Fundação Oswaldo Cruz, FIOCRUZ, Escola Nacional de Saúde Pública Sergio Arouca, Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, ZIP 21041-210, Brazil.
Universidade Federal do Estado do Rio de Janeiro, UNIRIO, Instituto de Saúde Coletiva, Rio de Janeiro, RJ, Brazil.
Qual Life Res. 2020 Sep;29(9):2497-2508. doi: 10.1007/s11136-020-02534-1. Epub 2020 May 25.
This study aimed to develop and evaluate different families of applicable models available for utility mapping between World Health Organization Quality of Life for HIV-abbreviated version (WHOQOL-HIV Bref) and EQ-5D-3L and to propose an optimised algorithm to estimate health utilities of people living with HIV.
Estimation dataset was collected between July 2014 and September 2016 in a cross-sectional study including 1526 people living with HIV/Aids (PLWH) under care at the Instituto Nacional de Infectologia Evandro Chagas-FIOCRUZ, in Brazil. Data of WHOQOL-HIV Bref and EQ-5D-3L questionnaires were collected. Fisher's exact tests were used for testing WHOQOL-HIV Bref response frequencies among groups of responses to each of the five EQ-5D-3L domains. Multiple correspondence analyses (MCA) were used to inspect the relationships between both instrument responses. Different families of applicable models available for utility mapping between WHOQOL-HIV Bref and EQ-5D-3L were adjusted for the prediction of disutility.
Candidate models' performances using mean absolute error (MAE), mean squared error (MSE), and root mean squared error (RMSE) were similarly good, which was evidenced by the overlapping of its 95% confidence intervals of the mean tenfold cross-validation or estimated generalisation errors. However, the Hurdle Logistic-Log-Normal model was better on average according to generalisation errors both in the prediction of Brazilian utility values (MAE = 0.1037, MSE = 0.0178, and RMSE = 0.1332) and for those of the UK (MAE = 0.1476, MSE = 0.0443, and RMSE = 0.2099).
Mapping EQ-5D-3L responses or deriving health utilities directly from WHOQOL-HIV Bref responses can be a valid alternative for settings with no preference-based health utility data.
本研究旨在开发和评估适用于世界卫生组织艾滋病毒简表生存质量量表（WHOQOL-HIV Bref）和 EQ-5D-3L 间效用映射的不同适用模型家族，并提出一种优化算法来估计艾滋病毒感染者的健康效用。
估计数据集于 2014 年 7 月至 2016 年 9 月期间在巴西国家传染病学研究所 Evandro Chagas-FIOCRUZ 艾滋病毒感染者/艾滋病患者（PLWH）护理的横断面研究中收集。收集了 WHOQOL-HIV Bref 和 EQ-5D-3L 问卷的数据。Fisher 确切检验用于检验 WHOQOL-HIV Bref 对五个 EQ-5D-3L 域中每个域的反应的反应频率。多元对应分析（MCA）用于检查两种仪器反应之间的关系。调整了适用于 WHOQOL-HIV Bref 和 EQ-5D-3L 间效用映射的不同适用模型家族，以预测效用损失。
使用平均绝对误差（MAE）、平均平方误差（MSE）和均方根误差（RMSE）的候选模型性能同样良好，这可以通过其 95%置信区间的平均十倍交叉验证或估计的泛化误差的重叠来证明。然而，根据英国的预测，Hurdle 逻辑正态模型在预测巴西效用值时的平均泛化误差方面（MAE=0.1037，MSE=0.0178，RMSE=0.1332）和英国的预测（MAE=0.1476，MSE=0.0443，RMSE=0.2099）都更好。
从 WHOQOL-HIV Bref 反应直接映射 EQ-5D-3L 反应或推导健康效用可以成为没有偏好健康效用数据的情况下的有效替代方法。
