A note on the relationship between age and health-related quality of life assessment

Cubí‐Mollá, Patricia; Shah, Koonal; Garside, Jamie; Herdman, Mike; Devlin, Nancy

doi:10.1007/s11136-018-2071-5

Cited by 7 publications

(7 citation statements)

References 14 publications

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“…This in turn suggests that the use of patient values in economic evaluations may lead to socio-demographic and/or health status inequalities. To illustrate, in line with previous research [44], older patients were found to systematically rate their own health lower than younger patients. As a consequence, the incremental gain from restoring older people to full health will likely be greater than that of younger people.…”

Section: Discussionsupporting

confidence: 84%

“…In line with findings of Cubi-Molla et al (2019), this also suggests that older people value their own health state lower than younger people do. Please note that this is true because general public values are fixed, meaning that every EQ-5D-3L health state is only associated with one utility value, whereas patient values are variable and may thus in- or decrease with age [44].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, it might also be possible that a certain intervention is not cost-effective on average, but cost-effective for a sub-group of older patients. In such instances, preference sub-group analyses can be used to recognize that there may be certain sub-groups whose preferences are significantly different from the overall average to produce meaningfully different cost-effectiveness outcomes [44].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study

Dongen

Hooff

Finch

et al. 2019

Health Qual Life Outcomes

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BackgroundUtility values can be obtained from different respondent groups, including patients and members of the general public. Evidence suggests that patient values are typically higher than general public values. This study explores whether the magnitude of disagreement between both values can be explained by socio-demographic characteristics and/or health status.MethodsData of 5037 chronic low back pain patients were used. Self-reported EQ-VAS was employed as a proxy of patients’ preference for their own health state. General public values for the patients’ EQ-5D-3L health states were obtained using the Dutch VAS-based tariff. The difference between patient and general public values was assessed using a paired t-test. Subsequently, this difference was used as a dependent variable and regressed upon dummy variables of socio-demographic and health status characteristics. Coefficients represented age, gender, education level, social support, back pain intensity, leg pain intensity, functional status, comorbidities, catastrophizing, and treatment expectations.ResultsPatient values were higher than general public values (0.069; 95%CI:0.063–0.076). The magnitude of disagreement between both values was associated with age, gender, education level, social support, functional status, and comorbidities, but not with back pain intensity, leg pain intensity, catastrophizing, and treatment expectations.ConclusionsPatients were found to value their own health status higher than members of the general public. The magnitude of disagreement between both values was found to differ by various socio-demographic and/or health status characteristics. This suggest that patient characteristics account for a relevant fraction of the identified disagreements between patient and general public values, and that mechanisms thought to be responsible for these disagreements, such as adaptation and response shift, have a differential impact across patient sub-groups.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study

Dongen

Hooff

Finch

et al. 2019

Health Qual Life Outcomes

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“…Given that the EQ-5D-Y-3L instrument is recommended to be used on a population in the age range of 8-15 years, it seemed appropriate to keep with our selected framing of a 10-year-old child for developing a unique country-specific EQ-5D-Y-3L value set. It should be noted that the EuroQol Group does not normally generate age-specific value sets for different adult age subgroups (or indeed any other subgroups) [35,36]. However, as preferences regarding the health of 10-year-old children may differ from preferences regarding the health of children or adolescents of other ages, further research is needed on this topic.…”

Section: Discussionmentioning

confidence: 99%

International Valuation Protocol for the EQ-5D-Y-3L

et al. 2020

Self Cite

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The EQ-5D-Y-3L is a generic, health-related, quality-of-life instrument for use in younger populations. Some methodological studies have explored the valuation of children's EQ-5D-Y-3L health states. There are currently no published value sets available for the EQ-5D-Y-3L that are appropriate for use in a cost-utility analysis. The aim of this article was to describe the development of the valuation protocol for the EQ-5D-Y-3L instrument. There were several research questions that needed to be answered to develop a valuation protocol for EQ-5D-Y-3L health states. Most important of these were: (1) Do we need to obtain separate values for the EQ-5D-Y-3L, or can we use the ones from the EQ-5D-3L? (2) Whose values should we elicit: children or adults? (3) Which valuation methods should be used to obtain values for child's health states that are anchored in Full health = 1 and Dead = 0? The EuroQol Research Foundation has pursued a research programme to provide insight into these questions. In this article, we summarized the results of the research programme concluding with the description of the features of the EQ-5D-Y-3L valuation protocol. The tasks included in the protocol for valuing EQ-5D-Y-3L health states are discrete choice experiments for obtaining the relative importance of dimensions/levels and composite time-tradeoff for anchoring the discrete choice experiment values on 1 = Full Health and 0 = Dead. This protocol is now available for use by research teams to generate EQ-5D-Y-3L value sets for their countries allowing the implementation of a cost-utility analysis for younger populations.

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“…Some authors see this as problematic, 34 because this aggregation is insufficiently sensitive to preference heterogeneity, and age is a demonstrable source of heterogeneity in valuation of the EQ-5D. 35 Extending the individual perspective to the valuation of the EQ-5D-Y would imply that only adults' age-specific preferences are considered, while excluding age-specific preferences for and of children and adolescents themselves.…”

Section: Why May An Individual Perspective For Valuation Of Eq-5d-y Health States Be Inappropriate?mentioning

confidence: 99%

Think of the Children: A Discussion of the Rationale for and Implications of the Perspective Used for EQ-5D-Y Health State Valuation

2021

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The recently published EQ-5D-Y valuation protocol prescribes the general public values EQ-5D-Y health states for a 10-year-old child. This child perspective differs from the individual perspective applied for valuation of adult EQ-5D instruments. This article discusses the rationale for and implications of applying a child perspective for EQ-5D-Y health state valuation.Methods: This article was informed by an exploration of the normative and empirical literature on health state valuation. We identified and summarized key discussion points in a narrative review.Results: Although valuing EQ-5D-Y health states from an individual perspective is feasible, it may be problematic for several reasons. The use of a child perspective implies that-rather than valuing one's own health-someone else's health is valued. This may require the projection of one's own beliefs, expectations, and preferences on others, which could change the decision processes underlying the elicited preferences. Furthermore, because preferences are obtained for a 10-year-old child, it is unclear if this given age as well as other (missing) information on the described child beneficiary (should) affect valuation of EQ-5D-Y health states. Conclusions:The change from an individual to a child perspective in the valuation of EQ-5D-Y will likely lead to differences in utilities. This has implications for the estimation of incremental health-related quality-of-life gains in economic evaluations of health technologies for children and adolescents and therefore might affect reimbursement decisions. Further research is necessary for gaining insight into the extent to which this impact is normatively and empirically justified.

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A note on the relationship between age and health-related quality of life assessment

Cited by 7 publications

References 14 publications

Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study

Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study

International Valuation Protocol for the EQ-5D-Y-3L

Think of the Children: A Discussion of the Rationale for and Implications of the Perspective Used for EQ-5D-Y Health State Valuation

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