Abstract
Background: Preference weights for EQ-5D-3L based on visual analogue scale (VAS) has recently been developed in Iran. The aim of the current study was to compare performance of this value set against the UK VAS-based value set. Methods: The mean scores for all possible 243 health states were compared using Student t test. Absolute agreement and consistency were investigated using concordance correlation coefficient (CCC) and Bland-Altman plot. Health gains for 29 403 possible transitions between pairs of EQ-5D-3L health states were compared. Responsiveness to change and discriminative ability across subgroups of health transitions were assessed. Results: The mean EQ-5D-3L scores were similar for two value sets (mean = 0.31, P = 1.00). For 36% of health states, the absolute differences were greater than 0.10. There were three pairwise logical inconsistencies in the Iranian value set. The Iranian scores were lower (higher) for severe (mild) health states than the United Kingdom. The CCC (95% CI) was 0.85 (0.81 to 0.88) and Bland-Altman plot showed good agreement. The mean health gain for all possible transitions predicted by the Iranian value set was higher (0.22 vs. 0.20, P < .001) and two value sets predicted opposite transitions in 15% of transitions. The responsiveness of these two value sets were similar with lower discriminative ability for Iranian value set. Conclusion: The Iranian value set attribute lower values to most severe health states and higher values to mild health states compared with the UK value set. Such systematic differences might translate into discrepant health gains and cost-effectiveness which should be taking into account for informed decision-making.
Highlights
The EQ-5D-3L is a widely used generic preference-based measure to elicit health state utility values for use in costutility analyses
The mean (SD) of the EQ-5D-3L index score predicted by the Iranian and UK value sets were 0.31 (0.20) and 0.31 (0.18), Table 1
The Bland-Altman plots (Figure 3) showed that there was a good agreement between two value sets and more than 96% of the differences in EQ-5D-3L index scores fell within the 95% limits of agreement
Summary
The EQ-5D-3L is a widely used generic preference-based measure to elicit health state utility values for use in costutility analyses. It comprises five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/ depression. Each dimension has 3 levels: no problems, some problems, extreme problems; resulting in 243 (35) possible health states.[1] Each health state is assigned an index score by applying a value set elicited from general population or from patients. There are several valuation techniques to elicit value sets including time trade-off (TTO), standard gamble (SG), visual analogue scale (VAS), person trade-off, and more recently discrete choice experiment (DCE).[2,3] Among these, the TTO
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