Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Symptom Research, MD Anderson Cancer Center, University of Houston, TX, USA.
Value Health. 2022 May;25(5):824-834. doi: 10.1016/j.jval.2021.10.012. Epub 2021 Dec 15.
The Patient-Reported Outcome Measurement Information System (PROMIS) Preference score (PROPr) can be used to assess health state utility (HSU) and estimate quality-adjusted life-years in cost-effectiveness analyses. It is based on item response theory and promises to overcome limitations of existing HSU scores such as ceiling effects. The PROPr contains 7 PROMIS domains: cognitive abilities, depression, fatigue, pain, physical function, sleep disturbance, and ability to participate in social roles and activities. We aimed to compare the PROPr with the 5-level EQ-5D (EQ-5D-5L) in terms of psychometric properties using data from 3 countries.
We collected PROMIS-29 profile and EQ-5D-5L data from 3 general population samples (United Kingdom = 1509, France = 1501, Germany = 1502). Given that cognition is not assessed by the PROMIS-29, it was predicted by the recommended linear regression model. We compared the convergent validity, known-groups construct validity, and ceiling and floor effects of the PROPr and EQ-5D-5L.
The mean PROPr (0.48, 0.53, 0.48; P<.01) and EQ-5D-5L scores (0.82, 0.85, 0.83; P<.01) showed significant differences of similar magnitudes (d = 0.34; d = 0.32; d = 0.35; P<.01) across all samples. The differences were invariant to sex, income, occupation, education, and most conditions but not for age. The Pearson correlation coefficients between both scores were r = 0.74, r = 0.69, and r = 0.72. PROPr's ceiling and floor effects both were minor to moderate. The EQ-5D-5L's ceiling (floor) effects were major (negligible).
Both the EQ-5D-5L and the PROPr assessed by the PROMIS-29 show high validity. The PROPr yields considerably lower HSU values than the EQ-5D-5L. Consequences for quality-adjusted life-year measurements should be investigated in future research.
患者报告结局测量信息系统（PROMIS）偏好评分（PROPr）可用于评估健康状态效用（HSU）并估算成本效益分析中的质量调整生命年。它基于项目反应理论，有望克服现有 HSU 评分的局限性，如天花板效应。PROPr 包含 7 个 PROMIS 领域：认知能力、抑郁、疲劳、疼痛、身体功能、睡眠障碍以及参与社会角色和活动的能力。我们旨在使用来自 3 个国家的数据，比较 PROPr 与 5 级 EQ-5D（EQ-5D-5L）在心理测量学特性方面的差异。
我们从 3 个一般人群样本（英国=1509，法国=1501，德国=1502）中收集了 PROMIS-29 概况和 EQ-5D-5L 数据。由于认知未通过 PROMIS-29 进行评估，因此使用推荐的线性回归模型进行预测。我们比较了 PROPr 和 EQ-5D-5L 的收敛效度、已知群体结构效度以及天花板和地板效应。
所有样本中，PROPr（0.48、0.53、0.48；P<.01）和 EQ-5D-5L 评分（0.82、0.85、0.83；P<.01）均显示出显著的差异，且差异程度相似（d=0.34；d=0.32；d=0.35；P<.01）。这些差异不受性别、收入、职业、教育和大多数疾病的影响，但受年龄的影响。两个评分之间的皮尔逊相关系数分别为 r=0.74、r=0.69 和 r=0.72。PROPr 的天花板和地板效应均为中到中度。EQ-5D-5L 的天花板（地板）效应均为主要（可忽略不计）。
PROMIS-29 评估的 EQ-5D-5L 和 PROPr 均具有较高的有效性。PROPr 产生的 HSU 值明显低于 EQ-5D-5L。未来的研究应探讨对质量调整生命年测量的影响。
