Statistical Analysis of EQ-5D Profiles: Does the Use of Value Sets Bias Inference?
Statistical Analysis of EQ-5D Profiles: Does the Use of Value Sets Bias Inference?
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DOI：
10.1177/0272989x09357473
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发表时间：
2010-09-01
影响因子：
3.6
通讯作者：
Devlin, Nancy
中科院分区：
文献类型：
--
作者：
Parkin, David;Rice, Nigel;Devlin, Nancy
健康状态概况数据，如EQ-5D提供的数据，广泛收集于临床试验、人口调查和越来越多的其他重要卫生部门应用中。然而，很难对这些概况数据进行总结，从而对某一特定人群的健康状况给出总体看法，从而分析群体之间或群体内部随时间的差异。简化此问题的一种常见方法是使用权重集将概要文件转换为单个数字或索引，这些权重集通常以值的形式从一般公众中获得。这个过程有什么问题吗？在本文中，作者演示了使用值集作为加权剖面数据的手段的潜在影响。他们表明，任何一组权重都会引入健康概况数据的外源方差。这可能会扭曲关于群体之间或时间之间健康变化重要性的研究结果。没有一组权重的效果是中性的。如果需要对患者报告的结果进行总结，最好使用直接产生结果的工具（如EQ VAS）和描述性工具。如果这是不可能的，研究人员应该有一个明确的理由来选择权重，并意识到这些权重可能会对他们的分析产生重大影响。本文的重点是EQ-5D，但其论点及其对统计分析的影响与所有健康状态描述系统相关。
Health state profile data, such as those provided by the EQ-5D, are widely collected in clinical trials, population surveys, and a growing range of other important health sector applications. However, these profile data are difficult to summarize to give an overall view of the health of a given population that can be analyzed for differences between groups or within groups over time. A common way of short cutting this problem is to transform profiles into a single number, or index, using sets of weights, often elicited from the general public in the form of values. Are there any problems with this procedure? In this article, the authors demonstrate the underlying effects of the use of value sets as a means of weighting profile data. They show that any set of weights introduces an exogenous source of variance to health profile data. These can distort findings about the significance of changes in health between groups or over time. No set of weights is neutral in its effect. If a summary of patient-reported outcomes is required, it may be better to use an instrument that yields this directly (such as the EQ VAS) along with the descriptive instrument. If this is not possible, researchers should have a clear rationale for their choice of weights and be aware that those weights may exert a nontrivial effect on their analysis. This article focuses on the EQ-5D, but the arguments and their implications for statistical analysis are relevant to all health state descriptive systems.