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源自多发性硬化症患者的健康状态值,用于特定于疾病的偏好测量:多发性硬化症影响量表-八个维度-患者版(MSIS-8D-P)。

Health State Values Derived from People with Multiple Sclerosis for a Condition-Specific Preference-Based Measure: Multiple Sclerosis Impact Scale-Eight Dimensions-Patient Version (MSIS-8D-P).

机构信息

Health Economics Group, Institute of Health Research, University of Exeter, Exeter, UK.

Health Economics Group, Institute of Health Research, University of Exeter, Exeter, UK; South West Collaboration for Leadership in Applied Health Research and Care (PenCLAHRC), University of Exeter Medical School, University of Exeter, Exeter, UK.

出版信息

Value Health. 2018 Nov;21(11):1338-1345. doi: 10.1016/j.jval.2018.03.019. Epub 2018 Jun 19.

DOI:10.1016/j.jval.2018.03.019
PMID:30442282
Abstract

OBJECTIVE

In economic evaluation, health outcomes are commonly quantified using quality-adjusted life-years (QALYs) derived from the preferences of a sample of the general population. It can be argued that this approach ignores the preferences of people with experience of the condition, and that patient preferences have a place in the valuation of health outcomes. Here we report the estimation of a preference-based index for an existing condition-specific preference-based measure for multiple sclerosis (MS), the MSIS-8D, based on the preferences of people with MS.

STUDY DESIGN

Internet time trade-off (TTO) survey, eliciting preferences from people with MS.

METHODS

We elicited preferences from a sample of people with MS (N = 1635) across 169 MSIS-8D health states, using the TTO technique. We fitted ordinary least squares and random effects models to the survey data to estimate values for all health states described by the MSIS-8D.

RESULTS

The new patient-derived index (the MSIS-8D-P) provides values ranging from 0.893 for the best possible health state to 0.138 for the worst state. The MSIS-8D-P exhibits good discriminative validity, identifying expected significant differences between groups based on presence/absence of MS, type of MS, and duration since diagnosis.

CONCLUSIONS

The MSIS-8D-P index of values for MS-specific health states provides an opportunity to estimate QALYs based on patient preferences, for use in economic evaluations of treatments for MS. More broadly, it adds to the methods and data available to consider the health-related quality of life of people with MS to inform resource allocation and individual-level decisions regarding treatments for MS.

摘要

目的

在经济评估中,健康结果通常使用来自一般人群样本偏好的质量调整生命年(QALY)来量化。有人认为,这种方法忽略了有患病经历的人的偏好,而患者的偏好应该在健康结果的评估中占有一席之地。在这里,我们报告了一种基于多发性硬化症(MS)现有条件特异性偏好测量方法(MSIS-8D)的偏好的偏好基指数的估计,该指数基于 MS 患者的偏好。

研究设计

互联网时间权衡(TTO)调查,从 MS 患者中收集偏好。

方法

我们使用 TTO 技术从 MS 患者样本(N=1635)中对 169 个 MSIS-8D 健康状态进行了偏好调查。我们对调查数据进行了普通最小二乘法和随机效应模型拟合,以估计 MSIS-8D 描述的所有健康状态的价值。

结果

新的患者衍生指数(MSIS-8D-P)提供了从最佳健康状态的 0.893 到最差状态的 0.138 的价值。MSIS-8D-P 具有良好的区分效度,能够根据 MS 的存在/不存在、MS 的类型和诊断后时间的长短,识别出不同组别之间预期的显著差异。

结论

MSIS-8D-P 指数为 MS 特定健康状态提供了一个基于患者偏好估计 QALY 的机会,可用于 MS 治疗的经济评估。更广泛地说,它增加了现有的方法和数据,以考虑 MS 患者的健康相关生活质量,为资源分配和个人层面的 MS 治疗决策提供信息。

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