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Tytuł:
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Does Inclusion of Interactions Result in Higher Precision of Estimated Health State Values?
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Autorzy:
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Nicolet A; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: .
Groothuis-Oudshoorn CGM; Department of Health Technology and Services Research, MIRA Institute, University of Twente, Enschede, The Netherlands.
Krabbe PFM; Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Źródło:
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Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research [Value Health] 2018 Dec; Vol. 21 (12), pp. 1437-1444. Date of Electronic Publication: 2018 Jul 14.
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Typ publikacji:
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Evaluation Study; Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Jan./Feb. 2011- : New York : Elsevier
Original Publication: Malden, MA : Blackwell Science, c1998-
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MeSH Terms:
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Health Status*
Models, Biological*
Quality of Life*
Research Design*
Surveys and Questionnaires*
Activities of Daily Living ; Adolescent ; Adult ; Aged ; Choice Behavior ; Female ; Humans ; Male ; Middle Aged ; Mobility Limitation ; Models, Statistical ; Quality-Adjusted Life Years ; Self Care ; Young Adult
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Contributed Indexing:
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Keywords: EQ-5D-3L; discrete choice; main effects; second-order interactions; values
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Entry Date(s):
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Date Created: 20181204 Date Completed: 20190102 Latest Revision: 20191210
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Update Code:
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20240105
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DOI:
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10.1016/j.jval.2018.06.001
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PMID:
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30502788
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Background: Most preference-based instruments producing overall values for health states are devised on the simplifying assumption that the overall effect of distinct health-related quality of life domains (attributes) of the instrument equals the sum of the attributes. Nevertheless, health attributes are often inter-related and depend on each other.
Objectives: To investigate whether inclusion of second-order interactions in the three-level EuroQol five-dimensional questionnaire (EQ-5D-3L) value function would result in better fit and lead to different health state values than a model with main effects only.
Methods: Using an efficient design, 400 pairs of EQ-5D-3L health states were generated in a pairwise choice format. We analyzed responses of 4000 people from the general population using a conditional logit model, and we tested goodness of fit using pseudo R 2 , Akaike information criterion, differences in log-likelihood, and likelihood ratio. We compared accuracies of models' predictions based on root mean square error and mean absolute error.
Results: The interaction-effects model showed systematically lower values than the main-effects model. Inclusion of interactions resulted only in a slightly better model fit. Interactions comprising mobility and self-care were the most salient.
Conclusions: For the EQ-5D-3L, a value function based on interactions produces systematically lower values than a main-effects model, meaning that the effect of two or more health problems combined is stronger than the sum of the individual main effects.
(Copyright © 2018 ISPOR–The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)
