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Quality-adjusted life years (QALYs) represent a critical metric in economic evaluations impacting key healthcare decisions in many countries. However, there is widespread disagreement as to which is the best of the health state utility (HSU) instruments that are designed to measure the Q in the QALY. Instruments differ in their descriptive systems as well as their valuation methodologies; that is, they simply measure different things. We propose a visual framework that can be utilized to make meaningful comparisons across HSU instruments.
The framework expands on existing HRQoL models, by incorporating four distinctive continua, and by putting HRQoL within the broader notion of subjective well-being (SWB). Using this conceptual map, we locate the five most widely used HSU-instruments (EQ-5D, SF-6D, HUI, 15D, AQoL).
By individually mapping dimensions onto this visual framework, we provide a clear picture of the significant conceptual and operational differences between instruments. Moreover, the conceptual map demonstrates the varying extent to which each instrument moves outside the traditional biomedical focus of physical health, to also incorporate indicators of mental health and social well-being.
Our visual comparison provides useful insights to assess the suitability of different instruments for particular purposes. Following on from this comparative analyses, we extract some important lessons for a new instrument that cover the domains of physical, mental and social aspects of health, i.e. it is in alignment with the seminal 1948 WHO definition of health.
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford: Oxford University Press.
Richardson, J., Khan, M. A., Iezzi, A., & Maxwell, A. (2015). Comparing and explaining differences in the magnitude, content, and sensitivity of utilities predicted by the EQ-5D, SF-6D, HUI 3, 15D, QWB, and AQoL-8D multiattribute utility instruments. Medical Decision Making, 35, 276–291. CrossRefPubMed
Peasgood T, Brazier JE, Mukuria C, Rowan D (2014) A conceptual comparison of well- being measures used in the UK. Project Report. Policy Research Unit in Economic Evaluation of Health and Care Interventions (EEPRU) (26). Policy Research Unit in Economic Evaluation of Health and Care Interventions
Cummins, R. A. (2010). Fluency disorders and life quality: Subjective wellbeing vs health-related quality of life. Journal of Fluency Disorders, 25(3), 161–172. CrossRef
Michalos, A. C. (2004). Social indicators research and health-related quality of life research. Social Indicators Research, 65(1), 27–72. CrossRef
Feng YS, Jiang R, Kohlmann T, Pickard S (2018) Conceptual models of alternative scoring functions for the EQ-5D-5L: Empirical analyses. Paper presented at the 35 EuroQol Plenary Meeting
de Charro F (2014) Happiness, Health and Health Status Measurement. A report to the Board and Executive Committee of the EuroQol Group. Accessed from the EuroQol website, October 2017.
Cummins, R. A., Eckersley, R., Pallant, J., Van Vugt, J., & Misajon, R. (2003). Developing a national index of subjective wellbeing: The Australian Unity Wellbeing Index. Social Indicators Research, 64, 159–190. CrossRef
Cummins, R. A. (2010). Subjective wellbeing, homeostatically protected mood and depression: A synthesis. Journal of Happiness Studies, 11, 1–17. CrossRef
Richardson, J., McKie, J., & Bariola, E. (2014). Multi attribute utility instruments and their use. In A. J. Culyer (Ed.), Encyclopedia of health economics (pp. 341–357). San Diego: Elsevier. CrossRef
Clark, A., Flèche, S., Layard, R., Powdthavee, N., & Ward, G. (2018). The origins of happiness: The science of well-being over the life course. Princeton: Princeton University Press. CrossRef
Brooks, R. (2013). The EuroQol Group after 25 years. Dordrecht: Springer. CrossRef
Brazier, J. E., Ratcliffe, J., Salomon, J. A., & Tsuchiya, A. (2017). Measuring and valuing health benefits for economic evaluation. Oxford: Oxford University Press.
- A conceptual map of health-related quality of life dimensions: key lessons for a new instrument
Jan Abel Olsen
- Springer International Publishing
Quality of Life Research
An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation - An Official Journal of the International Society of Quality of Life Research
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649