Interchangeability of the EQ-5D and the SF-6D in Long-Lasting Low Back Pain

Søgaard, Rikke; Christensen, Finn Kjær; Videbaek, Tina S.; Bünger, Cody; Christiansen, Terkel

doi:10.1111/j.1524-4733.2008.00466.x

Cited by 40 publications

(38 citation statements)

References 35 publications

(66 reference statements)

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“…The EQ-5D score is less sensitive to change than that of the SF-6D for patients with low-back disorders. 22,24,25,32,33 These differences in health utility valuation for the same disease entity in the same cohort have prompted researchers to present the results of cost-effectiveness analyses for both valuation methods. Several studies have shown that whereas the SF-6D and ODI scores are dispersed and normally distributed, the EQ-5D scores tend to cluster and to have a bimodal distribution.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 However, several studies have shown that although both the EQ-5D and SF-6D are psychometrically valid measures of health state utility in patients with low-back pain, they cannot be used interchangeably. 22,24,25,32,33 Differences in the health state utility values derived from the EQ-5D and SF-6D are substantial enough that several cost-effectiveness studies present their results using both the EQ-5D and the SF-6D as part of the sensitivity analysis. 34,35 The purpose of this study was to determine for patients with spondylolisthesis enrolled in the National Neurosurgery Quality and Outcomes Database (N 2 QOD) 2,26,27 at what threshold of increased surgical cost TLIF will become cost-prohibitive relative to PSF when both EQ-5D and SF-6D health state utility values are considered.…”

mentioning

confidence: 99%

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Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N2QOD data

Carreon

Glassman

Ghogawala

et al. 2016

SPI

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OBJECTIVE Transforaminal lumbar interbody fusion (TLIF) has become the most commonly used fusion technique for lumbar degenerative disorders. This suggests an expectation of better clinical outcomes with this technique, but this has not been validated consistently. How surgical variables and choice of health utility measures drive the cost-effectiveness of TLIF relative to posterolateral fusion (PSF) has not been established. The authors used health utility values derived from Short Form-6D (SF-6D) and EQ-5D and different cost-effectiveness thresholds to evaluate the relative cost-effectiveness of TLIF compared with PSF. METHODS From the National Neurosurgery Quality and Outcomes Database (N2QOD), 101 patients with spondylolisthesis who underwent PSF were propensity matched to patients who underwent TLIF. Health-related quality of life measures and perioperative parameters were compared. Because health utility values derived from the SF-6D and EQ-5D questionnaires have been shown to vary in patients with low-back pain, quality-adjusted life years (QALYs) were derived from both measures. On the basis of these matched cases, a sensitivity analysis for the relative cost per QALY of TLIF versus PSF was performed in a series of cost-assumption models. RESULTS Operative time, blood loss, hospital stay, and 30-day and 90-day readmission rates were similar for the TLIF and PSF groups. Both TLIF and PSF significantly improved back and leg pain, Oswestry Disability Index (ODI) scores, and EQ-5D and SF-6D scores at 3 and 12 months postoperatively. At 12 months postoperatively, patients who had undergone TLIF had greater improvements in mean ODI scores (30.4 vs 21.1, p = 0.001) and mean SF-6D scores (0.16 vs 0.11, p = 0.001) but similar improvements in mean EQ-5D scores (0.25 vs 0.22, p = 0.415) as patients treated with PSF. At a cost per QALY threshold of $100,000 and using SF-6D–based QALYs, the authors found that TLIF would be cost-prohibitive compared with PSF at a surgical cost of $4830 above that of PSF. However, with EQ-5D–based QALYs, TLIF would become cost-prohibitive at an increased surgical cost of $2960 relative to that of PSF. With the 2014 US per capita gross domestic product of $53,042 as a more stringent cost-effectiveness threshold, TLIF would become cost-prohibitive at surgical costs $2562 above that of PSF with SF-6D–based QALYs or at a surgical cost exceeding that of PSF by $1570 with EQ-5D–derived QALYs. CONCLUSIONS As with all cost-effectiveness studies, cost per QALY depended on the measure of health utility selected, durability of the intervention, readmission rates, and the accuracy of the cost assumptions.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N2QOD data

Carreon

Glassman

Ghogawala

et al. 2016

SPI

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“…3,7,10,26,35,36 This has been found to be true even in patients with low-back pain 7,24,25,27 or in patients with neck pain. 35 Theoretical causes for these differences in- clude dissimilarities in the descriptive components leading to the measurement of distinct constructs, variation in the period of recall, and the use of different valuation methods (time tradeoff for the EQ-5D and chained standard gamble for the SF-6D).…”

Section: Discussionmentioning

confidence: 93%

“…Whereas the SF-6D scores and NDI are dispersed and normally distributed, the EQ-5D tends to cluster or skew 35,36 or have a bimodal distribution. 7,27 Looking at the scatterplot between the NDI and the EQ-5D scores, a floor effect is evident as well as gaps in the EQ-5D values (Fig. 2).…”

Section: Discussionmentioning

confidence: 99%

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Estimating EQ-5D values from the Neck Disability Index and numeric rating scales for neck and arm pain

Carreon¹,

Bratcher²,

Das³

et al. 2014

SPI

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Object The Neck Disability Index (NDI) and numeric rating scales (0 to 10) for neck pain and arm pain are widely used cervical spine disease–specific measures. Recent studies have shown that there is a strong relationship between the SF-6D and the NDI such that using a simple linear regression allows for the estimation of an SF-6D value from the NDI alone. Due to ease of administration and scoring, the EQ-5D is increasingly being used as a measure of utility in the clinical setting. The purpose of this study is to determine if the EQ-5D values can be estimated from commonly available cervical spine disease–specific health-related quality of life measures, much like the SF-6D. Methods The EQ-5D, NDI, neck pain score, and arm pain score were prospectively collected in 3732 patients who presented to the authors' clinic with degenerative cervical spine disorders. Correlation coefficients for paired observations from multiple time points between the NDI, neck pain and arm pain scores, and EQ-5D were determined. Regression models were built to estimate the EQ-5D values from the NDI, neck pain, and arm pain scores. Results The mean age of the 3732 patients was 53.3 ± 12.2 years, and 43% were male. Correlations between the EQ-5D and the NDI, neck pain score, and arm pain score were statistically significant (p < 0.0001), with correlation coefficients of −0.77, −0.62, and −0.50, respectively. The regression equation 0.98947 + (−0.00705 × NDI) + (−0.00875 × arm pain score) + (−0.00877 × neck pain score) to predict EQ-5D had an R-square of 0.62 and a root mean square error (RMSE) of 0.146. The model using NDI alone had an R-square of 0.59 and a RMSE of 0.150. The model using the individual NDI items had an R-square of 0.46 and an RMSE of 0.172. The correlation coefficient between the observed and estimated EQ-5D scores was 0.79. There was no statistically significant difference between the actual EQ-5D score (0.603 ± 0.235) and the estimated EQ-5D score (0.603 ± 0.185) using the NDI, neck pain score, and arm pain score regression model. However, rounding off the coefficients to fewer than 5 decimal places produced less accurate results. Conclusions The regression model estimating the EQ-5D from the NDI, neck pain score, and arm pain score accounted for 60% of the variability of the EQ-5D with a relatively large RMSE. This regression model may not be sufficient to accurately or reliably estimate actual EQ-5D values.

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Summary and Future Directions

Barofsky¹

2011

Quality

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Interchangeability of the EQ-5D and the SF-6D in Long-Lasting Low Back Pain

Cited by 40 publications

References 35 publications

Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N2QOD data

Modeled cost-effectiveness of transforaminal lumbar interbody fusion compared with posterolateral fusion for spondylolisthesis using N2QOD data

Estimating EQ-5D values from the Neck Disability Index and numeric rating scales for neck and arm pain

Summary and Future Directions

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