The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Office of Health Economics, London, UK.
Value Health. 2018 Jun;21(6):732-741. doi: 10.1016/j.jval.2017.10.013.
EQ-5D-5L valuation studies previously reported many inconsistent responses in time trade-off (TTO) data. A number of possible elements, including ordering effects of the valuation tasks, mistakes at the sorting question, and interviewers' (learning) effects, may contribute to their inconsistency.
This study aimed to evaluate the effect of two modifications on consistency of TTO data in The Netherlands (NL) and Hong Kong (HK): (1) separating the valuation of the Better than Dead (BTD) and Worse than Dead (WTD) states; and (2) Implementation of feedback (FB) module by offering an opportunity to review TTO responses.
A crossover design with two study arms was used to test the effect of the modifications. In each jurisdiction, six interviewers were involved where half the interviewers started using the standard version, and the other half started with the split version. Each version was switched after every 25 (NL) or 30 (HK) interviews until 400 interviews were completed.
In the NL and HK, 404 and 403 respondents participated, respectively. With the use of the FB module, the proportion of respondents with inconsistent responses was lowered from 17.8% to 10.6% (P < 0.001) in NL and from 31.8% to 22.3% (P = 0.003) in HK. The result of separating the valuation of BTD and WTD states was not straightforward because it reduced the inconsistency rate in NL but not in HK.
The results support implementation of the FB module to promote the consistency of the data. The separation of the BTD and WTD task is not supported.
EQ-5D-5L 价值评估研究先前报告了时间权衡（TTO）数据中许多不一致的反应。一些可能的因素，包括评估任务的排序效应、排序问题上的错误以及访谈者的（学习）效应，可能导致了它们的不一致。
本研究旨在评估对荷兰（NL）和香港（HK） TTO 数据一致性的两种修改的效果：（1）分离更好状态（BTD）和更差状态（WTD）的评估；（2）通过提供审查 TTO 反应的机会，实施反馈（FB）模块。
采用交叉设计的两种研究臂来测试修改的效果。在每个司法管辖区，有 6 名访谈者参与，其中一半访谈者从使用标准版本开始，另一半从使用拆分版本开始。在完成 400 次访谈之前，每个版本每 25（NL）或 30（HK）次访谈切换一次。
NL 和 HK 分别有 404 名和 403 名受访者参与。使用 FB 模块后，NL 中不一致反应比例从 17.8%降至 10.6%（P<0.001），HK 中从 31.8%降至 22.3%（P=0.003）。BTD 和 WTD 评估任务分离的结果并不明确，因为它降低了 NL 中的不一致率，但没有降低 HK 中的不一致率。
结果支持实施 FB 模块以提高数据的一致性。不支持 BTD 和 WTD 任务的分离。
