School of Public Health, Medical College of Soochow University, Suzhou, China.
School of Public Health, Fudan University, Shanghai, China.
Qual Life Res. 2020 Nov;29(11):3087-3094. doi: 10.1007/s11136-020-02551-0. Epub 2020 Jun 12.
In China, multiple approaches to calculating EQ-5D utilities are available, including the two EQ-5D-3L (3L and 3L) scoring functions, the EQ-5D-5L (5L) scoring function, and the crosswalk function linking the 3L utilities and 5L health states. The study compared utilities derived from them in terms of agreement and discriminative power; and assessed whether the use of different approaches may affect QALY estimation in Chinese type 2 diabetes (T2D) patients.
Cross-sectional data of 289 T2D patients who self-completed both the 5L and 3L questions were used. Agreement were examined using intraclass correlation coefficient (ICC) and Bland-Altman plots. The ability of the EQ-5D utilities in differentiating the patients with and without clinical conditions was evaluated using F-statistics. Their influence on QALY estimation was assessed adopting mean absolute difference (MAD) in utility values between the patients.
The ICC values were 0.881 (3L-3L), 0.958 (5L-c5L), and 0.806 (5L-c5L). The two 3L utilities and the three 5L utilities had poor agreement at the lower end of utility scale according to Bland-Altman plots. The 3L utilities had lower F-statistics compared to the 3L utilities; the two c5L utilities had larger or similar F-statistics compared to the 5L utilities. The mean MADs were 0.138 (5L), 0.116 (3L), 0.115 (c5L), 0.055 (c5L), and 0.055 (3L).
The 3L utilities is more discriminative than the 3L utilities; and the two c5L utilities have no worse discriminative power compared with the 5L utilities. The choice of the approach to calculating the EQ-5D utilities is likely to affect QALY estimates.
在中国，有多种计算 EQ-5D 效用值的方法，包括 EQ-5D-3L（3L 和 3L）评分函数、EQ-5D-5L（5L）评分函数以及连接 3L 效用值和 5L 健康状态的转换函数。本研究比较了它们在一致性和区分能力方面的差异，并评估了使用不同方法是否会影响中国 2 型糖尿病（T2D）患者的 QALY 估计值。
使用 289 例同时完成 5L 和 3L 问卷的 T2D 患者的横断面数据。使用组内相关系数（ICC）和 Bland-Altman 图评估一致性。使用 F 统计量评估 EQ-5D 效用值区分有和无临床状况患者的能力。采用效用值之间的平均绝对差值（MAD）评估其对 QALY 估计的影响。
ICC 值分别为 0.881（3L-3L）、0.958（5L-c5L）和 0.806（5L-c5L）。根据 Bland-Altman 图，两种 3L 效用值和三种 5L 效用值在效用值较低的一端存在较差的一致性。3L 效用值的 F 统计量低于 3L 效用值；两种 c5L 效用值的 F 统计量大于或与 5L 效用值相似。平均 MAD 值分别为 0.138（5L）、0.116（3L）、0.115（c5L）、0.055（c5L）和 0.055（3L）。
3L 效用值比 3L 效用值具有更好的区分能力；两种 c5L 效用值与 5L 效用值相比没有更差的区分能力。计算 EQ-5D 效用值的方法选择可能会影响 QALY 估计值。
