Department of Orthopaedics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden.
Knee Surg Sports Traumatol Arthrosc. 2018 Oct;26(10):3083-3088. doi: 10.1007/s00167-018-4954-y. Epub 2018 Apr 24.
Health state utility values are derived from preference-based measurements and are useful in calculating quality-adjusted life years (QALYs), which is a metric commonly used in cost-effectiveness studies. The purpose of this study was to convert the Achilles Tendon Rupture Score (ATRS) to the preference-based European Quality of Life-5 Dimension Questionnaire (EQ-5D) by estimating the relationship between the two scores using mapping.
Data were collected from a randomised controlled trial, where 100 patients were treated either surgically or non-surgically for Achilles tendon rupture. Forty-three and forty-four patients in surgical group and non-surgical group completed the ATRS and the EQ-5D alongside each other during follow-up at three time points. Different models of the relationship between the ATRS and the EQ-5D were developed and analysed based on direct mapping and cross-validation. The model with the lowest mean absolute error was observed as the one with the best fit.
Among the competing models, mapping based on using a combination of the ATRS items four, five, and six associated with limitation due to pain, during activities of daily living and when walking on uneven ground, produced the best predictor of the EQ-5D score.
The present study provides a mapping algorithm to enable the derivation of utility values directly from the ATRS. This approach makes it feasible for researchers, as well as medical practitioners, to obtain preference-based values in clinical studies or settings where only the ATRS is being administered. The algorithm allows for the calculation of QALYs for use in cost-effectiveness analyses, making it valuable in the study of acute Achilles tendon ruptures.
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健康状态效用值源自基于偏好的测量,可用于计算质量调整生命年(QALY),这是成本效益研究中常用的衡量标准。本研究旨在通过估计两种评分之间的关系,将跟腱断裂评分(ATRS)转换为基于偏好的欧洲五维健康量表(EQ-5D)。
数据来自一项随机对照试验,其中 100 例跟腱断裂患者分别接受手术或非手术治疗。手术组和非手术组各有 43 例和 44 例患者在随访的三个时间点同时完成 ATRS 和 EQ-5D。基于直接映射和交叉验证,开发和分析了 ATRS 和 EQ-5D 之间关系的不同模型。观察到平均绝对误差最小的模型为拟合最佳的模型。
在竞争模型中,基于使用 ATRS 项目四、五和六的组合的映射,这些项目与日常生活活动中的疼痛相关,以及在不平坦的地面上行走时的活动受限,产生了对 EQ-5D 评分的最佳预测。
本研究提供了一种映射算法,可直接从 ATRS 得出效用值。这种方法使研究人员以及医疗从业者在仅进行 ATRS 评估的临床研究或环境中获得基于偏好的价值成为可能。该算法允许计算 QALY,用于成本效益分析,在急性跟腱断裂的研究中具有价值。
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