Using Health State Utility Values from the General Population to Approximate Baselines in Decision Analytic Models when Condition-Specific Data are Not Available
Using Health State Utility Values from the General Population to Approximate Baselines in Decision Analytic Models when Condition-Specific Data are Not Available
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DOI：
10.1016/j.jval.2010.10.029
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发表时间：
2011-06-01
期刊：
影响因子：
4.5
通讯作者：
Brazier, John E.
中科院分区：
文献类型：
--
作者：
Ara, Roberta;Brazier, John E.
背景资料：卫生保健中的决策分析模型需要基线健康相关的生活质量数据，以准确评估干预措施的益处。使用不适当的基线，例如假设没有疾病的完美健康值（EQ-5D = 1）可能会高估某些治疗的获益，从而扭曲由每质量调整生命年成本阈值得出的政策决定。目的：主要目的是确定当特定条件数据不可用时，一般人群的数据是否适用于基线健康状态效用值（HSUV）。方法：收集了英国连续四次健康调查的数据。提取自我报告的健康状况和EQ-5D数据，并用于生成有或无流行健康状况的队列的平均HSUV。这些与所有受访者的平均HSUV进行了比较，无论健康状况如何。结果：超过45%的受访者（n = 41，174）报告至少有一种情况，近20%的人报告至少有两种情况。我们的研究结果表明，在某些分析中，来自普通人群的数据可用于近似基线HSUV，但不是所有分析。特别是，来自普通人群的HSUV对于只有一种疾病的队列来说不是合适的基线。在这些情况下，如果无法获得特定条件的数据，则报告其没有任何流行健康状况的受访者的数据可能更合适。探索性分析表明，在所有条件下，健康相关生活质量的下降在不同年龄段可能不是恒定的，这些关系可能是条件特异性的。需要进一步的研究来验证我们的发现。
Background: Decision analytic models in health care require baseline health-related quality of life data to accurately assess the benefits of interventions. The use of inappropriate baselines such as assuming the value of perfect health (EQ-5D = 1) for not having a condition may overestimate the benefits of some treatment and thus distort policy decisions informed by cost per quality adjusted life years thresholds. Objective: The primary objective was to determine if data from the general population are appropriate for baseline health state utility values (HSUVs) when condition specific data are not available. Methods: Data from four consecutive Health Surveys for England were pooled. Self-reported health status and EQ-5D data were extracted and used to generate mean HSUVs for cohorts with or without prevalent health conditions. These were compared with mean HSUVs from all respondents irrespective of health status. Results: More than 45% of respondents (n = 41,174) reported at least one condition and almost 20% reported at least two. Our results suggest that data from the general population could be used to approximate baseline HSUVs in some analyses, but not all. In particular, HSUVs from the general population would not be an appropriate baseline for cohorts who have just one condition. In these instances, if condition specific data are not available, data from respondents who report they do not have any prevalent health condition may be more appropriate. Exploratory analyses suggest the decrement on health-related quality of life may not be constant across ages for all conditions and these relationships may be condition specific. Additional research is required to validate our findings.