埃及 EQ-5D-5L 估值研究。

The EQ-5D-5L Valuation Study in Egypt.

机构信息

Department of Clinical Pharmacy, Faculty of Pharmacy, Cairo University, Kasr El-Aini St., Cairo, 11562, Egypt.

EuroQol Group Office, Rotterdam, The Netherlands.

出版信息

Pharmacoeconomics. 2022 Apr;40(4):433-447. doi: 10.1007/s40273-021-01100-y. Epub 2021 Nov 17.

Abstract

INTRODUCTION

No value sets exist for either the EQ-5D-3L or the EQ-5D-5L in Egypt, despite local pharmacoeconomic guidelines recommending the use of the EQ-5D to derive utility. Most published Egyptian economic evaluation studies have used utility values from other published studies and systematic reviews.

OBJECTIVE

Our objective was to develop an Egyptian EQ-5D-5L value set using the international EuroQol standardized protocol (EQ-VT-2.1). This study is a revision of a previous EQ-5D-5L value set for Egypt retracted by the authors.

METHODS

Adult Egyptian participants were recruited from public places using multi-stratified quota sampling based on age, sex, and geographical distribution. Two elicitation techniques were applied: the composite time trade-off (cTTO) and discrete-choice experiments (DCEs). Before actual data collection, interviewers' performance was assessed in a pilot phase. Data were modelled using generalized least squares, Tobit, heteroskedastic, logit, and hybrid models, and the best fitting model was selected based on logical consistency of the parameters, significance level, prediction accuracy, and model parsimony.

RESULTS

A total of 1378 interviews were conducted, of which 188 were excluded because they were incomplete and did not comply with the protocol, 216 were pilot interviews, and 974 were included in the final analysis. The heteroskedastic model with constraints (model 4) based on the cTTO data was selected as the preferred model to generate the value set. Values ranged from - 0.964 for the worst health state (55555) to 1 for full health (11111) and 0.948 for 11211, with 1123 of all predicted health states (35.94%) being worse than dead. Mobility had the largest impact on health state preference values.

CONCLUSION

This is the first value set for the EQ-5D-5L based on social preferences obtained from a nationally representative sample in Egypt or any Arabic-speaking country. The value set can be used as a scoring system for economic evaluation and to improve the quality of health technology assessment in the Egyptian healthcare system.

摘要

简介

尽管当地药物经济学指南建议使用 EQ-5D 来获得效用,但埃及既没有 EQ-5D-3L 也没有 EQ-5D-5L 的价值集。大多数已发表的埃及经济评估研究都使用了来自其他已发表研究和系统评价的效用值。

目的

我们的目的是使用国际 EuroQol 标准化协议 (EQ-VT-2.1) 为埃及开发一个 EQ-5D-5L 价值集。本研究是对作者之前撤回的埃及 EQ-5D-5L 价值集的修订。

方法

使用基于年龄、性别和地理分布的多分层配额抽样,从公共场所招募成年埃及参与者。应用了两种 elicitation 技术:复合时间交易 (cTTO) 和离散选择实验 (DCEs)。在实际数据收集之前,在试点阶段评估了采访者的表现。使用广义最小二乘法、Tobit、异方差、Logit 和混合模型对数据进行建模,并根据参数的逻辑一致性、显著性水平、预测准确性和模型简约性选择最佳拟合模型。

结果

共进行了 1378 次访谈,其中 188 次因不完整且不符合方案而被排除,216 次为试点访谈,974 次被纳入最终分析。基于 cTTO 数据的具有约束的异方差模型(模型 4)被选为生成价值集的首选模型。价值范围从最差健康状态 (55555) 的-0.964 到完全健康 (11111) 的 1 和 11211 的 0.948,所有预测健康状态中有 1123 个(35.94%)比死亡更差。流动性对健康状态偏好值的影响最大。

结论

这是第一个基于从埃及或任何阿拉伯语国家获得的具有代表性的社会偏好的 EQ-5D-5L 价值集。该价值集可用于经济评估的评分系统,并提高埃及医疗保健系统中卫生技术评估的质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/858a/9007763/cda6be102be5/40273_2021_1100_Fig1_HTML.jpg

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