Key result
EHS-based valuation reproduces actual patient-reported quality of life more accurately than traditional GHS-based valuation.
Why the study?
Quality of life as an endpoint in clinical studies may be sensitive to the value set used to derive a single score, and it is unclear how well different EQ-5D-3L value sets reproduce patients' reported valuations.
Does the EHS-VAS value set improve accuracy in estimating patient-reported quality of life compared to GHS-TTO in post-myocardial infarction rehabilitation patients?
Cohort (n=145)
Comprehensive cohort design (most allocated on preference)
Does the EHS-VAS value set improve accuracy in estimating patient-reported quality of life compared to GHS-TTO in post-myocardial infarction rehabilitation patients?
Answers are grounded in this paper and cite their sources.
Experienced health states-based value sets provide a more accurate reflection of actual patient-reported quality of life in post-MI rehabilitation compared to traditional economic utility measurements.
BACKGROUND: Quality of life as an endpoint in a clinical study may be sensitive to the value set used to derive a single score. Focusing on patients' actual valuations in a clinical study, we compare different value sets for the EQ-5D-3L and assess how well they reproduce patients' reported results. METHODS: A clinical study comparing inpatient (n = 98) and outpatient (n = 47) rehabilitation of patients after an acute coronary event is re-analyzed. Value sets include: 1. Given health states and time-trade-off valuation (GHS-TTO) rendering economic utilities; 2. Experienced health states and valuation by visual analog scale (EHS-VAS). Valuations are compared with patient-reported VAS rating. Accuracy is assessed by mean absolute error (MAE) and by Pearson's correlation ρ. External validity is tested by correlation with established MacNew global scores. Drivers of differences between value sets and VAS are analyzed using repeated measures regression. RESULTS: EHS-VAS had smaller MAEs and higher ρ in all patients and in the inpatient group, and correlated best with MacNew global score. Quality-adjusted survival was more accurately reflected by EHS-VAS. Younger, better educated patients reported lower VAS at admission than the EHS-based value set. EHS-based estimates were mostly able to reproduce patient-reported valuation. Economic utility measurement is conceptually different, produced results less strongly related to patients' reports, and resulted in about 20 % longer quality-adjusted survival. CONCLUSION: Decision makers should take into account the impact of choosing value sets on effectiveness results. For transferring the results of heart rehabilitation patients from another country or from another valuation method, the EHS-based value set offers a promising estimation option for those decision makers who prioritize patient-reported valuation. Yet, EHS-based estimates may not fully reflect patient-reported VAS in all situations.
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Leidl et al. (2016) conducted a cohort in Acute myocardial infarction undergoing rehabilitation (n=145). Experienced health states valuation by visual analog scale (EHS-VAS) value set vs. Given health states and time-trade-off (GHS-TTO) value set was evaluated on Accuracy in reproducing patient-reported VAS rating (assessed by mean absolute error and Pearson's correlation). The experienced health states (EHS-based) value set more accurately reproduced actual patient-reported quality of life valuations than the traditional given health states (GHS-based) value set.
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