归模型在描述TTO值与健康状态特征之间关系方面的表现。最终价值通过表现最佳的模型和重新缩放方法生成。
在交叉验证分析中,对于样本外健康状态的预测值,8参数和9参数乘法模型在使用随机或固定截距时均一致优于20参数加法模型,且其系数估计的标准误差更低。通过平均绝对误差和组内相关系数衡量的两个乘法模型的预测准确性非常相似,因此更倾向于选择更简约的模型。
8参数乘法模型在本研究中表现最佳,因此用于生成中国的EQ - 5D - 5L价值集。我们建议使用重新缩放后的值,即只要有EQ - 5D - 5L数据,在中国卫生技术的经济评估中,1代表工具定义的完全健康的值。