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

卫生项目的经济评估是寻求从卫生资金中获得最佳价值的资助者和购买者的共同要求。但研究人员采用了广泛的疾病特异性和通用的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。为了解决这个问题，Segal博士及其同事开发了一种“转移到效用”或TTU技术，将临床试验中报告的各种结果转化为效用评分，因此可以用成本QALY表示各种健康干预措施的性能并进行比较。该技术建立了临床试验中常用仪器之间的统计转换和实用价值。虽然该技术似乎非常有用，但基于骨关节炎的优先级设置练习，可以比较20种不同的干预措施，但其在其他情况下的有效性和适用性尚未确定。该补助金的目的是探索TTU技术，以i）建立最佳方法来估计常见健康结果指标与效用评分之间的回归方程，并验证该方法; ii）测试对其他疾病领域的普遍性，对于这些疾病领域，生活质量是管理的主要目标（中风、药物依赖和抑郁症），iii）开发并验证一种用于翻译最常用的一般健康状况指标SF-36的方法，转化为效用评分和iv）说明TTU在比较预防和管理抑郁症的干预中的应用。研究结果将对i）决策者具有价值，他们必须比较各种疾病和模式的医疗保健干预措施的性能，ii）希望实践基于证据的医疗保健的临床医生。社区在保健方面的潜在收益是巨大的，这有助于将资源转用于更有效和更具成本效益的项目。

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