Kularatna Sanjeewa, Byrnes Joshua, Chan Yih Kai, Ski Chantal F, Carrington Melinda, Thompson David, Stewart Simon, Scuffham Paul A
Australian Centre for Health Services Innovation, School of Public Health and Social Work, Institute of Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Centre for Applied Health Economics, School of Medicine, Griffith University, Brisbane, QLD, Australia.
Qual Life Res. 2017 Dec;26(12):3399-3408. doi: 10.1007/s11136-017-1666-6. Epub 2017 Aug 1.
Multi-attribute utility instruments (MAUIs) are widely used to measure utility weights. This study sought to compare utility weights of two popular MAUIs, the EQ-5D-3L and the SF-6D, and inform researchers in the selection of generic MAUI for use with cardiovascular (CVD) patients.
Data were collected in the Young@Heart study, a randomised controlled trial of a nurse-led multidisciplinary home-based intervention compared to standard usual care. Participants (n = 598) completed the EQ-5D-3L and the SF-12v2, from which the SF-6D can be constructed, at baseline and at 24-month follow-up. This study examined discrimination, responsiveness, correlation and differences across the two instruments.
Both MAUIs were able to discriminate between the NYHA severity classes and recorded similar changes between the two time points although only SF-6D differences were significant. Correlations between the dimensions of the two MAUIs were low. There were significant differences between the two instruments in mild conditions but they were similar in severe conditions. Substantial ceiling and floor effects were observed.
Our findings indicate that the EQ-5D and the SF-6D cover different spaces in health due to their classification systems. Both measures were capable of discriminating between severity groups and responsive to quality of life changes in the follow-up. It is recommended to use the EQ-5D-3L in severe and the SF-6D in mild CVD conditions.
多属性效用工具（MAUIs）被广泛用于测量效用权重。本研究旨在比较两种常用的MAUIs（EQ-5D-3L和SF-6D）的效用权重，并为研究人员在选择用于心血管疾病（CVD）患者的通用MAUI时提供参考。
数据收集于“年轻之心”研究，这是一项将护士主导的多学科家庭干预与标准常规护理进行比较的随机对照试验。参与者（n = 598）在基线和24个月随访时完成了EQ-5D-3L和SF-12v2（可从中构建SF-6D）。本研究考察了这两种工具的区分度、反应性、相关性和差异。
两种MAUIs都能够区分纽约心脏协会（NYHA）心功能分级，并且在两个时间点记录到了相似的变化，尽管只有SF-6D的差异具有统计学意义。两种MAUIs维度之间的相关性较低。在轻度情况下，两种工具之间存在显著差异，但在重度情况下它们相似。观察到了明显的天花板效应和地板效应。
我们的研究结果表明，由于EQ-5D和SF-6D的分类系统不同，它们在健康领域覆盖不同的范围。两种测量方法都能够区分严重程度组，并对随访期间的生活质量变化做出反应。建议在重度CVD情况下使用EQ-5D-3L，在轻度情况下使用SF-6D。
