Round Jeff, Hawton Annie
School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
Health Economics Group, University of Exeter Medical School, University of Exeter, Exeter, UK.
Pharmacoecon Open. 2017 Dec;1(4):233-239. doi: 10.1007/s41669-017-0027-2.
Mapping between non-preference- and preference-based health-related quality-of-life instruments has become a common technique for estimating health state utility values for use in economic evaluations. Despite the increased use of mapped health state utility estimates in health technology assessment and economic evaluation, the methods for deriving them have not been fully justified. Recent guidelines aim to standardise reporting of the methods used to map between instruments but do not address fundamental concerns in the underlying conceptual model. Current mapping methods ignore the important conceptual issues that arise when extrapolating results from potentially unrelated measures. At the crux of the mapping problem is a question of validity; because one instrument can be used to predict the scores on another, does this mean that the same preference for health is being measured in actual and estimated health state utility values? We refer to this as conceptual validity. This paper aims to (1) explain the idea of conceptual validity in mapping and its implications; (2) consider the consequences of poor conceptual validity when mapping for decision making in the context of healthcare resource allocation; and (3) offer some preliminary suggestions for improving conceptual validity in mapping.
在基于非偏好和基于偏好的健康相关生活质量工具之间进行映射，已成为一种用于估计健康状态效用值以进行经济评估的常用技术。尽管在卫生技术评估和经济评估中，映射后的健康状态效用估计值的使用越来越多，但其推导方法尚未得到充分论证。近期的指南旨在规范用于工具间映射方法的报告，但未涉及基础概念模型中的根本问题。当前的映射方法忽略了从潜在不相关测量中推断结果时出现的重要概念问题。映射问题的关键在于有效性问题；因为一种工具可用于预测另一种工具的得分，这是否意味着在实际和估计的健康状态效用值中测量的是对健康的相同偏好？我们将此称为概念有效性。本文旨在：（1）解释映射中概念有效性的概念及其影响；（2）考虑在医疗资源分配背景下进行映射以用于决策时，概念有效性不佳的后果；（3）为提高映射中的概念有效性提供一些初步建议。
