Katanyoo Kanyarat, Thavorncharoensap Montarat, Chaikledkaew Usa, Riewpaiboon Arthorn
Social, Economic and Administrative Pharmacy (SEAP) Graduate Program, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
Radiation Oncology Unit, Department of Radiology, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand.
Expert Rev Pharmacoecon Outcomes Res. 2022 Jan;22(1):107-117. doi: 10.1080/14737167.2021.1906224. Epub 2021 Apr 6.
Several instruments are available to measure health utility values. However, limited studies have not yet comprehensively assessed the agreement among these instruments. This study therefore aimed to investigate the performance and agreement of six instruments for utility measures: EQ-5D-3L, EQ-5D-5L (cTTO model), EQ-5D-5L (DCE model), EQ-5D-5L (Hybrid model), TTO, and VAS, among locally advanced cervical cancer (LACC) patients in Thailand.
We compared utility scores derived from six approaches using Friedman's test. We also assessed the agreement of utility scores between each pairwise comparison by intraclass correlation coefficient (ICC) and Bland-Altman plot.
The mean (SD) utility values derived from six approaches were as follows: 0.755 ± 0.248 (EQ-5D-3L), 0.801 ± 280 (TTO), 0.806 ± 0.156 (VAS), 0.871 ± 0.184 (cTTO model), 0.875 ± 0.168 (Hybrid model), and 0.900 ± 0.142 (DCE model). Significant differences across six approaches were found in Friedman's test. The ICC showed high agreement between EQ-5D-5L and EQ-5D-3L, and very high agreement between all three models of EQ-5D-5L. The Bland-Altman plots showed wide limit of agreement, except the pairwise comparison, between each model of the EQ-5D-5L.
TTO, VAS, EQ-5D-3L and EQ-5D-5L could not be used interchangeably in LACC patients. The impact of using different instruments on economic evaluation findings warrants further investigation.
有多种工具可用于测量健康效用值。然而，有限的研究尚未全面评估这些工具之间的一致性。因此，本研究旨在调查泰国局部晚期宫颈癌（LACC）患者中用于效用测量的六种工具的性能和一致性：EQ-5D-3L、EQ-5D-5L（cTTO模型）、EQ-5D-5L（DCE模型）、EQ-5D-5L（混合模型）、TTO和VAS。
我们使用Friedman检验比较了六种方法得出的效用得分。我们还通过组内相关系数（ICC）和Bland-Altman图评估了每对比较之间效用得分的一致性。
六种方法得出的平均（标准差）效用值如下：0.755±0.248（EQ-5D-3L）、0.801±280（TTO）、0.806±0.156（VAS）、0.871±0.184（cTTO模型）、0.875±0.168（混合模型）和0.900±0.142（DCE模型）。Friedman检验发现六种方法之间存在显著差异。ICC显示EQ-5D-5L和EQ-5D-3L之间具有高度一致性，EQ-5D-5L的所有三种模型之间具有非常高的一致性。Bland-Altman图显示，除了EQ-5D-5L各模型之间的成对比较外，一致性界限较宽。
在LACC患者中，TTO、VAS、EQ-5D-3L和EQ-5D-5L不能互换使用。使用不同工具对经济评估结果的影响值得进一步研究。
