Dolan P
Department of Economics, University of Newcastle, Newcastle-Upon-Tyne, UK.
Med Care. 1997 Nov;35(11):1095-108. doi: 10.1097/00005650-199711000-00002.
OBJECTIVES: It has become increasingly common for preference-based measures of health-related quality of life to be used in the evaluation of different health-care interventions. For one such measure, The EuroQol, designed to be used for these purposes, it was necessary to derive a single index value for each of the 243 health states it generates. The problem was that it was virtually impossible to generate direct valuations for all of these states, and thus it was necessary to find a procedure that allows the valuations of all EuroQol states to be interpolated from direct valuations on a subset of these. METHODS: In a recent study, direct valuations were elicited for 42 EuroQol health states (using the time trade-off method) from a representative sample of the UK population. This article reports on the methodology that was adopted to build up a "tariff" of EuroQol values from this data. RESULTS: A parsimonious model that fits the data well was defined as one in which valuations were explained in terms of the level of severity associated with each dimension, an intercept associated with any move away from full health, and a term that picked up whether any dimension in the state was at its most severe level. CONCLUSIONS: The model presented in this article appears to predict the values of the states for which there are direct observations and, thus, can be used to interpolate values for the states for which no direct observations exist.
目的:在不同医疗保健干预措施的评估中,使用基于偏好的健康相关生活质量测量方法已变得越来越普遍。对于一种旨在用于这些目的的此类测量方法——欧洲五维度健康量表(EuroQol),有必要为它所生成的243种健康状态中的每一种得出一个单一的指数值。问题在于几乎不可能对所有这些状态进行直接估值,因此有必要找到一种程序,能够根据对其中一部分状态的直接估值来内插所有欧洲五维度健康量表状态的估值。 方法:在最近的一项研究中,从英国人口的代表性样本中(使用时间权衡法)获取了42种欧洲五维度健康量表健康状态的直接估值。本文报告了从这些数据构建欧洲五维度健康量表价值“价目表”所采用的方法。 结果:一个与数据拟合良好的简约模型被定义为这样一种模型,其中估值是根据与每个维度相关的严重程度水平、与偏离完全健康状态相关的截距以及一个反映该状态中任何维度是否处于最严重水平的项来解释的。 结论:本文提出的模型似乎能够预测有直接观测值的状态的值,因此可用于内插不存在直接观测值的状态的值。
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