Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: results of two pilot studies in Belgium.
(2017) Archives of Public Health — Vol. 75, n° 1, p. 6 [1-12] (2017)
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- Background: Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In 2010 and 2013, Salomon et al. proposed a set of DWs for 220 and 183 health states, respectively. The objective of this study is to develop an approach for mapping EQ-5D utilities to existing GBD 2010 and GBD 2013 DWs, allowing to predict new GBD 2010/2013 DWs based on EQ-5D utilities. Methods: We conducted two pilot studies including respectively four and twenty-seven health states selected from the 220 DWs of the GBD 2010 study. In the first study, each participant evaluated four health conditions using the standard written EQ-5D-5L questionnaire. In the second study, each participant evaluated four health conditions randomly selected among the twenty-seven health states using a previously developed web-based EQ-5D-5L questionnaire. The EQ-5D responses were translated into utilities using the model developed by Cleemput et al. A loess regression allowed to map EQ-5D utilities to logit transformed DWs. Results: Overall, 81 and 393 respondents completed the first and the second survey, respectively. In the first study, a monotonic relationship between derived utilities and predicted GBD 2010/2013 DWs was observed, but not in the second study. There were some important differences in ranking of health states based on utilities versus GBD 2010/2013 DWs. The participants of the current study attributed a relatively higher severity level to musculoskeletal disorders such as 'Amputation of both legs' and a relatively lower severity level to non-functional disorders such as 'Headache migraine' compared to the participants of the GBD 2010/2013 studies. Conclusion: This study suggests the possibility to translate any utility derived from EQ-5D scores into a DW, but also highlights important caveats. We observed a satisfactory result of this methodology when utilities were derived from a population of public health students, a written questionnaire and a small number of health states in the presence of a study leader. However the results were unsatisfactory when utilities were derived from a sample of the general population, using a web-based questionnaire. We recommend to repeat the study in a larger and more diverse sample to obtain a more representative distribution of educational level and age.
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Maertens De Noordhout, C., Devleesschauwer, B., Gielens, L., Plasmans, M., Haagsma, J., & Speybroeck, N. (2017). Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: results of two pilot studies in Belgium. Archives of Public Health, 75(1), 6 [1-12]. https://doi.org/10.1186/s13690-017-0174-z (Original work published 2017)