Department of Biostatistics, Singapore Clinical Research Institute, #02-01, 31 Biopolis Way, Singapore, Singapore.
Centre for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, Singapore, Singapore.
Eur J Health Econ. 2020 Jun;21(4):501-511. doi: 10.1007/s10198-019-01156-w. Epub 2020 Jan 4.
OBJECTIVES: (1) To evaluate the effect of adding a vision dimension ('bolt-on') to the 5-level EQ-5D (EQ-5D-5L) and 3-level EQ-5D (EQ-5D-3L) on their responsiveness, and (2) to compare the responsiveness of a vision 'bolt-on' EQ-5D-3L (EQ-5D-3L + V) with SF-6D and Health Utilities Index Mark 3 (HUI3) to the benefit of cataract surgery. METHODS: Sixty-three patients were assessed before and after their cataract surgery using the EQ-5D-3L, EQ-5D-5L, SF-6D, HUI3, as well as a 3-level and a 5-level vision dimension. Preference-based indices were calculated using available value sets for EQ-5D-3L, EQ-5D-3L + V, EQ-5D-5L, SF-6D, and HUI3, and non-preference-based indices were calculated using the sum-score method for EQ-5D-5L and EQ-5D-5L + V (vision bolt-on EQ-5D-5L). Responsiveness was assessed using the standardized response mean (SRM) and F-statistic. RESULTS: Among preference-based indices, mean changes from pre to post-surgery in EQ-5D-3L + V and EQ-5D-3L indices were 0.031 and 0.018, respectively. The mean changes for EQ-5D-5L, SF-6D and HUI3 indices were 0.020, 0.012 and 0.105, respectively. The SRM (F-statistic) for EQ-5D-3L + V and EQ-5D-3L indices were 0.458 (13.2) and 0.098 (0.6), respectively. The responsiveness of EQ-5D-3L + V was better than EQ-5D-5L, SF-6D; the responsiveness of HUI3 was better than all other measures. Using non-preference-based indices, mean change for EQ-5D-5L + V and EQ-5D-5L were 0.067 and 0.017, respectively. The corresponding SRM (F-statistic) were 0.709 (31.7) and 0.295 (5.4). CONCLUSIONS: Preliminary evidence from our study suggests that a vision 'bolt-on' may increase the responsiveness of EQ-5D-3L and EQ-5D-5L to change in health outcomes experienced by patients undergoing cataract surgery. In absence of the preference-based vision bolt-on EQ-5D-5L index, HUI3 was the most responsive measure.
目的：（1）评估在 5 级 EQ-5D（EQ-5D-5L）和 3 级 EQ-5D（EQ-5D-3L）中添加视力维度（“附加组件”）对其反应能力的影响，（2）比较附加视力的 EQ-5D-3L（EQ-5D-3L+V）与 SF-6D 和健康效用指数第 3 版（HUI3）对白内障手术获益的反应能力。
方法：63 名患者在白内障手术后使用 EQ-5D-3L、EQ-5D-5L、SF-6D、HUI3 以及 3 级和 5 级视力维度进行了评估。使用 EQ-5D-3L、EQ-5D-3L+V、EQ-5D-5L、SF-6D 和 HUI3 的可用价值集计算偏好指数，使用 EQ-5D-5L 和 EQ-5D-5L+V（视觉附加 EQ-5D-5L）的总和评分法计算非偏好指数。使用标准化反应均值（SRM）和 F 统计量评估反应能力。
结果：在偏好指数中，EQ-5D-3L+V 和 EQ-5D-3L 指数从术前到术后的平均变化分别为 0.031 和 0.018。EQ-5D-5L、SF-6D 和 HUI3 指数的平均变化分别为 0.020、0.012 和 0.105。EQ-5D-3L+V 和 EQ-5D-3L 指数的 SRM（F 统计量）分别为 0.458（13.2）和 0.098（0.6）。EQ-5D-3L+V 的反应能力优于 EQ-5D-5L、SF-6D；HUI3 的反应能力优于所有其他测量指标。使用非偏好指数，EQ-5D-5L+V 和 EQ-5D-5L 的平均变化分别为 0.067 和 0.017。相应的 SRM（F 统计量）分别为 0.709（31.7）和 0.295（5.4）。
结论：我们的研究初步证据表明，附加视力“附加组件”可能会提高接受白内障手术的患者健康结果变化的 EQ-5D-3L 和 EQ-5D-5L 的反应能力。在没有偏好的附加组件 EQ-5D-5L 指数的情况下，HUI3 是最敏感的指标。
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