Hybrid Methodology to Improve Health Status Utility Values Derivation Using EQ-5D-5L and Advanced Multi-Criteria Techniques.

Johanna Vásquez,Sergio Botero

doi:10.3390/ijerph17041423

Abstract

This paper presented a new approach to the calculation of quality-adjusted life years (QALY) based on multi-criteria decision-making (MCDM) methods and using the EQ-5D-5L questionnaire. The health status utility values were calculated through a hybrid methodology. We combined the analytic hierarchy process (AHP), the AHP with a D-number extended fuzzy preference relation (D-AHP), the fuzzy analytic hierarchy process (F-AHP), and the technique for order preference by similarity to the ideal solution (TOPSIS) to obtain individual and aggregated utility values. The preference data were elicited using a sample of individuals from a Colombian university. In all tested methods, the ordinal preferences were consistent, and the weights were compared using the Euclidean distance criterion (EDC). We identified F-AHP-TOPSIS as the optimal method; its benefits were associated with modeling the response options of the EQ-5D in linguistic terms, it gave the best approximation to the initial preferences according to EDC, and it could be used as an alternative to the known prioritization method. This hybrid methodology was particularly useful in certain medical decisions concerned with understanding how a specific person values his or her current health or possible health outcomes from different interventions in small population samples and studies carried out in low- and middle-low-income countries.

Highlights

Decision-making is a natural process in which a person chooses one course of action from a finite set, where each action leads to possible states according to a probability distribution associated with their expected utility value [1]
79% of the interviewees associated the self-care and usual activities dimensions with the capacity of mobility; no significant differences were found in demographic characteristics, which could show the possibility of dependence among the health status dimensions
The hybrid method approach has some attractive properties, such as a low-cost survey process, The hybrid methodalgorithm, approachahas someconsistency attractive properties, such as a low‐cost process, a simple mathematical natural index, rank preservation, andsurvey precision, and ait simple mathematical algorithm, a natural consistency index, rank preservation, and precision, and can be used as an alternative to the known prioritization methods. It can be applied it be used as andecisions alternative to the known prioritization methods. It can be incan certain medical concerned with understanding how a specific person values hisapplied or her in certain medical decisions concerned with understanding how a specific person values his or her current health or possible health outcomes from different interventions in small population samples, current health or possible health outcomes from different interventions in small population samples, and it is useful for studies carried out in low- and middle-low-income countries, which do and it is carriedestimation out in low‐and and middle‐low‐income countries, which not have a populationuseful valuefor set studies for the quality-adjusted life years (QALY)

Summary

Introduction

Decision-making is a natural process in which a person chooses one course of action from a finite set, where each action leads to possible states according to a probability distribution associated with their expected utility value [1]. Healthcare decision-making is based on economic assessment through a cost-utility or effectiveness analysis In these studies, utility values are measured through social preferences for health states and are expressed in quality-adjusted life years (QALY). The prioritization method to measure utility values uses the EQ-5D questionnaire and applies the time tradeoff (TTO) to elicit preferences and the visual analog scale (VAS) to establish a reference point. This conventional measurement assigns only a utility value that describes a particular health status and aggregates individual subjective utility values to make objective social decisions.

Methods

Results

Conclusion