Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D
Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D
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DOI：
10.1007/s11136-004-7713-0
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发表时间：
2005-08-01
影响因子：
3.5
通讯作者：
Brazier, JE
中科院分区：
文献类型：
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作者：
Walters, SJ;Brazier, JE
背景：SF-6D和EQ-5D都是基于偏好的健康指标。需要进行实证研究，以确定效用分数中可以被视为重要的最小变化是什么，以及效用值的这种变化在各种度量和条件下是否是恒定的。目的：使用基于分布和锚点的方法确定并比较各种数据集的SF-6D和EQ-5D的最小重要差异（MID）。方法：SF-6D采用0.29-1.00量表评分，EQ-5D采用-0.59-1.00量表评分，两者均为1.00，表示“完全健康”。对患者进行一段时间的随访，然后使用SF-36的问题2作为我们的锚点，询问他们的总体健康状况是否比上次评估时好得多（5）、稍微好一点（4）、保持不变（3）、稍微差一点（2）或差得多（1）。我们认为总体评分为4或2的患者发生了与MID相当的变化。本文描述并比较了使用两种工具的8项I I患者组纵向研究中SF-6D和EQ-5D的MID和标准化应答均值（SRM）。结果：根据I I审查的研究，SF-6D的MID范围为0.011至0.097，平均值为0.041。相应的SRM范围为0.12至0.87，平均值为0.39，使用Cohen标准，主要在“小至中等”范围内，支持MID结果。EQ-5D的平均MID为0.074（范围为-0.011-0.140），SRM范围为-0.05至0.43，平均值为0.24。EQ-5D的平均MID几乎是SF-6D平均MID的两倍。结论：有证据表明，这两个效用指标的MID不相等，并且绝对值不同。EQ-5D量表的范围约为SF-6D量表的两倍。因此，在每个量表的效用评分范围内，每个量表的MID估计值似乎在比例上相等。需要进一步的实证工作，看看这是否适用于其他效用措施，患者群体和人群。
Background: The SF-6D and EQ-5D are both preference-based measures of health. Empirical work is required to determine what the smallest change is in utility scores that can be regarded as important and whether this change in utility value is constant across measures and conditions. Objectives: To use distribution and anchor-based methods to determine and compare the minimally important difference (MID) for the SF-6D and EQ-5D for various datasets. Methods: The SF-6D is scored on a 0.29-1.00 scale and the EQ-5D on a -0.59-1.00 scale, with a score of 1.00 on both, indicating 'full health'. Patients were followed for a period of time, then asked, using question 2 of the SF-36 as our anchor, if their general health is much better (5), somewhat better (4), stayed the same (3), somewhat worse (2) or much worse (1) compared to the last time they were assessed. We considered patients whose global rating score was 4 or 2 as having experienced some change equivalent to the MID. This paper describes and compares the MID and standardised response mean (SRM) for the SF-6D and EQ-5D from eight longitudinal studies in I I patient groups that used both instruments. Results: From the I I reviewed studies, the MID for the SF-6D ranged from 0.011 to 0.097, mean 0.041. The corresponding SRMs ranged from 0.12 to 0.87, mean 0.39 and were mainly in the 'small to moderate' range using Cohen's criteria, supporting the MID results. The mean MID for the EQ-5D was 0.074 (range -0.011-0.140) and the SRMs ranged from -0.05 to 0.43, mean 0.24. The mean MID for the EQ-5D was almost double that of the mean MID for the SF-6D. Conclusions: There is evidence that the MID for these two utility measures are not equal and differ in absolute values. The EQ-5D scale has approximately twice the range of the SF-6D scale. Therefore, the estimates of the MID for each scale appear to be proportionally equivalent in the context of the range of utility scores for each scale. Further empirical work is required to see whether or not this holds true for other utility measures, patient groups and populations.