Relative Importance Of Domains Research Articles

Value Set for the EQ-5D-Y-3L in Hungary.

BackgroundThe Hungarian health technology assessment guidelines recommend the use of the EuroQol instrument family in quality-adjusted life-year calculations. However, no national value set exists for the EQ-5D-Y-3L or any other youth-specific instrument.ObjectiveThis study aims to develop a national value set of the EQ-5D-Y-3L for Hungary based on preferences of the general adult population.MethodsThis study followed the international valuation protocol for the EQ-5D-Y-3L. Two independent samples, representative of the Hungarian general adult population in terms of age and sex were recruited to complete online discrete choice experiment (DCE) tasks and composite time trade-off (cTTO) tasks by computer-assisted personal interviews. Adults valued hypothetical EQ-5D-Y-3L health states considering the health of a 10-year-old child. DCE data were modelled using a mixed logit model with random-correlated coefficients. Latent DCE utility estimates were mapped onto mean observed cTTO utilities using ordinary least squares regression.ResultsOverall, 996 and 200 respondents completed the DCE and cTTO surveys, respectively. For each domain, the value set resulted in larger utility decrements with more severe response levels. The relative importance of domains by level 3 coefficients was as follows: having pain or discomfort > feeling worried, sad or unhappy > mobility > doing usual activities > looking after myself. Overall, 12.3% of all health states had negative utilities in the value set, with the worst health state having the lowest predicted utility of − 0.485.ConclusionThis study developed a national value set of the EQ-5D-Y-3L for Hungary. The value set enables to evaluate the cost utility of health technologies for children and adolescents based on societal preferences in Hungary.Supplementary InformationThe online version contains supplementary material available at 10.1007/s40273-022-01190-2.

A patient-derived conceptual framework of lung cancer care priorities.

206 Background: Patient-centric healthcare delivery, where patients are the ultimate decision-makers, warrants care evaluated based on patient priorities. A heterogeneous lung cancer patient population fosters variation in care priorities. This study identified care concept domains in a wholly patient-driven manner. Methods: Group concept mapping was used to assess priorities among patients invited from the PatientsLikeMe online community aged ≥18, US residents, and self-reporting lung cancer. In Phase I, 26 patients generated ideas based on the focus prompt: “ What do you want to achieve when it comes to the treatment you are receiving or are considering receiving for your lung cancer?”. 78 ideas were generated over 2 weeks. Supplementation from literature, editing for relatability, independence, and consistency yielded 78 concepts. In Phase II 67 patients used CSGlobalMax® (Concept Systems, 2018) to rate the concepts for importance (1 = not important to 5 = very important); 64 of which grouped and named the ideas into categories of unrestricted size. Multidimensional scaling and hierarchical cluster analysis generated visual maps, average importance, and categorized concept domains. Domains were compared across all patients and by treatment experience (≤1 or > 1 systemic regimens) and stage at diagnosis. Results: Patients were female (78%), white (93%), and mean age of 62 (SD 8.9). 93% reported non-small cell lung cancer, 70% reported Stage III or IV diagnosis, and 58% were classified as early in treatment experience. 11 unique domains were visually represented. In order of average importance the domains were: managing lifestyle (4.52), care team quality, active participation in treatment, treatment goals, treatment options, side effects, social well-being, physical well-being, future options, fulfillment in daily living, and supportive environment (4.01). There was strong correlation between treatment subgroups (r = 0.89), although relative importance of domains shifted. Generalizability is limited. Conclusions: In this patient-driven research approach, patients developed the focus prompt, generated ideas, and structured concepts. The unique domains may help evaluate care value in patient-centric healthcare delivery.

Health-Related Quality of Life After Stroke: Does Response Shift Occur in Self-Perceived Physical Function?

Barclay-Goddard R, Lix LM, Tate R, Weinberg L, Mayo NE. Health-related quality of life after stroke: does response shift occur in self-perceived physical function? Objective To determine whether response shift (a change in the self-perceived meaning of health-related quality of life [HRQL]) was present in a model of physical function over time poststroke. Design Secondary data analysis of a longitudinal observational study. Setting Community. Participants A consecutive sample of stroke survivors (N=677) at 1, 3, 6, and 12 months poststroke was included. Sixty-seven individuals were approached, but refused. Sixty-seven percent completed the study at 12 months. Mean age was 68 years; 45% of the participants were women. Interventions Not applicable. Main Outcomes Measures The Medical Outcomes Study 36-Item Short-Form Health Survey, Euroqol, Stroke Impact Scale, Preference-Based Stroke Index, and the Health Utilities Index. Results Structural equation modeling was used to identify response shift. A chi-square difference test between constrained and unconstrained longitudinal models suggested the presence of response shift in the data. Reprioritization response shift, a change in relative importance of domains, was observed for physical activites. Recalibration response shift, a change in internal standards of measurement, was observed in physical activities, stairs, walking, and hand function. Conclusions Response shift has implications for the measurement of change in physical function. Measures that focus on difficulty in task performance may be sensitive to response shift, resulting in a change in perceived HRQL over time. This has implications for choosing self-perceived or performance-based measures to detect change in physical function.