Assessing the Use of a Feedback Module to Model EQ-5D-5L Health States Values in Hong Kong

Abstract

BackgroundAn international valuation protocol exists for obtaining societal values for each of the 3125 health states of the five-level EuroQol-five dimensions (EQ-5D-5L) questionnaire. A feedback module (FM) that can be related to theoretical models used in behavioral economics was recently included in this protocol.ObjectivesOur objective was to assess the impact of using an FM to estimate an EQ-5D-5L value set in Hong Kong.MethodsEQ-5D-5L health states were elicited using a composite time trade-off (C-TTO) and a discrete-choice (DC) experiment. Use of the FM according to participant characteristics and the impact of the FM on the number of inconsistent C-TTO responses were assessed. We employed a main-effects hybrid model that combined data from both elicitation techniques.ResultsIn total, 1014 individuals completed the survey. The sample was representative of the general Chinese Hong Kong population in terms of sex, educational attainment, marital status, and most age groups but not for employment status. The use of the FM reduced the number of C-TTO inconsistencies. Participant characteristics differed significantly between those who used and did not use the FM. The model without a constant resulted in logical consistent coefficients and was therefore selected as the model to produce the value set. The predicted EQ-5D-5L values ranged from −0.864 to 1.ConclusionsThe use of an FM to allow participants to exclude C-TTO responses reduced the number of inconsistent responses and improved the quality of the data when estimating an EQ-5D-5L value set in Hong Kong.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-017-0278-0) contains supplementary material, which is available to authorized users.

Health-related quality of life among patients with hypertension: population-based survey using EQ-5D-5L in Hong Kong SAR, China

“…In our study, the mean EQ-5D utility for patients with hypertension was 0.85 (mean=0.92 for HK general population20) and ranged from −0.864 to 1.0. The mean utility was slightly higher than that reported in Japan,25 but lower than that reported in South Korea,8 Singapore,26 Mainland China6 and the UK 27.…”

“…EQ-5D-5L is the new version of the original EQ-5D-3L (three levels for each dimension), and it has been confirmed to exhibit improved ability to control the ceiling effect. The EQ-5D-5L HK version was developed and validated in HK cultural settings following the latest international protocol in 2017, which allowed the evaluation of people’s HRQoL by considering their perceptions in the HK context of culture and value systems 20. All health states defined by EQ-5D-5L can be converted into a single summary index called utility.…”

“…The calculation of utility was based on an HK value set. The basic formula is utility=1 – β 1 *MO – β 2 *SC – β 3 *UA – β 4 *PD – β 5 *AD 20. The value of β depends on the levels selected by the respondent at each dimension.…”

Beyond cost‐effectiveness: A five‐step framework for appraising the value of health technologies in Asia‐Pacific

“…This is despite the availability of EQ‐5D (the most commonly used generic, preference‐based measure of health‐related quality of life) value sets for a number of APAC countries . Only recently have most of the EQ‐5D value sets been developed, so moving forward, it may be increasingly practical to estimate QALYs within the region. However, it is likely that a number of APAC countries (eg, Nepal, Cambodia, and Vietnam) will not have the resources available to calculate QALYs specifically for their country and will have to rely on utility weights from other countries.…”

Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

“…Those with a score of 3 or more (which suggests depression) were further measured by the 9-item PHQ (PHQ-9)48; (3) anxiety (screened by the 2-item Generalised Anxiety Disorder (GAD-2)). Those with a score of 3 or more (which suggests anxiety) were further measured by the 7-item GAD (GAD-7)49; (4) loneliness (measured by the 6-item De Jong Gierveld Loneliness Scale),50 as well as one loneliness question; (5) insomnia (measured by the 7-item Insomnia Severity Index)51 among those who answered yes to a screening question); (6) pain (measured by the Brief Pain Inventory among those who were screened positive in pain); (7) physical activity (measured by Physical Activity Scale for the Elderly (PASE)52 among those who were screened positive in pain); (8) frailty (measured by the Edmonton Frail Scale53 which was translated and back-translated by experienced bilingual translators); (9) meaning of existence (measured by one question extracted from the validated Chinese Purpose in Life test which was used in a previous study)54; (10) sarcopenia (measured by the 5-item Sarcopenia Assessment)55 56; (11) cognition (measured by the Hong Kong Montreal Cognitive Assessment (HK-MoCA) with a score of 22 or above being with normal cognition)57; (12) alcohol use (screened by one question and then measured by the 3-item Alcohol Use Disorders Identification Test-consumption for those who screened positive); (13) smoking (non-smoker, current smoker, ex-smoker); (14) medication use (number and duration (0–1 year/2–5 years/>5 years) of antihypertensive, cardiovascular and hypolipidaemic drugs, antidiabetics, antipsychotics and analgesics was checked in electronic medical system, and compliance of medication use was measured by ‘At times, do you forget to take your prescription medications?’ (no/yes)); (15) self-rated health; (16) community network; (17) use of social media (measured by a screening question, and for those who answered yes to any of the social media, they were further assessed on the importance and comfort of using the internet); (17) oral health; (18) incontinence; (19) caregiving to somebody; (20) quality of life (measured by the EuroQoL-5-Dimensions-5-Level (EQ-5D-5L))58; (21) daily function (ability to use the telephone, mode of transportation, shopping, food preparation, ability to handle finances were measured); (22) health service utilisation (visits to primary care doctors, specialist outpatient clinics (SOPC), admission to hospital, use of services in elderly daycare centres and out-of-pocket healthcare costs which were not covered by public health system or insurance both in private and public in the past year). In addition, physical examinations included blood pressure, body mass index (BMI), waist circumference and handgrip strength (kg).…”