Centre for Health Studies and Research of the University of Coimbra (CEISUC), Coimbra, Portugal.
Faculty of Economics, University of Coimbra, Coimbra, Portugal.
Qual Life Res. 2019 Dec;28(12):3163-3175. doi: 10.1007/s11136-019-02226-5. Epub 2019 Jun 14.
The EQ-5D is a generic preference-based quality of life measure considered useful for supporting clinical and policy decisions by providing utility values that can easily be converted into quality-adjusted life years to be integrated in cost-utility economic evaluations. Although the three-level classification system of the EuroQol questionnaire (EQ-5D-3L) is still the most popular preference-based instrument used worldwide, several studies reported a ceiling effect on this version, especially in healthy and/or young individuals. In 2009, the EuroQol Group introduced a five-level EQ-5D, which expands the descriptive system from three to five levels within the same five dimensions. For this version to be used in health economic evaluation, societal values need to be assigned to the 3125 health states generated by this instrument.
The aims of this study were to elicit the EQ-5D-5L health state preferences from the general Portuguese population and to derive the Portuguese value set for the EQ-5D-5L.
A representative sample of the Portuguese general population aged above 18 years was stratified by age and gender (n = 1451). Between October 2015 and July 2016, 28 interviewers carried out a series of 1-h-long computer-assisted personal interviews following the EuroQol Valuation Technology protocol. Each interview included the valuation of ten health states using the composite time trade-off (cTTO) and seven pairs of discrete choice experiments (DCEs). A standardized tool for quality control was used to assess the quality of the data as well as direct supervision and cross-examination of 10% of the global sample size. Data from both cTTO and DCE valuation tasks were modelled using a censored heteroskedastic hybrid model.
Interviewers complied with the quality control protocol in providing high-quality valuation data. The hybrid econometric model had consistent and significant parameters. The derived societal values for the Portuguese population ranged from - 0.603 to 1.
This study provided the Portuguese value set for the EQ-5D-5L on the basis of a hybrid econometric model using cTTO and DCE data. These results represent the preferences of the Portuguese population and are recommended to inform health decision-making in Portugal.
EQ-5D 是一种通用的偏好基础生活质量衡量标准，被认为通过提供效用值（可轻松转换为质量调整生命年来纳入成本效用经济评估），对支持临床和政策决策很有用。尽管欧洲五维健康量表（EQ-5D-3L）的三级分类系统仍然是全球最流行的偏好基础工具，但有几项研究报告称该版本存在上限效应，尤其是在健康和/或年轻个体中。2009 年，欧洲五维健康量表组引入了 EQ-5D-5L，该版本在同一五个维度内将描述系统从三级扩展到五级。为了在健康经济评估中使用该版本，需要为该工具生成的 3125 种健康状态赋予社会价值。
本研究旨在从葡萄牙一般人群中得出 EQ-5D-5L 健康状态偏好，并推导出葡萄牙 EQ-5D-5L 值集。
按年龄和性别对 18 岁以上的葡萄牙一般人群进行分层（n=1451），并对其进行代表性抽样。2015 年 10 月至 2016 年 7 月期间，28 名访谈员根据欧洲五维健康量表估值技术方案开展了一系列持续 1 小时的计算机辅助个人访谈。每次访谈均使用综合时间权衡法（cTTO）和七个离散选择实验（DCE）对 10 种健康状态进行估值。使用标准化质量控制工具评估数据质量，并对全球样本量的 10%进行直接监督和交叉检查。cTTO 和 DCE 估值任务的数据均使用有偏异方差混合模型进行建模。
访谈员在提供高质量估值数据方面符合质量控制方案。混合计量经济学模型的参数具有一致性和显著性。基于 cTTO 和 DCE 数据的混合计量经济学模型推导出的葡萄牙人群社会价值范围为-0.603 至 1。
本研究基于使用 cTTO 和 DCE 数据的混合计量经济学模型，提供了葡萄牙 EQ-5D-5L 值集。这些结果代表了葡萄牙人群的偏好，建议用于葡萄牙的卫生决策。
