Developing a common outcome measure for priority setting in health: Validation of the 'Transfer to Utility' Technique

对健康项目进行经济评估是资助者和购买者寻求从健康资金中获得最佳价值的共同要求。但研究人员使用了广泛的疾病特定和通用健康状况工具来描述试验结果，使得不同干预措施之间的比较变得困难。针对这一问题，西格尔博士和他的同事开发了一种“向公用事业转移”或TTU技术，将临床试验中报告的各种结果转换为效用得分，以便各种卫生干预措施的绩效可以用成本-QALY表示并进行比较。这项技术在临床试验中常用的仪器和实用价值之间建立了统计转换。虽然这项技术看起来非常有用，但基于骨性关节炎的优先设置练习，可以比较20种不同的干预措施，但它在其他情况下的有效性和适用性尚未确定。这笔赠款的目的是探索TTU技术，以i)建立估计共同健康结果衡量标准和效用评分之间回归方程的最佳方法并验证该方法；ii)测试TTU在其他以生活质量为主要管理目标的疾病领域(中风、药物依赖和抑郁症)的普遍性；iii)开发和验证将最常用的一般健康状况衡量标准SF-36转换为效用评分的方法；以及iv)说明TTU在比较抑郁症预防和管理干预措施中的应用。研究结果将对i)决策者有价值，他们必须比较各种疾病和模式的医疗保健干预措施的表现，ii)希望实行循证保健的临床医生。社区的潜在健康收益是巨大的，支持将资源重新用于更有效和更具成本效益的资源

The economic evaluation of health programs is a common requirement of funders and purchasers seeking to get the best value from the health dollar. But researchers employ a wide range of disease specific and generic health status instruments to describe trial outcomes, making comparison between diverse interventions difficult. In response to this problem a 'Transfer to Utility' or TTU technique was developed by Dr Segal and colleagues, to translate diverse outcomes reported in clinical trials, into a utility score, so the performance of diverse health interventions can be expressed in cost-QALY and compared. The technique establishes a statistical transformation between instruments commonly used in clinical trials and a utility value. While the technique appears highly useful, based on a priority setting exercise in osteoarthritis enabling 20 disparate interventions to be compared its validity and applicability in other contexts is not established. The purpose of the grant is to explore the TTU technique to i) establish the best method for estimating the regression equation between common health outcome measures and a utility score and validating that method; ii) test generalisability to other disease areas, for which quality of life is the primary objective of management (in stroke, drug dependence and depression), iii) develop and validate a method for translating the most commonly used measure of general health status, the SF-36, into a utility score and iv) illustrate the application of the TTU in comparing intervensions for the prevention and management of depression. The results of the research will be of value to i) decision makers who must compare the performance of medical-health care interventions across a range of diseases and modalities and ii) to clinicians who want to practice evidenced based health care. The potential health gains for the community are substantial, in supporting the redirection of resources to more effective and cost-effective