Office of Health Economics, London, UK; Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Office of Health Economics, London, UK; School of Health and Related Research, University of Sheffield, Sheffield, UK.
Value Health. 2019 Mar;22(3):355-361. doi: 10.1016/j.jval.2018.08.012. Epub 2018 Nov 1.
The distribution of EQ-5D-3L values (health state profiles, weighted by value sets) often shows two distinct groups, arising from both the distribution of profiles and the characteristics of value sets. To date, there is little evidence about the distribution of EQ-5D-5L values.
To explore the distribution of EQ-5D-5L profiles; to compare the distributions of EQ-5D-5L values arising from the English value set (EVS) and a 'mapped' value set (MVS); and to develop further the methods used to investigate clustering within EQ-5D data.
We obtained data from Cambridgeshire Community Services NHS Trust containing EQ-5D-5L profiles before treatment for three patient groups: community rehabilitation (N=6919); musculoskeletal physiotherapy (N=19999); and specialist nursing services (N=3366). Values were calculated using the EVS and MVS. Clusters were examined using the k-means method and Calinski-Harabasz pseudo-F index stopping rule.
We found no evidence for clustering of EQ-5D-5L values arising from the classification system and no strong or consistent evidence of clustering arising from the EVS. There was clearer evidence of clustering using the MVS, with two being the optimal number of clusters. The clusters that were found for the EVS were very different from the MVS clusters.
Unlike the EQ-5D-3L, clustering of EQ-5D-5L values does not seem to be driven by clustering of its profile. This suggests the EQ-5D-5L is superior in that it is less likely to generate artefactual clusters - however, clusters may still result from using value sets such as MVS that have the tendency to generate them.
EQ-5D-3L 值(根据值集加权的健康状况分布)的分布通常呈现两个明显的群体,这既源于分布状况又源于值集的特点。迄今为止,关于 EQ-5D-5L 值分布的证据很少。
探索 EQ-5D-5L 分布状况;比较英国值集(EVS)和“映射”值集(MVS)产生的 EQ-5D-5L 值分布;并进一步开发用于调查 EQ-5D 数据中聚类的方法。
我们从剑桥郡社区服务国民保健信托基金获得了三个患者群体治疗前的 EQ-5D-5L 分布数据:社区康复(N=6919);肌肉骨骼物理治疗(N=19999);和专科护理服务(N=3366)。使用 EVS 和 MVS 计算值。使用 k-均值方法和 Calinski-Harabasz 伪 F 指数停止规则检查聚类。
我们没有发现分类系统产生的 EQ-5D-5L 值聚类的证据,也没有发现 EVS 产生的聚类的有力或一致证据。使用 MVS 时,聚类的证据更为明确,最佳聚类数为 2。EVS 聚类与 MVS 聚类非常不同。
与 EQ-5D-3L 不同,EQ-5D-5L 值的聚类似乎不是由其分布的聚类驱动的。这表明 EQ-5D-5L 更优越,因为它不太可能产生人为的聚类-但是,聚类仍可能来自于使用 MVS 等有产生聚类倾向的价值集。