Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.

Hdl Handle:
http://hdl.handle.net/10147/207790
Title:
Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.
Authors:
Adams, Roisin; Walsh, Cathal; Veale, Douglas; Bresnihan, Barry; FitzGerald, Oliver; Barry, Michael
Affiliation:
National Centre for Pharmacoeconomics, St. James' Hospital, Dublin 8, Ireland., radams@stjames.ie
Citation:
Pharmacoeconomics. 2010;28(6):477-87. doi: 10.2165/11533010-000000000-00000.
Journal:
PharmacoEconomics
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207790
DOI:
10.2165/11533010-000000000-00000
PubMed ID:
20465316
Abstract:
BACKGROUND: The growth of economic analyses and in particular cost-utility analyses (CUA), which use the QALY as a measure of outcome, has heightened the interest in the methodologies used to calculate the QALY. The EQ-5D has produced quite different utility values from that of the SF-6D. This article seeks to understand these differences using a cohort of patients with inflammatory arthritis. OBJECTIVE: To examine the relationship between the disease-specific measure, Health Assessment Questionnaire (HAQ) disability index (DI) and the preference-based measures, SF-6D, EQ-5D and European League Against Arthritis (EULAR) Disease Activity Score (DAS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: Patients with RA and PsA (n = 504) attending a tertiary rheumatology referral centre completed the HAQ, SF-6D and the EQ-5D before starting biological therapy and again 12 months later. The SF-36 was converted into a utility using the preference-based SF-6D. Clinical outcomes such as the DAS, joint counts and laboratory measures were also recorded. We calculated single index utility scores from the preference-based instruments using UK population norms. We used regression analysis to derive a mapping function and calculated utility scores from the HAQDI and the DAS 28. RESULTS: The mean utility observed at baseline for RA was 0.43 for the EQ-5D and 0.54 for the SF-6D and for PsA was 0.49 for the EQ-5D and 0.57 for the SF-6D. The utility gain demonstrated by the EQ-5D was over twice that of the SF-6D. The EQ-5D scored 17% of the RA group as less than 0 (state defined as worse than death); 7% of this group remained less than 0 at follow-up. The distribution of the utility estimates was similar for both RA and PsA. CONCLUSIONS: Our findings draw attention to the impact of states worse than death on the overall distribution for the EQ-5D derived utilities and how these impact on its use in practice. EQ-5D-derived QALY changes are over twice that of the SF-6D. The implication of this for decision makers is that cost-effectiveness evaluations for treatments in this disease class are likely to be very sensitive to the choice of utility measure.
Language:
eng
MeSH:
Adolescent; Adult; Aged; Aged, 80 and over; Arthritis, Psoriatic/*economics; Arthritis, Rheumatoid/*economics; Cost-Benefit Analysis/*methods; Female; Humans; Male; Middle Aged; Models, Econometric; Outcome Assessment (Health Care)/*methods; *Quality-Adjusted Life Years; Severity of Illness Index
ISSN:
1179-2027 (Electronic); 1170-7690 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorAdams, Roisinen_GB
dc.contributor.authorWalsh, Cathalen_GB
dc.contributor.authorVeale, Douglasen_GB
dc.contributor.authorBresnihan, Barryen_GB
dc.contributor.authorFitzGerald, Oliveren_GB
dc.contributor.authorBarry, Michaelen_GB
dc.date.accessioned2012-02-01T10:44:47Z-
dc.date.available2012-02-01T10:44:47Z-
dc.date.issued2012-02-01T10:44:47Z-
dc.identifier.citationPharmacoeconomics. 2010;28(6):477-87. doi: 10.2165/11533010-000000000-00000.en_GB
dc.identifier.issn1179-2027 (Electronic)en_GB
dc.identifier.issn1170-7690 (Linking)en_GB
dc.identifier.pmid20465316en_GB
dc.identifier.doi10.2165/11533010-000000000-00000en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207790-
dc.description.abstractBACKGROUND: The growth of economic analyses and in particular cost-utility analyses (CUA), which use the QALY as a measure of outcome, has heightened the interest in the methodologies used to calculate the QALY. The EQ-5D has produced quite different utility values from that of the SF-6D. This article seeks to understand these differences using a cohort of patients with inflammatory arthritis. OBJECTIVE: To examine the relationship between the disease-specific measure, Health Assessment Questionnaire (HAQ) disability index (DI) and the preference-based measures, SF-6D, EQ-5D and European League Against Arthritis (EULAR) Disease Activity Score (DAS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: Patients with RA and PsA (n = 504) attending a tertiary rheumatology referral centre completed the HAQ, SF-6D and the EQ-5D before starting biological therapy and again 12 months later. The SF-36 was converted into a utility using the preference-based SF-6D. Clinical outcomes such as the DAS, joint counts and laboratory measures were also recorded. We calculated single index utility scores from the preference-based instruments using UK population norms. We used regression analysis to derive a mapping function and calculated utility scores from the HAQDI and the DAS 28. RESULTS: The mean utility observed at baseline for RA was 0.43 for the EQ-5D and 0.54 for the SF-6D and for PsA was 0.49 for the EQ-5D and 0.57 for the SF-6D. The utility gain demonstrated by the EQ-5D was over twice that of the SF-6D. The EQ-5D scored 17% of the RA group as less than 0 (state defined as worse than death); 7% of this group remained less than 0 at follow-up. The distribution of the utility estimates was similar for both RA and PsA. CONCLUSIONS: Our findings draw attention to the impact of states worse than death on the overall distribution for the EQ-5D derived utilities and how these impact on its use in practice. EQ-5D-derived QALY changes are over twice that of the SF-6D. The implication of this for decision makers is that cost-effectiveness evaluations for treatments in this disease class are likely to be very sensitive to the choice of utility measure.en_GB
dc.language.isoengen_GB
dc.subject.meshAdolescenten_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshArthritis, Psoriatic/*economicsen_GB
dc.subject.meshArthritis, Rheumatoid/*economicsen_GB
dc.subject.meshCost-Benefit Analysis/*methodsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshModels, Econometricen_GB
dc.subject.meshOutcome Assessment (Health Care)/*methodsen_GB
dc.subject.mesh*Quality-Adjusted Life Yearsen_GB
dc.subject.meshSeverity of Illness Indexen_GB
dc.titleUnderstanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.en_GB
dc.contributor.departmentNational Centre for Pharmacoeconomics, St. James' Hospital, Dublin 8, Ireland., radams@stjames.ieen_GB
dc.identifier.journalPharmacoEconomicsen_GB
dc.description.provinceLeinster-

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