Determining the value of hand surgery through mapping algorithms

Introduction: Health state utility values describe the desirability of health states and are needed to calculate quality-adjusted life years. Traditionally, they are derived using generic measures such as the EuroQol 5-Dimension scale. No hand-specific measures can be used to derive them. This study aimed to develop and evaluate mapping algorithms to estimate the EuroQol 5-Dimension utility index from the Patient Evaluation Measure. Methods: Matched Patient Evaluation Measures and EuroQol 5-Dimension 5-Level data from 2043 patients were used to develop mapping algorithms. Transfer-to-utility models were developed and assessed through a 1000-fold bootstrap validation. Results: We present a range of mapping algorithms to derive health state utility values from the Patient Evaluation Measure, a commonly used hand-specific Patient Reported Outcome Measure (PROM). The population-level prediction error of our best performing models was clinically relevant. Conclusions: This suggests that mapping hand-specific PROMs on to generic preference-based measures may not be appropriate. Level of evidence: II