Poder Thomas G, Carrier Nathalie
School of Public Health, Department of Management, Evaluation and Health Policy, University of Montreal, Montreal, QC, Canada.
Centre de recherche de l'Institut universitaire en santé mentale de Montréal, CIUSSS de l'Est-de-l'Île-de-Montréal, Montreal, QC, Canada.
J Pain Res. 2020 Mar 26;13:623-631. doi: 10.2147/JPR.S236957. eCollection 2020.
Cost utility analysis is important for measuring the impact of chronic disease and helps clinicians and policymakers in patient management and policy decisions, but generic preference-based measures are not always considered in clinical studies.
To evaluate if health-related quality-of-life (HRQoL)-specific questionnaires used in chronic low back pain (CLBP) can predict EQ-5D-5L utility scores.
The data come from an online survey on low back pain conducted between October 2018 and January 2019. Health utility scores for EuroQol Five Dimensions Five Levels (EQ-5D-5L) were calculated with the recommended model of Xie et al. The EQ-5D-5L health states ranged from -0.148 for the worst (55555) to 0.949 for the best (11111). Univariate and multivariate linear regression were performed to predict EQ-5D-5L with Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ) and clinical variables.
Analyses were performed in 408 subjects who completed the questionnaires EQ-5D-5L, ODI or RMDQ. Median (range) of EQ-5D-5L was 0.622 (-0.072 to 0.905). There was high correlation between EQ-5D-5L and ODI (r=-0.78, p<0.001), while it was moderate with RMDQ (r=-0.62, p<0.001). The multivariate model to predict EQ-5D-5L with ODI explained 67.6% of variability, and the correlation between actual and predicted EQ-5D-5L was 0.82. Principal predictors were ODI, duration of LBP, invalidity, health satisfaction (0-10 cm), life satisfaction (0-10 cm), and intensity of pain today (0-10 cm).
Data from this study demonstrated that individual correlation between ODI and EQ-5D-5L was high, but moderate with RMDQ. Correlations between actual and predicted EQ-5D-5L from multivariate models were higher and very high. Considering these results, the multivariate model can be used in similar studies for patient with CLBP to estimate the utility scores from the ODI when the EQ-5D-5L was not measured.
成本效用分析对于衡量慢性病的影响很重要，有助于临床医生和政策制定者进行患者管理和政策决策，但临床研究中并不总是考虑通用的基于偏好的测量方法。
评估慢性下腰痛（CLBP）中使用的特定于健康相关生活质量（HRQoL）的问卷是否能够预测EQ-5D-5L效用评分。
数据来自2018年10月至2019年1月期间进行的一项关于下腰痛的在线调查。使用Xie等人推荐的模型计算欧洲五维健康量表（EQ-5D-5L）的健康效用评分。EQ-5D-5L健康状态范围从最差（55555）的-0.148到最好（11111）的0.949。进行单变量和多变量线性回归，以用Oswestry功能障碍指数（ODI）、罗兰-莫里斯功能障碍问卷（RMDQ）和临床变量预测EQ-5D-5L。
对408名完成EQ-5D-5L、ODI或RMDQ问卷的受试者进行了分析。EQ-5D-5L的中位数（范围）为0.622（-0.072至0.905）。EQ-5D-5L与ODI之间存在高度相关性（r=-0.78，p<0.001），而与RMDQ的相关性为中等（r=-0.62，p<0.001）。用ODI预测EQ-5D-5L的多变量模型解释了67.6%的变异性，实际和预测的EQ-5D-5L之间的相关性为0.82。主要预测因素为ODI、下腰痛持续时间、残疾状态、健康满意度（0-10厘米）、生活满意度（0-10厘米）和今日疼痛强度（0-10厘米）。
本研究数据表明，ODI与EQ-5D-5L之间的个体相关性较高，但与RMDQ的相关性为中等。多变量模型中实际和预测的EQ-5D-5L之间的相关性更高且非常高。考虑到这些结果，当未测量EQ-5D-5L时，多变量模型可用于类似的CLBP患者研究，以从ODI估计效用评分。
