Abstract
BackgroundEQ-5D health state utilities (HSU) are commonly used in health economics to compute quality-adjusted life years (QALYs). The EQ-5D, which is country-specific, can be derived directly or by mapping from self-reported health-related quality of life (HRQoL) scales such as the PROMIS-29 profile. The PROMIS-29 from the Patient Reported Outcome Measures Information System is a comprehensive assessment of self-reported health with excellent psychometric properties. We sought to find optimal models predicting the EQ-5D-5L crosswalk from the PROMIS-29 in the United Kingdom, France, and Germany and compared the prediction performances with that of a US model.MethodsWe collected EQ-5D-5L and PROMIS-29 profiles and three samples representative of the general populations in the UK (n = 1509), France (n = 1501), and Germany (n = 1502). We used stepwise regression with backward selection to find the best models to predict the EQ-5D-5L crosswalk from all seven PROMIS-29 domains. We investigated the agreement between the observed and predicted EQ-5D-5L crosswalk in all three countries using various indices for the prediction performance, including Bland–Altman plots to examine the performance along the HSU continuum.ResultsThe EQ-5D-5L crosswalk was best predicted in France (nRMSEFRA = 0.075, nMAEFRA = 0.052), followed by the UK (nRMSEUK = 0.076, nMAEUK = 0.053) and Germany (nRMSEGER = 0.079, nMAEGER = 0.051). The Bland–Altman plots show that the inclusion of higher-order effects reduced the overprediction of low HSU scores.ConclusionsOur models provide a valid method to predict the EQ-5D-5L crosswalk from the PROMIS-29 for the UK, France, and Germany.
Highlights
EuroQoL 5 dimensions (EQ-5D) health state utilities (HSU) are commonly used in health economics to compute qualityadjusted life years (QALYs)
A QALY is defined as the product of the number of life years and a health state utility (HSU) score that represents the value of a particular health state
The EQ-5D-5 levels (5L) crosswalk is the default HSU score for economic evaluations demanded by Health technology assessments (HTA) agencies such as National Institute of Health and Clinical Excellence (NICE) [4,5,6,7]
Summary
EQ-5D health state utilities (HSU) are commonly used in health economics to compute qualityadjusted life years (QALYs). Quality-adjusted life years (QALYs) are routinely used in cost-utility analyses (CUA) to evaluate the economic effectiveness of health care innovations or interventions [1]. A QALY is defined as the product of the number of life years and a health state utility (HSU) score that represents the value of a particular health state. Individual HSU scores are patient-reported, generic, preference-based measures of health-related quality of life (HRQoL) [3]. The most frequently used generic HRQoL measure is the EuroQoL EQ-5D-5L crosswalk differentiating 3125 (i.e., 55) health states. The EQ-5D-5L crosswalk is the default HSU score for economic evaluations demanded by HTA agencies such as NICE [4,5,6,7]
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