School of Health and Related Research, University of Sheffield, Sheffield, UK.
Health Econ. 2022 Jun;31(6):923-939. doi: 10.1002/hec.4487. Epub 2022 Feb 28.
EQ-5D is a 5-item questionnaire instrument designed to measure health-related quality of life. It is extremely important, since it is used to measure health benefits in many studies providing evidence for reimbursement decisions by the National Institute for Health and Care Excellence in England and similar policy bodies in other countries. EQ-5D has been redesigned in a more detailed form (EQ-5D-5L), but much existing cost-effectiveness evidence is based on the older version (EQ-5D-3L). Statistical mapping from one version to another is widely used, exploiting data from multi-instrument surveys incorporating both variants. However, little is known about the robustness of data from such multi-instrument surveys. We design a randomized experiment to investigate whether inclusion of both versions at different stages in a single interview gives a reliable picture of the relationship between health measures from the two instruments and embed it in individual interviews from the UK Understanding Society household panel. We find that sequencing of the two versions of EQ-5D within an interview has a significant impact not only on the resulting data but also on the estimated mapping models. We illustrate the non-negligible effects in two real-world cost-effectiveness examples and discuss the implications for future multi-instrument survey design.
EQ-5D 是一种 5 项问卷工具，旨在衡量与健康相关的生活质量。它非常重要，因为它被用于衡量许多研究中的健康效益，为英国国家卫生与保健卓越研究所和其他国家类似的政策机构的报销决策提供证据。EQ-5D 已经以更详细的形式（EQ-5D-5L）进行了重新设计，但许多现有的成本效益证据都是基于旧版本（EQ-5D-3L）。从一个版本到另一个版本的统计映射被广泛使用，利用包含两种变体的多仪器调查的数据。然而，对于这种多仪器调查的数据的稳健性知之甚少。我们设计了一项随机实验，以调查在单个访谈的不同阶段同时包含这两个版本是否能可靠地反映两种仪器的健康测量之间的关系，并将其嵌入英国社会理解家庭小组的个人访谈中。我们发现，在访谈中对 EQ-5D 的两个版本进行排序不仅会对结果数据产生重大影响，还会对估计的映射模型产生影响。我们在两个现实的成本效益示例中说明了不可忽视的影响，并讨论了对未来多仪器调查设计的影响。
