Balázs Péter György, Gáspár Krisztián, Gergely Hunor L, Hajdú Krisztina, Holló Péter, Koszorú Kamilla, Poór Adrienn Katalin, Sárdy Miklós, Szegedi Andrea, Tamási Béla, Wikonkál Norbert, Brodszky Valentin
Institute of Social and Political Sciences, Corvinus University of Budapest, Budapest, Hungary.
Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Arch Dermatol Res. 2025 Jan 18;317(1):291. doi: 10.1007/s00403-024-03786-4.
This study aims to explore the measurement agreement between direct and indirect health utility measures in four chronic dermatological conditions (atopic dermatitis, hidradenitis suppurativa, pemphigus, psoriasis). Outpatients survey data collected between 2015 and 2021 were analysed. Health-related quality of life (HRQoL) outcome measures included time trade-off (TTO), EQ-5D-5L and Dermatology Life Quality Index (DLQI). Descriptive statistics were computed for the pooled sample and four diseases. Mean, standard deviation (SD), median, interquartile range (IQR), ceiling and floor effects were calculated for TTO, EQ-5D-5L and DLQI utilities. Bland‒Altman plots and intraclass correlation coefficients (ICC) were applied to investigate the agreement between health utility measures. Sociodemographic characteristics (age, sex, educational level, employment status) and health-related information (disease duration, outpatient care visits in the past 3 months and disease severity) impact on utilities was investigated by Tobit regressions. The sample includes N = 765 patient responses with a mean age of 41.5 (SD = 16.2), majority being males (52.7%). Total sample mean utilities were the highest according to TTO (0.83), followed by EQ-5D-5L and vDLQI (0.81 and 0.81) and lowest in mDLQI (0.77). Measurement agreement was found only between TTO and EQ-5D-5L. Skin-disease severity impacted all health state utilities, though only TTO differentiated utility values according to disease type. The discrepancies between the TTO and DLQI warn to compare DLQI-based utilities in different dermatological conditions with extreme caution.
本研究旨在探讨四种慢性皮肤病（特应性皮炎、化脓性汗腺炎、天疱疮、银屑病）中直接和间接健康效用测量方法之间的测量一致性。对2015年至2021年期间收集的门诊患者调查数据进行了分析。健康相关生活质量（HRQoL）结局测量指标包括时间权衡法（TTO）、EQ-5D-5L和皮肤病生活质量指数（DLQI）。计算了汇总样本和四种疾病的描述性统计数据。计算了TTO、EQ-5D-5L和DLQI效用值的均值、标准差（SD）、中位数、四分位数间距（IQR）、天花板效应和地板效应。应用Bland-Altman图和组内相关系数（ICC）来研究健康效用测量方法之间的一致性。通过Tobit回归研究了社会人口学特征（年龄、性别、教育水平、就业状况）和健康相关信息（疾病持续时间、过去3个月的门诊就诊次数和疾病严重程度）对效用值的影响。样本包括N = 765名患者的回复，平均年龄为41.5岁（SD = 16.2），大多数为男性（52.7%）。根据TTO得出的总样本平均效用值最高（0.83），其次是EQ-5D-5L和vDLQI（0.81和0.81），mDLQI最低（0.77）。仅在TTO和EQ-5D-5L之间发现了测量一致性。皮肤病严重程度影响所有健康状态效用值，不过只有TTO根据疾病类型区分了效用值。TTO和DLQI之间的差异提醒在比较不同皮肤病情况下基于DLQI的效用值时要极其谨慎。
