Abstract
ObjectiveA ‘lite’ version of the EQ-5D-5L valuation protocol, which requires a smaller sample by collecting more data from each participant, was proposed and used to develop an EQ-5D-5L value set for Uganda.MethodsAdult respondents from the general Ugandan population were quota sampled based on age and sex. Eligible participants were asked to complete 20 composite time trade-off tasks in the tablet-assisted personal interviews using the offline EuroQol Portable Valuation Technology software under routine quality control. No discrete choice experiment task was administered.The composite time trade-off data were modelled using four additive and two multiplicative regression models. Model performance was evaluated based on face validity, prediction accuracy in cross-validation and in predicting mild health states. The final value set was generated using the best-performing model.ResultsA representative sample (N = 545) participated in this study. Responses to composite time trade-off tasks from 492 participants were included in the primary analysis. All models showed face validity and generated comparable prediction accuracy. The Tobit model with constrained intercepts and corrected for heteroscedasticity was considered the preferred model for the value set on the basis of better performance. The value set ranges from − 1.116 (state 55555) to 1 (state 11111) with ‘pain/discomfort’ as the most important dimension.ConclusionsThis is the first EQ-5D-5L valuation study using a ‘lite’ protocol involving composite time trade-off data only. Our results suggest its feasibility in resource-constrained settings. The established EQ-5D-5L value set for Uganda is expected to be used for economic evaluations and decision making in Uganda and the East Africa region.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-021-01101-x.
Highlights
The EQ-5D family of instruments has been widely used around the world as a measure of health outcomes to inform resource allocation and decision making
In the recently available EQ-5D-5L value set for Peru [22], the authors explored the feasibility of a protocol using discrete choice experiment (DCE) data; the results suggest substantial differences between composite time tradeoff (cTTO)-derived and DCEderived values
When the respondents indicate that they would rather die (0 years in full health) than have to live in a health state for 10 years, this state is considered ‘worse than dead’ and the respondents move into the lead time time tradeoff (TTO) (LT-TTO), in which they are asked to choose between 10 years of full health in life A, and 10 years of full health in life B followed by 10 years in the health state that is valued
Summary
The EQ-5D family of instruments has been widely used around the world as a measure of health outcomes to inform resource allocation and decision making. The value set accompanying EQ-5D represents the preferences of the general population of a country/region for health states defined by EQ-5D. It generates preference-based health-related quality-of-life scores on a scale anchored at 1 (full health) and 0 (dead), which allows quality-adjusted life-year (QALY) calculations, often used in economic evaluations. The EuroQol group developed a standardised valuation study protocol, the EuroQol Valuation Technology (EQ-VT), to create value sets for the EQ-5D-5L [5]. EQ-5D-5L value sets have been developed in several countries, mainly in Asia [6,7,8,9,10,11], Europe [12,13,14,15,16,17], North America [18,19,20] and South America [21, 22]
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