Self-Reported Population Health: An International Perspective based on EQ-5D

Szende, Ágota; Janssen, Bas; Cabases, Juan M.

doi:10.1007/978-94-007-7596-1

Cited by 477 publications

(58 citation statements)

References 37 publications

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“…The excellent outcome is supported by the ODI scores showing absence of back related disability in virtually all patients [20]. Furthermore, normal EQ 5D-index in Swedes aged 18-24 years are 0.860 and normal EQVAS 81.7 [21], similar to the 1-year data for girls and boys in our study.…”

Section: Discussionsupporting

confidence: 88%

Lumbar disc herniation surgery in children: outcome and gender differences

Strömqvist

Jönsson

et al. 2015

Eur Spine J

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Section: Discussionsupporting

confidence: 88%

Lumbar disc herniation surgery in children: outcome and gender differences

Strömqvist

Jönsson

et al. 2015

Eur Spine J

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“…Comparison of the UK population norm utility data with those from other European and Scandinavian countries indicates differences in underlying health and utility weights. 99 The values for the UK population are at the lower end of the range of population norm utility estimates (UK = 0.773 for 64-75 years, range = 0.773-0.904). 99 However, the UK population norm utility values for non-smokers 94 lie within the ranges reported at baseline in clinical trials, which are between 0.72 and 0.81 for participants in evaluations of surveillance or surgical repair.…”

Section: Economic Evaluation: Data Inputs and Resultsmentioning

confidence: 96%

“…99 The values for the UK population are at the lower end of the range of population norm utility estimates (UK = 0.773 for 64-75 years, range = 0.773-0.904). 99 However, the UK population norm utility values for non-smokers 94 lie within the ranges reported at baseline in clinical trials, which are between 0.72 and 0.81 for participants in evaluations of surveillance or surgical repair. 76,78,79,100,101 Economic models that use age-specific population norms report values in the range 0.72-0.87.…”

Section: Economic Evaluation: Data Inputs and Resultsmentioning

confidence: 96%

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Calculating when elective abdominal aortic aneurysm repair improves survival for individual patients: development of the Aneurysm Repair Decision Aid and economic evaluation

Grant

Sperrin

Carlson

et al. 2015

Health Technology Assessment

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BackgroundAbdominal aortic aneurysm (AAA) repair aims to prevent premature death from AAA rupture. Elective repair is currently recommended when AAA diameter reaches 5.5 cm (men) and 5.0 cm (women). Applying population-based indications may not be appropriate for individual patient decisions, as the optimal indication is likely to differ between patients based on age and comorbidities.ObjectiveTo develop an Aneurysm Repair Decision Aid (ARDA) to indicate when elective AAA repair optimises survival for individual patients and to assess the cost-effectiveness and associated uncertainty of elective repair at the aneurysm diameter recommended by the ARDA compared with current practice.Data sourcesThe UK Vascular Governance North West and National Vascular Database provided individual patient data to develop predictive models for perioperative mortality and survival. Data from published literature were used to model AAA growth and risk of rupture. The cost-effectiveness analysis used data from published literature and from local and national databases.MethodsA combination of systematic review methods and clinical registries were used to provide data to populate models and inform the structure of the ARDA. Discrete event simulation (DES) was used to model the patient journey from diagnosis to death and synthesised data were used to estimate patient outcomes and costs for elective repair at alternative aneurysm diameters. Eight patient clinical scenarios (vignettes) were used as exemplars. The DES structure was validated by clinical and statistical experts. The economic evaluation estimated costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) from the NHS, social care provider and patient perspective over a lifetime horizon. Cost-effectiveness acceptability analyses and probabilistic sensitivity analyses explored uncertainty in the data and the value for money of ARDA-based decisions. The ARDA outcome measures include perioperative mortality risk, annual risk of rupture, 1-, 5- and 10-year survival, postoperative long-term survival, median life expectancy and predicted time to current threshold for aneurysm repair. The primary economic measure was the ICER using the QALY as the measure of health benefit.ResultsThe analysis demonstrated it is feasible to build and run a complex clinical decision aid using DES. The model results support current guidelines for most vignettes but suggest that earlier repair may be effective in younger, fitter patients and ongoing surveillance may be effective in elderly patients with comorbidities. The model adds information to support decisions for patients with aneurysms outside current indications. The economic evaluation suggests that using the ARDA compared with current guidelines could be cost-effective but there is a high level of uncertainty.LimitationsLack of high-quality long-term data to populate all sections of the model meant that there is high uncertainty about the long-term clinical and economic consequences of repair. Modelling assumptions were necessary and the developed survival models require external validation.ConclusionsThe ARDA provides detailed information on the potential consequences of AAA repair or a decision not to repair that may be helpful to vascular surgeons and their patients in reaching informed decisions. Further research is required to reduce uncertainty about key data, including reintervention following AAA repair, and assess the acceptability and feasibility of the ARDA for use in routine clinical practice.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Fifteen years after surgery, survival outcomes were assumed to correspond to World Health Organization life tables for each country from 2013 [27] and quality of life was assumed to be the same as that of women in the general population for each country [28]. HRs for the efficacy of treatments were considered constant during the 15 years after surgery because the meta-analysis of the EBCTCG [1] suggests persistent effects of adjuvant treatments on breast cancer mortality until 15 years.…”

Section: Lifetime Extrapolationmentioning

confidence: 99%