Law Ernest H, Pickard Alan Simon, Walton Surrey M, Xie Feng, Lee Todd A, Schwartz Alan
Department of Pharmacy Systems, Outcomes and Policy, University of Illinois, Chicago, IL.
Department of Health Research Methods, McMaster University, St. Joseph's Hospital, Hamilton, ON, Canada.
Med Care. 2022 Jun 1;60(6):462-469. doi: 10.1097/MLR.0000000000001714. Epub 2022 Mar 22.
Changes over time in health state values from a societal perspective may be an important reason to consider updating societal value sets for preference-based measures of health.
The aim was to examine whether stated health preferences are different between 2002 and 2017, controlling for demographic changes in the United States.
Data from 2002 and 2017 US EQ-5D-3L valuation studies were combined. The primary analysis compared valuations of better-than-dead (BTD) states only, as both studies used the same time trade-off (TTO) method for these states. For worse-than-dead (WTD) states, the 2017 study used the lead-time TTO and the 2002 study used the conventional TTO, which necessitated transformation. Regression models were fitted to BTD values to estimate time-specific differences, adjusting for respondent characteristics. Secondary analyses examined models that fitted WTD values (using linear and nonlinear transformations of the 2002 data) and all values.
The adjusted BTD-only model showed mean values were higher for 2017 compared with 2002 (βY2017=0.05, P<0.001). WTD-only models showed negative changes over time but that were dependent on the transformation method (linear βY2017=-0.72; nonlinear βY2017=-0.35; both P<0.001). Using all values, 2017 mean valuations were lower using a linear transformation (βY2017=-0.11; P<0.001) but did not differ with the nonlinear transformation.
Individuals in 2017 are generally less willing to trade quantity for quality of life compared with 2002. This study provides evidence of time-specific differences in a society's preferences, suggesting that the era in which values were elicited may be an important reason to consider updating societal value sets.
从社会角度来看，健康状态值随时间的变化可能是考虑更新基于偏好的健康测量社会价值集的一个重要原因。
旨在研究在控制美国人口结构变化的情况下，2002年和2017年的陈述性健康偏好是否存在差异。
合并了2002年和2017年美国EQ-5D-3L估值研究的数据。主要分析仅比较了优于死亡（BTD）状态的估值，因为两项研究对这些状态都使用了相同的时间权衡（TTO）方法。对于差于死亡（WTD）状态，2017年的研究使用了提前期TTO，2002年的研究使用了传统TTO，这需要进行转换。对BTD值拟合回归模型以估计特定时间的差异，并对受访者特征进行调整。二次分析检查了拟合WTD值的模型（使用2002年数据的线性和非线性转换）以及所有值。
仅调整BTD的模型显示，2017年的平均值高于2002年（βY2017 = 0.05，P < 0.001）。仅WTD的模型显示随时间有负面变化，但这取决于转换方法（线性βY2017 = -0.72；非线性βY2017 = -0.35；两者P < 0.001）。使用所有值时，线性转换下2017年的平均估值较低（βY2017 = -0.11；P < 0.001），但非线性转换下无差异。
与2002年相比，2017年的个人总体上不太愿意用生活质量换取数量。本研究提供了社会偏好中特定时间差异的证据，表明获取价值的时代可能是考虑更新社会价值集的一个重要原因。
