Estimating EuroQoL EQ-5D scores from Population Healthy Days data

School of Nursing, Columbia University, New York, NY 10032, USA.
Medical Decision Making (Impact Factor: 3.24). 07/2008; 28(4):491-9. DOI: 10.1177/0272989X07312708
Source: PubMed


Preference-based assessments of population health, which may be used for cost-utility analyses, are lacking for most states and communities. With adequate population data, preference-based values can be estimated from non-preference-based health-related quality of life (HRQOL) data. This study estimates scores on the EuroQol EQ-5D, a preference-based measure, from the Healthy Days

No data set from the US population asks both the Healthy Days and EQ-5D questions for the same respondents. Therefore, estimates for EQ-5D scores were obtained indirectly by matching cumulative distributions of the 2 measures. These distributions were estimated from the 2000- 2002 Behavioral Risk Factor Surveillance System (BRFSS) and the Medical Expenditure Panel Survey (MEPS). The validity of estimates was examined by comparing the mean estimated and observed scores across particular population subgroups. A simulation study was conducted to compare the performance of the proposed method to the regression method.
The overall mean observed EQ-5D index was 0.871 and the mean estimated EQ-5D index was 0.872. In the majority of examined subgroups, the mean scores demonstrated a good match according to sociodemographic variables and health-related conditions and, with the exception of the most impaired health states, the differences tended to be less than 0.04.
This study provided preliminary estimates of EQ-5D scores from the Healthy Days Measures and demonstrated acceptable validity of the estimates. Because the Healthy Days Measures have been included in many state and local surveys, preliminary cost-utility analyses and determination of burden of disease might be able to be conducted at the national, state, and community levels as well as over time.

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    • "This study applied a previously constructed algorithm to obtain values for the EuroQol five-dimensional questionnaire index, a preference-based HRQOL measure, for respondents in the BRFSS, based on their age and answers to these four questions [12] [20]. This algorithm provides valid estimates of EuroQol fivedimensional questionnaire scores of the US population by some demographic subgroups and common health conditions from the BRFSS [12] [20], and the bias of estimated QALE from these scores has been estimated to be less than 1% of that using the actual EuroQol five-dimensional questionnaire questions [11]. The BRFSS includes a set of core questions asked in all 50 states and the District of Columbia and a set of modular questions asked in a subset of states. "
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    ABSTRACT: Quality-adjusted life expectancy (QALE) is a summary measure that combines mortality and health-related quality of life across different stages of life. The objective of this study was to estimate QALE loss due to five chronic diseases-diabetes mellitus, hypertension, asthma, heart disease, and stroke. Health-related quality of life scores were from the 1993-2009 Behavioral Risk Factor Surveillance System. Using age-specific deaths from the Compressed Mortality File, this study constructed life tables to calculate losses in life expectancy and QALE due to each of the five diseases from 1993 through 2009 and for 50 US states and the District of Columbia. In 2009, the individual-level QALE loss for diabetic people, compared with nondiabetic people, was 11.1 years; for those with hypertension, 6.3 years; for those with asthma, 7.0 years; for those with heart disease, 10.3 years; and for those with stroke, 12.4 years. At the population level, diabetes, hypertension, asthma, heart disease, and stroke contributed 1.9, 2.2, 0.8, 1.2, and 0.8 years of population QALE loss at age 18 years, respectively. Persons with each of the five diseases had significantly lower life expectancy and QALE. Because the prevalence of diabetes and hypertension has increased significantly in the United States in the last two decades, the burdens of these two conditions, measured by population QALE losses, had increased 83% and 29% from 1993 to 2009, respectively. Also, by examining changes in population QALE loss at different ages, policymakers can identify age groups most affected by particular diseases and develop the most cost-effective interventions by focusing on these groups.
    Full-text · Article · Feb 2013 · Value in Health
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    • "The primary outcome was general health state (physical and mental component), determined with the Short Form-12 Health Survey (SF-12) [32]. The secondary outcome was health related quality of life, determined with the Spanish version of EuroQoL-5D (EuroQoL-5D and EuroQol-VAS [33,34]. "
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    ABSTRACT: Musculoskeletal disorders are major causes of morbidity in the world, and these conditions have a strong negative influence in terms of health-related quality of life. The purpose of this study was to evaluate the effect of an 8-week multimodal physical therapy program on general health state and health-related quality of life in patients with chronic musculoskeletal disorders. There were 244 participants in this prospective cohort analysis with 8-week follow-up. The primary outcome was general health state (physical and mental components), determined with the Short Form-12 Health Survey (SF-12). The secondary outcome was health related quality of life, determined with the EuroQoL-5D and VAS. The intervention was evaluated by comparing pre- and post-outcome measurements. T-tests were performed for paired data. Differences were statistically significant for physical health state: +1.68 (p < 0.05) (baseline: 42.38); mental health state: +3.15 (p < 0.001) (baseline: 46.57); and health related quality of life: +0.18 (EuroQoL 5D) (baseline: 46.57) and +7.22 (EuroQoL_VAS) (p < 0.001) (baseline: 60.81). Intervention resulted in clinically relevant changes in terms of percentage improvement from baseline scores. Eight weeks of a Multimodal Physical Therapy Program seemed to moderately enhance the general health state and HRQoL of patients with chronic musculoskeletal diseases. This kind of therapeutic exercise can be recommended to patients with chronic low back pain, chronic neck pain and osteoarthritis, at least in the short term.
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    • "The EQ-5D valuation questionnaire comprises a visual analogue scale which was not included in this research. It has shown to be a acceptable and valid tool, with an average estimation of 0.87 [17]. "
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    ABSTRACT: The purpose is to assess cardiopulmonary function outcomes and quality of life values in inactive people that participated in the Physical Activity Promotion Programme (PAPP) against the control group that did not perform this program. A total of 100 subjects of both genders participated in the randomized controlled trial with systematic random sampling; all were aged 55 and older, from Torremolinos, Spain. Participants either received (n = 50) the PAPP for 60 minutes, twice a week during three months or (n = 50) they received health education. The effectiveness of the intervention was measured by general state of health the Short Form 12 health survey questionnaire, and the quality of life was determined with the EuroQoL-5D questionnaire. Cardiopulmonary function was measured with a spirometry and a walking test according to the Bruce protocol. This pilot study had a significant impact on the quality of life (p = 0.05) in men, which increased. However, the quality of life in women did not improve. The average changes in the lung and cardiovascular function was not significant between groups. Changes in the quality of life measured with EQ-5D in the group of men who carried out the PAPP were statistically significant when comparing between groups. However changes in cardiopulmonary function were not as relevant when comparing between groups. There was a significant effect within each group in the pulmonary outcomes of values in men, within the experimental group. Trial registration Developed by the University of Málaga. ID: NCT01172483.
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