Philipson Anna, Hagberg Lars, Hermansson Liselotte, Karlsson Jan, Ohlsson-Nevo Emma, Ryen Linda
University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Universitetssjukhuset Örebro, S-huset, vån 2, 701 85, Örebro, Sweden.
Pharmacoecon Open. 2023 Sep;7(5):765-776. doi: 10.1007/s41669-023-00425-y. Epub 2023 Jun 15.
Mapping algorithms can be used for estimating quality-adjusted life years (QALYs) when studies apply non-preference-based instruments. In this study, we estimate a regression-based algorithm for mapping between the World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the preference-based instrument SF-6D to obtain preference estimates usable in health economic evaluations. This was done separately for the working and non-working populations, as WHODAS 2.0 discriminates between these groups when estimating scores.
Using a dataset including 2258 participants from the general Swedish population, we estimated the statistical relationship between SF-6D and WHODAS 2.0. We applied three regression methods, i.e., ordinary least squares (OLS), generalized linear models (GLM), and Tobit, in mapping onto SF-6D from WHODAS 2.0 at the overall-score and domain levels. Root mean squared error (RMSE) and mean absolute error (MAE) were used for validation of the models; R was used to assess model fit.
The best-performing models for both the working and non-working populations were GLM models with RMSE ranging from 0.084 to 0.088, MAE ranging from 0.068 to 0.071, and R ranging from 0.503 to 0.608. When mapping from the WHODAS 2.0 overall score, the preferred model also included sex for both the working and non-working populations. When mapping from the WHODAS 2.0 domain level, the preferred model for the working population included the domains mobility, household activities, work/study activities, and sex. For the non-working population, the domain-level model included the domains mobility, household activities, participation, and education.
It is possible to apply the derived mapping algorithms for health economic evaluations in studies using WHODAS 2.0. As conceptual overlap is incomplete, we recommend using the domain-based algorithms over the overall score. Different algorithms must be applied depending on whether the population is working or non-working, due to the characteristics of WHODAS 2.0.
当研究使用非基于偏好的工具时,映射算法可用于估计质量调整生命年(QALY)。在本研究中,我们估计了一种基于回归的算法,用于在世界卫生组织残疾评估量表(WHODAS 2.0)和基于偏好的工具SF-6D之间进行映射,以获得可用于卫生经济评估的偏好估计值。由于WHODAS 2.0在估计分数时区分了工作人群和非工作人群,因此分别针对这两类人群进行了此项工作。
使用一个包含2258名瑞典普通人群参与者的数据集,我们估计了SF-6D与WHODAS 2.0之间的统计关系。我们应用了三种回归方法,即普通最小二乘法(OLS)、广义线性模型(GLM)和托比特模型,在总分和领域层面从WHODAS 2.0映射到SF-6D。均方根误差(RMSE)和平均绝对误差(MAE)用于模型验证;R用于评估模型拟合度。
工作人群和非工作人群中表现最佳的模型均为GLM模型,RMSE范围为0.084至0.088,MAE范围为0.068至0.071,R范围为0.503至0.608。从WHODAS 2.0总分进行映射时,首选模型在工作人群和非工作人群中均纳入了性别因素。从WHODAS 2.0领域层面进行映射时,工作人群的首选模型纳入了活动能力、家务活动、工作/学习活动和性别领域。对于非工作人群,领域层面模型纳入了活动能力、家务活动、参与和教育领域。
在使用WHODAS 2.0的研究中,可以将推导得出的映射算法应用于卫生经济评估。由于概念重叠不完全,我们建议使用基于领域的算法而非总分算法。由于WHODAS 2.0的特点,根据人群是工作还是非工作,必须应用不同的算法。