Abstract
BackgroundUtility values can be obtained from different respondent groups, including patients and members of the general public. Evidence suggests that patient values are typically higher than general public values. This study explores whether the magnitude of disagreement between both values can be explained by socio-demographic characteristics and/or health status.MethodsData of 5037 chronic low back pain patients were used. Self-reported EQ-VAS was employed as a proxy of patients’ preference for their own health state. General public values for the patients’ EQ-5D-3L health states were obtained using the Dutch VAS-based tariff. The difference between patient and general public values was assessed using a paired t-test. Subsequently, this difference was used as a dependent variable and regressed upon dummy variables of socio-demographic and health status characteristics. Coefficients represented age, gender, education level, social support, back pain intensity, leg pain intensity, functional status, comorbidities, catastrophizing, and treatment expectations.ResultsPatient values were higher than general public values (0.069; 95%CI:0.063–0.076). The magnitude of disagreement between both values was associated with age, gender, education level, social support, functional status, and comorbidities, but not with back pain intensity, leg pain intensity, catastrophizing, and treatment expectations.ConclusionsPatients were found to value their own health status higher than members of the general public. The magnitude of disagreement between both values was found to differ by various socio-demographic and/or health status characteristics. This suggest that patient characteristics account for a relevant fraction of the identified disagreements between patient and general public values, and that mechanisms thought to be responsible for these disagreements, such as adaptation and response shift, have a differential impact across patient sub-groups.
Highlights
Utility values are commonly used in economic evaluations to calculate quality adjusted life years (QALYs), an index encompassing duration and quality of life
This study aims to build on the previous work by exploring whether the magnitude of disagreement between patient and general public values differs by socio-demographic group and/or health status in a large consecutive cohort of chronic low back pain patients
The magnitude of disagreement between patient and general public values was found to be statistically significantly associated with all socio-demographic variables, i.e. age, gender, education level, and social support as well as two health status variables, i.e. functioning and comorbidities (Table 3)
Summary
Utility values are commonly used in economic evaluations to calculate quality adjusted life years (QALYs), an index encompassing duration and quality of life. The basic construct of a QALY is that people move through different health states over time, all of which have a certain value attached to it [1]. Such values, referred to as utility values, can be estimated using multiple sources, including preferences from patients, carers, health professionals, and members of the general public [1, 2]. There is no agreement on whose preferences should be used to obtain utility values Agencies, such as the United Kingdom National Institute for Health and Care Excellence and the Dutch Health Care Institute, advocate the use of general public preferences for the assessment of new healthcare services [3, 4]. This study explores whether the magnitude of disagreement between both values can be explained by socio-demographic characteristics and/or health status
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