Mihir Gandhi1, Ru San Tan2, Shir Lynn Lim3, Kim Rand4, Carolyn S P Lam2, Nan Luo5, Yin Bun Cheung6. 1. Biostatistics, Singapore Clinical Research Institute, Singapore; Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; Centre for Child Health Research, Tampere University, Finland. Electronic address: mihir.gandhi@scri.cris.sg. 2. Department of Cardiology, National Heart Centre Singapore, Singapore. 3. Department of Cardiology, National University Heart Centre, Singapore. 4. Health Services Research Centre, Akershus University Hospital, Lørenskog, Norway; Maths in Health B. V, Rotterdam, The Netherlands. 5. Saw Swee Hock School of Public Health, National University of Singapore, Singapore. 6. Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore; Centre for Child Health Research, Tampere University, Finland.
Abstract
OBJECTIVES: Several studies have shown that patients with heart disease value hypothetical health states differently from the general population. We aimed to investigate the health preferences of patients with heart disease and develop a value set for the 5-level EQ-5D (EQ-5D-5L) based on these patient preferences. METHODS: Patients with confirmed heart disease were recruited from 2 hospitals in Singapore. A total of 86 EQ-5D-5L health states (10 per patient) were valued using a composite time trade-off method according to the international valuation protocol for EQ-5D-5L; 20-parameter linear models and 8-parameter cross-attribute level effects models with and without an N45 term (indicating whether any health state dimension at level 4 or 5 existed) were estimated. Each model included patient-specific random intercepts. Model performance was evaluated for out-of-sample and in-sample predictive accuracy in terms of root mean square error. The discriminative ability of the utility values was assessed using heart disease-related functional classes. RESULTS: A total of 576 patients were included in the analysis. The preferred model, with the lowest out-of-sample root mean square error, was a 20-parameter linear model including N45. Predicted utility values ranged from -0.727 for the worst state to 1 for full health; the value for the second-best state was 0.981. Utility values demonstrated good discriminative ability in differentiating among patients of varied functional classes. CONCLUSIONS: An EQ-5D-5L value set representing the preferences of patients with heart disease was developed. The value set could be used for patient-centric economic evaluation and health-related quality of life assessment for patients with heart disease.
OBJECTIVES: Several studies have shown that patients with heart disease value hypothetical health states differently from the general population. We aimed to investigate the health preferences of patients with heart disease and develop a value set for the 5-level EQ-5D (EQ-5D-5L) based on these patient preferences. METHODS: Patients with confirmed heart disease were recruited from 2 hospitals in Singapore. A total of 86 EQ-5D-5L health states (10 per patient) were valued using a composite time trade-off method according to the international valuation protocol for EQ-5D-5L; 20-parameter linear models and 8-parameter cross-attribute level effects models with and without an N45 term (indicating whether any health state dimension at level 4 or 5 existed) were estimated. Each model included patient-specific random intercepts. Model performance was evaluated for out-of-sample and in-sample predictive accuracy in terms of root mean square error. The discriminative ability of the utility values was assessed using heart disease-related functional classes. RESULTS: A total of 576 patients were included in the analysis. The preferred model, with the lowest out-of-sample root mean square error, was a 20-parameter linear model including N45. Predicted utility values ranged from -0.727 for the worst state to 1 for full health; the value for the second-best state was 0.981. Utility values demonstrated good discriminative ability in differentiating among patients of varied functional classes. CONCLUSIONS: An EQ-5D-5L value set representing the preferences of patients with heart disease was developed. The value set could be used for patient-centric economic evaluation and health-related quality of life assessment for patients with heart disease.
Authors: Kar-Fu Yeung; Yu Qi Lee; Mary Foong Fong Chong; Mihir Gandhi; Amanda Yun Rui Lam; Selly Julianty; Gilbert Choon Seng Tan; Emily Tse Lin Ho; Su-Yen Goh; Gavin Siew Wei Tan; Eugene Jin Wen Shum; Eric A Finkelstein; Tazeen H Jafar; Rob M van Dam; Yee Leong Teoh; Julian Thumboo; Yong Mong Bee Journal: BMJ Open Diabetes Res Care Date: 2022-10