Mendwas D Dzingina1, Paul McCrone2, Irene J Higginson1. 1. 1 Department of Palliative Care, Policy & Rehabilitation, Cicely Saunders Institute, King's College London, London, UK. 2. 2 King's Health Economics, King's College London, London, UK.
Abstract
BACKGROUND: The main measure to generate utility data for economic evaluations is the EQ-5D, but no study has tested whether or how to map from palliative care measures to the EQ-5D. AIMS: To assess the level of conceptual overlap between palliative outcomes and the EQ-5D, and the feasibility of mapping between them to obtain utilities for the Palliative care Outcome Scale. DESIGN: A cross-sectional secondary analysis of data from three studies. SETTING/PARTICIPANTS: Patients receiving palliative care and bereaved relatives, recruited from three tertiary National Health Service hospitals in South London. METHODS: The overlap between both measures was assessed using principal component analysis. The Palliative care Outcome Scale was mapped onto the EQ-5D using three regression models. RESULTS: Spearman's correlations between both instruments were low (mean rho = 0.11). The principal component analysis showed the Palliative care Outcome Scale is associated with only two EQ-5D dimensions (pain; and anxiety/depression). No Palliative care Outcome Scale items loaded onto the mobility, self-care and usual activities dimensions of the EQ-5D. The mapping models performed poorly at predicting utilities from Palliative care Outcome Scale data (mean absolute error >0.3 and R2 <0.10). Hence, none of the models can be recommended as acceptable for calculating utilities from Palliative care Outcome Scale responses. CONCLUSION: Differences between the Palliative care Outcome Scale and the EQ-5D do not undermine the qualities of either instrument when used for their own purposes. However, due to conceptual differences, the EQ-5D does not capture some of the concerns measured by the Palliative care Outcome Scale, and therefore, mapping onto the EQ-5D is unlikely to provide an appropriate basis for estimating utilities for conducting economic evaluations in palliative care studies.
BACKGROUND: The main measure to generate utility data for economic evaluations is the EQ-5D, but no study has tested whether or how to map from palliative care measures to the EQ-5D. AIMS: To assess the level of conceptual overlap between palliative outcomes and the EQ-5D, and the feasibility of mapping between them to obtain utilities for the Palliative care Outcome Scale. DESIGN: A cross-sectional secondary analysis of data from three studies. SETTING/PARTICIPANTS: Patients receiving palliative care and bereaved relatives, recruited from three tertiary National Health Service hospitals in South London. METHODS: The overlap between both measures was assessed using principal component analysis. The Palliative care Outcome Scale was mapped onto the EQ-5D using three regression models. RESULTS: Spearman's correlations between both instruments were low (mean rho = 0.11). The principal component analysis showed the Palliative care Outcome Scale is associated with only two EQ-5D dimensions (pain; and anxiety/depression). No Palliative care Outcome Scale items loaded onto the mobility, self-care and usual activities dimensions of the EQ-5D. The mapping models performed poorly at predicting utilities from Palliative care Outcome Scale data (mean absolute error >0.3 and R2 <0.10). Hence, none of the models can be recommended as acceptable for calculating utilities from Palliative care Outcome Scale responses. CONCLUSION: Differences between the Palliative care Outcome Scale and the EQ-5D do not undermine the qualities of either instrument when used for their own purposes. However, due to conceptual differences, the EQ-5D does not capture some of the concerns measured by the Palliative care Outcome Scale, and therefore, mapping onto the EQ-5D is unlikely to provide an appropriate basis for estimating utilities for conducting economic evaluations in palliative care studies.
Authors: Mohamed El Alili; Hanneke J A Smaling; Karlijn J Joling; Wilco P Achterberg; Anneke L Francke; Judith E Bosmans; Jenny T van der Steen Journal: BMC Health Serv Res Date: 2020-09-04 Impact factor: 2.655
Authors: Mohamed El Alili; Claudia S E W Schuurhuizen; Annemarie M J Braamse; Aartjan T F Beekman; Mecheline H van der Linden; Inge R Konings; Joost Dekker; Judith E Bosmans Journal: Palliat Med Date: 2020-04-29 Impact factor: 4.762
Authors: Paul Mark Mitchell; Joanna Coast; Gareth Myring; Federico Ricciardi; Victoria Vickerstaff; Louise Jones; Shazia Zafar; Sarah Cudmore; Joanne Jordan; Laurie McKibben; Lisa Graham-Wisener; Anne M Finucane; Alistair Hewison; Erna Haraldsdottir; Kevin Brazil; W George Kernohan Journal: BMC Palliat Care Date: 2020-08-07 Impact factor: 3.234