Development of United States population-based preference weights for the EQ-5D health states

Persistent Link:
http://hdl.handle.net/10150/290084
Title:
Development of United States population-based preference weights for the EQ-5D health states
Author:
Shaw, James Warren
Issue Date:
2004
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The EQ-5D is a brief, multi-attribute, preference-based health status measure. This dissertation describes the development of a statistical model for estimating U.S. population-based preference weights for the EQ-5D health states. A multistage probability sample was selected from the adult U.S. population. Using the time trade-off (TTO) method, each respondent valued 13 of the 243 health states described by the EQ-5D. The valuations were linearly transformed to lie on the interval [-1, 1]. Numerous model specifications were investigated, and a modified split-sample approach was used to evaluate the predictive accuracy of the models. All statistical analyses took into account the clustering and disproportionate selection probabilities inherent in our sampling design. The best model proved to be one based on a conceptual notion of the effect of movements away from perfect health. This model, which we have named D1, included ordinal terms to capture the effect of departures from perfect health as well as interaction effects due to increasing health problems. Relative to other models tested, a random effects specification of the D1 model provided a good fit for the observed TTO data. This model yielded an overall R² of 0.38, a mean absolute error of 0.02, and a correlation between mean observed and predicted valuations of 0.99. We also examined differences in health state valuations among the three major racial/ethnic groups in the U.S., i.e., Hispanics, non-Hispanic blacks, and others. In general, non-Hispanic blacks valued health states more highly than Hispanics or non-Hispanic non-blacks. Non-Hispanic blacks appeared to perceive extreme health problems to be associated with less disutility than did members of the other racial/ethnic groups. Differences in valuations did not appear to be related to differences between groups in education, income, or self-reported chronic conditions. The D1 model predicts the values for observed health states with a high degree of accuracy. This model's predictions provide a set of EQ-5D preference weights specifically developed for use in the U.S. population. Within the U.S. population, there exist differences among the major racial/ethnic groups in the perceived desirability of the EQ-5D health states. These differences cannot be readily explained by socioeconomic disparities.
Type:
text; Dissertation-Reproduction (electronic)
Keywords:
Health Sciences, Pharmacy.; Health Sciences, Health Care Management.
Degree Name:
Ph.D.
Degree Level:
doctoral
Degree Program:
Graduate College; Pharmaceutical Sciences
Degree Grantor:
University of Arizona
Advisor:
Coons, Stephen Joel

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_US
dc.titleDevelopment of United States population-based preference weights for the EQ-5D health statesen_US
dc.creatorShaw, James Warrenen_US
dc.contributor.authorShaw, James Warrenen_US
dc.date.issued2004en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe EQ-5D is a brief, multi-attribute, preference-based health status measure. This dissertation describes the development of a statistical model for estimating U.S. population-based preference weights for the EQ-5D health states. A multistage probability sample was selected from the adult U.S. population. Using the time trade-off (TTO) method, each respondent valued 13 of the 243 health states described by the EQ-5D. The valuations were linearly transformed to lie on the interval [-1, 1]. Numerous model specifications were investigated, and a modified split-sample approach was used to evaluate the predictive accuracy of the models. All statistical analyses took into account the clustering and disproportionate selection probabilities inherent in our sampling design. The best model proved to be one based on a conceptual notion of the effect of movements away from perfect health. This model, which we have named D1, included ordinal terms to capture the effect of departures from perfect health as well as interaction effects due to increasing health problems. Relative to other models tested, a random effects specification of the D1 model provided a good fit for the observed TTO data. This model yielded an overall R² of 0.38, a mean absolute error of 0.02, and a correlation between mean observed and predicted valuations of 0.99. We also examined differences in health state valuations among the three major racial/ethnic groups in the U.S., i.e., Hispanics, non-Hispanic blacks, and others. In general, non-Hispanic blacks valued health states more highly than Hispanics or non-Hispanic non-blacks. Non-Hispanic blacks appeared to perceive extreme health problems to be associated with less disutility than did members of the other racial/ethnic groups. Differences in valuations did not appear to be related to differences between groups in education, income, or self-reported chronic conditions. The D1 model predicts the values for observed health states with a high degree of accuracy. This model's predictions provide a set of EQ-5D preference weights specifically developed for use in the U.S. population. Within the U.S. population, there exist differences among the major racial/ethnic groups in the perceived desirability of the EQ-5D health states. These differences cannot be readily explained by socioeconomic disparities.en_US
dc.typetexten_US
dc.typeDissertation-Reproduction (electronic)en_US
dc.subjectHealth Sciences, Pharmacy.en_US
dc.subjectHealth Sciences, Health Care Management.en_US
thesis.degree.namePh.D.en_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.disciplinePharmaceutical Sciencesen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.advisorCoons, Stephen Joelen_US
dc.identifier.proquest3132256en_US
dc.identifier.bibrecord.b46711673en_US
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