Abstract
The PROMIS Preference score (PROPr) is a new generic, societal, and preference-based health-related quality of life (HRQoL) score which can be used as utility score for Quality-adjusted life years (QALY) in cost-effectiveness analyses. It is the first of its kind using modern instruments based on Item Response Theory (IRT). The PROPr contains seven PROMIS domains: cognition, depression, fatigue, pain, physical function, sleep disturbance, and ability to participate in social roles and activities. It was developed with the preferences of the US general population. The aim of this study is to validate the PROPr in independent data of German patients and compare it to their outcomes in the established EQ-5D-5L index value. We collected PROPr and EQ-5D-5L index value from 68 patients in the rheumatology ward at Charité University Medicine Berlin between March 18th and Mai 31st 2018. We conducted descriptive statistical analyses comparing both scores across age, gender and conditions, as well as their correlation and distribution over the full range of health. The mean PROPr (0.35, 95%CI: 0.32; 0.38) score and the mean EQ-5D-5L index value (0.75, 95%CI: 0.70; 0.80) differ significantly (d = 0.40, p < 0.001). The Pearson correlation coefficient between both scores was observed to be 0.53 (95%CI: 0.33; 0.68) compared to 0.70 in the US valuation survey. Both scores have similar discrimination across gender but not across age and conditions. While the PROPr is approximately normally distributed, the EQ-5D-5L index value shows a ceiling effect, indicating a limited range of measurement. Our analysis suggests that PROPr and EQ-5D-5L index value are not equivalent in German patients, which would greatly affect QALY in cost-effectiveness analyses. Evaluation of PROPr health states in German preferences and larger samples could resolve this. Further research should address which instrument more accurately reflects health utility.
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