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重视与健康相关的生活质量:英国的EQ-5D-5L价值集。

Valuing health-related quality of life: An EQ-5D-5L value set for England.

作者信息

Devlin Nancy J, Shah Koonal K, Feng Yan, Mulhern Brendan, van Hout Ben

机构信息

Office of Health Economics, London, UK.

School of Health and Related Research, University of Sheffield, Sheffield, UK.

出版信息

Health Econ. 2018 Jan;27(1):7-22. doi: 10.1002/hec.3564. Epub 2017 Aug 22.

Abstract

A new version of the EQ-5D, the EQ-5D-5L, is available. The aim of this study is to produce a value set to support use of EQ-5D-5L data in decision-making. The study design followed an international research protocol. Randomly selected members of the English general public completed 10 time trade-off and 7 discrete choice experiment tasks in face-to-face interviews. A 20-parameter hybrid model was used to combine time trade-off and discrete choice experiment data to generate values for the 3,125 EQ-5D-5L health states. Valuation data are available for 996 respondents. Face validity of the data has been demonstrated, with more severe health states generally given lower values. Problems with pain/discomfort and anxiety/depression received the greatest weight. Compared to the existing EQ-5D-3L value set, there are considerably fewer "worse than dead" states (5.1%, compared with over one third), and the minimum value is higher. Values range from -0.285 (extreme problems on all dimensions) to 0.950 (for health states 11211 and 21111). Results have important implications for users of the EQ-5D-5L both in England and internationally. Quality-adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated.

摘要

EQ-5D的新版本EQ-5D-5L已经问世。本研究的目的是生成一个价值集,以支持在决策中使用EQ-5D-5L数据。研究设计遵循国际研究方案。从英国普通公众中随机挑选的成员在面对面访谈中完成了10项时间权衡任务和7项离散选择实验任务。使用一个20参数混合模型来合并时间权衡和离散选择实验数据,以生成3125种EQ-5D-5L健康状态的值。现有996名受访者的估值数据。已证明数据具有表面效度,一般来说,健康状态越严重,所赋予的值越低。疼痛/不适和焦虑/抑郁方面的问题权重最大。与现有的EQ-5D-3L价值集相比,“比死亡更糟”的状态要少得多(5.1%,而之前超过三分之一),且最小值更高。值的范围从-0.285(所有维度都存在极端问题)到0.950(针对健康状态11211和21111)。研究结果对英国和国际上EQ-5D-5L的用户都具有重要意义。使用这个价值集,旨在改善极差健康状况的干预措施所带来的质量调整生命年增益可能会更小,而且之前可能被高估了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/261c/6680214/a0bb2d5ae309/HEC-27-7-g001.jpg

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