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关税的选择重要吗?:使用中国、英国和日本关税对中国中南地区寻常型银屑病患者的EQ-5D-5L效用评分进行比较。

Does the choice of tariff matter?: A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China.

作者信息

Zhao Yue, Li Shun-Ping, Liu Liu, Zhang Jiang-Lin, Chen Gang

机构信息

Department of Dermatology, Heping Hospital, Changzhi Medical College, Changzhi, Shanxi School of Health Care Management, Shandong University Key Laboratory of Health Economics and Policy Research, NHFPC (Shandong University), Jinan Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China Centre for Health Economics, Monash Business School, Monash University, Clayton, Australia.

出版信息

Medicine (Baltimore). 2017 Aug;96(34):e7840. doi: 10.1097/MD.0000000000007840.

Abstract

There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.

摘要

全球范围内有一种日益增长的趋势,即制定针对特定国家的关税,理论上这种关税能够更好地反映民众对基于偏好的健康相关生活质量工具(也称为多属性效用工具)所涉及的健康状态的偏好。本研究聚焦于世界上最著名的多属性效用工具之一——最新开发的5级版本欧洲五维健康量表(EQ-5D)问卷,并旨在以中国大陆寻常型银屑病患者为样本,实证探索应用特定国家关税与应用其他国家制定的关税之间的一致性和已知群组效度。

采用便利抽样框架,于2014年5月至2015年2月期间从中国中南大学湘雅医院招募被诊断为寻常型银屑病的患者。使用中国、日本和英国的关税对5级欧洲五维健康量表(EQ-5D-5L)效用进行评分。使用一系列非参数检验比较健康状态效用。使用组内相关系数和Bland-Altman图来检验3个EQ-5D-5L评分之间的一致性。使用效应量和回归分析研究已知群组之间的健康状态效用递减情况。

总共招募了350名患者(年龄16岁及以上)。3套国家关税之间存在显著差异。总体而言,3种关税显示出极好的一致性(组内相关系数>0.90);然而,Bland-Altman图显示的较宽一致性界限表明这些关税不能互换使用。在这个中国患者样本中,使用中国特定关税的EQ-5D-5L评分显示出比其他两种关税更好的已知群组效度。本研究的证据支持在中国大陆使用特定国家关税的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/782a/5572015/28a4a35bcea1/medi-96-e7840-g002.jpg

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