Relating health-related Quality of Life to disability progression in multiple sclerosis, using the 5-level EQ-5D
Relating health-related Quality of Life to disability progression in multiple sclerosis, using the 5-level EQ-5D
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DOI：
10.1177/1352458512474860
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发表时间：
2013-08-01
影响因子：
5.8
通讯作者：
Tubridy, Niall
中科院分区：
文献类型：
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作者：
Fogarty, Emer;Walsh, Cathal;Tubridy, Niall
背景：越来越多地使用质量调整生命年来为资源分配决策提供信息，这突出了多发性硬化症（MS）患者相关临床和健康相关生活质量（HRQoL）结果的重要性。目的与方法：采用5级EQ-5D （EQ-5D- 5l）量表，探讨扩展残疾状态量表（EDSS）与HRQoL效用的关系。采用香农指数评价EQ-5D-5L的鉴别能力。结果：随着EDSS评分从0到6的变化，观察到效用的线性下降，此后关系表现出更大的变异性。平均效用值从EDSS 9时的-0.22到EDSS 0时的0.88。我们发现EQ-5D-5L在自我保健和焦虑/抑郁领域的区分能力明显低于其他健康相关领域。结论：在首次报道的多发性硬化症人群中，EQ-5D-5L表现出良好的区分能力，尽管在各个健康领域的表现有所不同，有证据表明在自我保健和焦虑/抑郁领域存在天花板效应。在我们的MS队列中，EQ-5D-5L与EDSS高度相关，直至EDSS 6，在此之后，严重健康状态的效用评估表现出更大的变异性。本研究的效用估计可用于MS疾病改善疗法的经济评估，为资源分配决策提供信息。
Background: Increasing use of the Quality-Adjusted Life-Year to inform resource allocation decision-making has highlighted the importance of relating clinical and health-related quality of life (HRQoL) outcomes in multiple sclerosis (MS) patients.Objective and Methods: To investigate the relationship between the Expanded Disability Status Scale (EDSS) and HRQoL utility, using the 5-level EQ-5D (EQ-5D-5L). The discriminatory power of the EQ-5D-5L was assessed using Shannon's indices.Results: A linear decline in utility was observed with changes in EDSS score from 0 to 6, after which point the relationship exhibited greater variability. Mean utility values ranged from -0.22 at EDSS 9 to 0.88 at EDSS 0. We found that the discriminative capacity of the EQ-5D-5L was considerably lower for the domains self-care and anxiety/depression, compared with other health-related domains.Conclusion: In its first reported use in an MS population, the EQ-5D-5L displayed good discriminatory capacity, although performance differed between the various domains of health, with evidence of a ceiling effect present in the domains of self-care and anxiety/depression. The EQ-5D-5L demonstrated a high correlation with EDSS in our MS cohort up to EDSS 6, after which point the utility valuation of severe health states exhibited much greater variability. Utility estimates from this study may be used in economic evaluations of disease-modifying therapies in MS, to inform resource-allocation decisions.