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Assessing the performance of direct and indirect utility eliciting methods in patients with colorectal cancer: EQ-5D-5L versus C-TTO

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Abstract

Direct and indirect preference-based methods are two main types of utility generating methods which are being frequently used in cost-utility analysis. However, a key question is how do these two methods perform in terms of validity? The aim of this study is to assess the utilities derived from EuroQol five-dimensional 5 level (EQ-5D-5L) as an indirect method and composite time trade-off (C-TTO) as a direct method in patients with colorectal cancer (CRC). A total of 223 patients with CRC were consecutively selected from three cancer centers in Tehran between May and September 2017. The EQ-5D-5L and C-TTO methods were used to estimate utilities in patients. Wilcoxon test was performed to compare utilities between C-TTO and EQ-5D-5L. In addition, intraclass correlation coefficient (ICC) and Bland–Altman plot were used to assess the agreement between the two methods. Bootstrapping quantile regression analysis was performed for comparison coefficient. The mean values of EQ-5D-5L (0.7186 ± 0.1275) for all stages were significantly higher than the C-TTO (0.4180 ± 0.4670) values. Stage 1 had the highest utility in both C-TTO (0.8167 ± 0.2332) and EQ-5D-5L (0.8339 ± 0.0535), whereas stage 4 had the lowest utility (0.1283 ± 0.5530 and 0.6001 ± 0.1220, respectively). As well, the C-TTO underestimates the values in low level of utilities and overestimates in high level of utilities. The overall ICC between the two methods was 0.50. Our study provides some tentative results about the differences between values of EQ-5D-5L and C-TTO, but clearly more work is needed to be done on this issue.

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References

  • Ameri, H., Yousefi, M., Yaseri, M., Nahvijou, A., Arab, M., Akbari Sari, A.: Mapping the cancer-specific QLQ-C30 onto the generic EQ-5D-5L and SF-6D in colorectal cancer patients. Expert Rev. Pharmacoecon. Outcomes Res. 19(1), 1–8 (2018)

    Google Scholar 

  • Ameri, H., Yousefi, M., Yaseri, M., Nahvijou, A., Arab, M., Akbari Sari, A.: Mapping EORTC-QLQ-C30 and QLQ-CR29 onto EQ-5D-5L in colorectal cancer patients. J. Gastrointest. Cancer. (2019a). https://doi.org/10.1007/s12029-019-00229-6

    Article  Google Scholar 

  • Ameri, H., Yousefi, M., Yaseri, M., Nahvijou, A., Arab, M., Akbari, Sari A.: Mapping the cancer-specific QLQ-C30 onto the generic EQ-5D-5L and SF-6D in colorectal cancer patients. Expert Rev. Pharmacoecon. Outcomes Res. 19(1), 89–96 (2019b)

    Article  PubMed  Google Scholar 

  • Badia, X., Diaz-Prieto, A., Gorriz, M., Herdman, M., Torrado, H., Farrero, E., et al.: Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit. Intensive Care Med. 27(12), 1901–1907 (2001)

    Article  CAS  PubMed  Google Scholar 

  • Bozzani, F.M., Alavi, Y., Jofre-Bonet, M., Kuper, H.: A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma. BMC Ophthalmol. 12(1), 43 (2012)

    Article  PubMed  PubMed Central  Google Scholar 

  • Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A., Jemal, A.: Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 68(6), 394–424 (2018)

    Article  PubMed  Google Scholar 

  • Burström, K., Johannesson, M., Diderichsen, F.: A comparison of individual and social time trade-off values for health states in the general population. Health Policy 76(3), 359–370 (2006)

    Article  PubMed  Google Scholar 

  • EuroQol Research Foundation: EQ-5D-5L|about. cited 2017 Aug. https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/

  • Golicki, D., Niewada, M., van Hout, B., Janssen, M., Pickard, A.S.: Interim EQ-5D-5L value set for Poland: first crosswalk value set in Central and Eastern Europe. Value Health Reg. Issues 4, 19–23 (2014)

    Article  PubMed  Google Scholar 

  • Golicki, D., Niewada, M., Karlińska, A., Buczek, J., Kobayashi, A., Janssen, M., et al.: Comparing responsiveness of the EQ-5D-5L, EQ-5D-3L and EQ VAS in stroke patients. Qual. Life Res. 24(6), 1555–1563 (2015)

    Article  PubMed  Google Scholar 

  • Goudarzi, R., Sari, A.A., Zeraati, H., Rashidian, A., Mohammad, K., Amini, S.: Valuation of quality weights for EuroQol 5-dimensional health states with the time trade-off method in the capital of Iran. Value Health Reg. Issues 18, 170–175 (2019)

    Article  PubMed  Google Scholar 

  • Heintz, E., Wiréhn, A.-B., Peebo, B.B., Rosenqvist, U., Levin, L.-Å.: QALY weights for diabetic retinopathy—a comparison of health state valuations with HUI-3, EQ-5D, EQ-VAS, and TTO. Value Health 15(3), 475–484 (2012)

    Article  PubMed  Google Scholar 

  • Janssen, B.M., Oppe, M., Versteegh, M.M., Stolk, E.A.: Introducing the composite time trade-off: a test of feasibility and face validity. Eur. J. Health Econ. 14(1), 5–13 (2013)

    Article  PubMed Central  Google Scholar 

  • Johnson, J.A., Coons, S.J., Ergo, A., Szava-Kovats, G.: Valuation of EuroQOL (EQ-5D) health states in an adult US sample. Pharmacoeconomics 13(4), 421–433 (1998)

    Article  CAS  PubMed  Google Scholar 

  • Kang, H.-J., Kang, E., Jo, M.-W., Park, E.-J., Yoon, S., Lee, E.-K.: The utility score of epilepsy with partial seizure measured by TTO, VAS, and EQ-5D in the general Korean population. Epilepsy Res. 108(5), 963–971 (2014)

    Article  PubMed  Google Scholar 

  • Lidgren, M., Wilking, N., Jönsson, B., Rehnberg, C.: Health related quality of life in different states of breast cancer. Qual. Life Res. 16(6), 1073–1081 (2007)

    Article  PubMed  Google Scholar 

  • Luo, N., Li, M., Stolk, E.A., Devlin, N.J.: The effects of lead time and visual aids in TTO valuation: a study of the EQ-VT framework. Eur. J. Health Econ. 14(1), 15–24 (2013)

    Article  PubMed Central  Google Scholar 

  • Oppe, M., Rand-Hendriksen, K., Shah, K., Ramos-Goñi, J.M., Luo, N.: EuroQol protocols for time trade-off valuation of health outcomes. Pharmacoeconomics 34(10), 993–1004 (2016)

    Article  PubMed  PubMed Central  Google Scholar 

  • Peeters, Y., Stiggelbout, A.M.: Health state valuations of patients and the general public analytically compared: a meta-analytical comparison of patient and population health state utilities. Value Health 13(2), 306–309 (2010)

    Article  PubMed  Google Scholar 

  • Perez, D.J., Williams, S.M., Christensen, E.A., McGee, R.O., Campbell, A.V.: A longitudinal study of health related quality of life and utility measures in patients with advanced breast cancer. Qual. Life Res. 10(7), 587–593 (2001)

    Article  CAS  PubMed  Google Scholar 

  • Polsky, D., Willke, R.J., Scott, K., Schulman, K.A., Glick, H.A.: A comparison of scoring weights for the EuroQol© derived from patients and the general public. Health Econ. 10(1), 27–37 (2001)

    Article  CAS  PubMed  Google Scholar 

  • Ratcliffe, J., Brazier, J., Palfreyman, S., Michaels, J.: A comparison of patient and population values for health states in varicose veins patients. Health Econ. 16(4), 395–405 (2007)

    Article  PubMed  Google Scholar 

  • Round, J.: Once bitten twice shy: thinking carefully before adopting the EQ-5D-5L. PharmacoEconomics 36(6), 641–643 (2018)

    Article  PubMed  Google Scholar 

  • Ubel, P.A., Loewenstein, G., Jepson, C.: Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Qual. Life Res. 12(6), 599–607 (2003)

    Article  PubMed  Google Scholar 

  • Van Hout, B., Janssen, M., Feng, Y.-S., Kohlmann, T., Busschbach, J., Golicki, D., et al.: Interim scoring for the EQ-5D-5L: mapping the EQ-5D-5L to EQ-5D-3L value sets. Value Health 15(5), 708–715 (2012)

    Article  PubMed  Google Scholar 

  • van Reenen, M., Janssen, B.: EQ-5D-5L User Guide: Basic Information on How to Use the EQ-5D-5L Instrument. EuroQol Research Foundation, Rotterdam (2015)

    Google Scholar 

  • Walters, S.J., Brazier, J.E.: Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual. Life Res. 14(6), 1523–1532 (2005)

    Article  PubMed  Google Scholar 

  • Zethraeus, N., Johannesson, M.: A comparison of patient and social tariff values derived from the time trade-off method. Health Econ. 8(6), 541–545 (1999)

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The authors hereby bestow much gratitude to the chemotherapy and radiography departments of Imam Khomeini Hospital, Shohada Tajrish Hospital, and Shohada Haft-Tir Hospital for their valuable collaboration and participation in the present study. We express our gratitude to EuroQoL Group who converted EQ-5D-3L into EQ-5D-5L values, and Iranian National Science Foundation (Grant No. 96010306) that provide fund for this project.

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Authors and Affiliations

  1. Iranian Center of Excellence in Health Management, Health Economics Department, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran

    Mahmood Yousefi

  2. Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran

    Hossein Safari

  3. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Ali Akbari Sari & Behzad Raei

  4. Department of Health Management and Economics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

    Hosein Ameri

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  1. Mahmood Yousefi
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  2. Hossein Safari
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  5. Hosein Ameri
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Correspondence to Hosein Ameri.

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Yousefi, M., Safari, H., Akbari Sari, A. et al. Assessing the performance of direct and indirect utility eliciting methods in patients with colorectal cancer: EQ-5D-5L versus C-TTO. Health Serv Outcomes Res Method 19, 259–270 (2019). https://doi.org/10.1007/s10742-019-00204-5

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  • DOI: https://doi.org/10.1007/s10742-019-00204-5

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