The impact of age-related macular degeneration on health status utility values
The impact of age-related macular degeneration on health status utility values
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DOI：
10.1167/iovs.05-0072
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发表时间：
2005-11-01
影响因子：
4.4
通讯作者：
Brazier, JE
中科院分区：
文献类型：
--
作者：
Espallargues, M;Czoski-Murray, CJ;Brazier, JE
目的。通过使用基于偏好的健康测量方法，估计与视力障碍相关的年龄相关性黄斑变性（ARMD）患者的健康状况效用值。这是一项横断面研究，涉及在一家大型教学医院就诊的单侧或双侧ARMD患者。患者接受视力测试（近、远视力[VA]和对比敏感度[CS]），并完成健康状况问卷，包括视觉功能指数(VF)-14和三项基于偏好的测量（健康效用指数标记III [HUI-3]、EuroQoL健康问卷[EQ-5D]和短表格6D健康状况问卷[SF-6D]）和时间权衡（TTO）。根据视力较好的眼的VA和4个CS组定义的5组平均健康状况。通过视力测试（视力较好的眼的平均VA值为0.2）和自我报告（平均VF-14评分为41.5），招募了299名视力明显丧失的患者。HUI-3的平均（+/- SD）效用为0.34 +/- 0.28，SF-6D为0.66 +/- 0.14，EQ-5D为0.72 +/- 0.22，TTO为0.64 +/- 0.31。HUI-3与VA和CS的相关性最高（分别为0.40和- 0.34），其次是TTO（分别为0.25和- 0.21）。在VA组和CS组中，只有HUI3和TTO有显著的线性趋势（P < 0.05）。在以CS和VA为解释变量的回归模型中，只有CS的系数具有统计学意义。ARMD与患者健康状况的重大影响相关，但这并未反映在所使用的两种基于偏好的通用测量中。HUI-3似乎是在需要社区数据的经济评价中使用的首选工具。将经济模型建立在社会价值或社会价值与社会价值的某种组合上，而不是仅仅建立在社会价值的基础上，可能更为合适。
PURPOSE. To estimate health status utility values in patients with age-related macular degeneration (ARMD) associated with visual impairments, by using preference-based measures of health.METHOD. This was a cross-sectional study involving patients with unilateral or bilateral ARMD who attended a large teaching hospital. Patients underwent visual tests ( near and distant visual acuity [VA] and contrast sensitivity [ CS]) and completed health status questionnaires including the Index of Visual Function (VF)-14 and three preference-based measures ( the Health Utilities Index Mark III [HUI-3], the EuroQoL Health Questionnaire [EQ-5D], and the Short Form 6D Health Status Questionnaire [SF-6D]) and the time tradeoff (TTO). The mean health status is presented for five groups, defined according to the VA in the better-seeing eye and for four CS groups.RESULTS. Two hundred nine patients were recruited with substantial loss of visual function as obtained by visual tests ( mean decimal VA in the better-seeing eye: 0.2) and self-report ( mean VF-14 score: 41.5). The mean ( +/- SD) utilities were 0.34 +/- 0.28 for HUI-3, 0.66 +/- 0.14 for SF-6D, 0.72 +/- 0.22 for EQ-5D, and 0.64 +/- 0.31 for TTO. The HUI-3 had the highest correlation with VA and CS (0.40 and - 0.34), followed by TTO (0.25 and - 0.21). Across the VA and CS groups, only HUI3 and TTO had a significant linear trend ( P < 0.05). In a regression model with CS and VA as explanatory variables, only the coefficient on CS was statistically significant.CONCLUSIONS. ARMD is associated with a substantial impact on patients' health status, but this was not reflected in two of the generic preference-based measures used. The HUI-3 seems to be the instrument of choice for use in economic evaluations in which community data are needed. It may be more appropriate to base economic models on CS or some combination of CS and VA rather than on VA alone.