Exploring the Impact of Adding a Respiratory Dimension to the EQ-5D-5L. (May 2019)

• Record Type: Journal Article
• Authors: Hoogendoorn, Martine; Oppe, Mark; Boland, Melinde R. S.; Goossens, Lucas M. A.; Stolk, Elly A.; Rutten–van Mölken, Maureen P. M. H.
• Is Part Of: Medical decision making. Volume 39:Number 4(2019)
• Page Start: 393
• Page End: 404
• Publication Date: 2019-05
• Subjects: EQ-5D -- respiratory symptoms -- bolt-on -- valuation study -- pilot; Medical policy -- Periodicals; Clinical medicine -- Decision making -- Periodicals; Medicine -- Periodicals; Médecine clinique -- Prise de décision -- Périodiques; 362.1
• DOI: 10.1177/0272989X19847983
• Languages: English
• ISSNs: 0272-989X

Abstract

Objectives. To evaluate the impact of adding a respiratory dimension (a bolt-on dimension) to the EQ-5D-5L health state valuations.Methods. Based on extensive regression and principal component analyses, 2 respiratory bolt-on candidates were formulated: R1, limitations in physical activities due to shortness of breath, and R2, breathing problems. Valuation interviews for the selected bolt-ons were performed with a representative sample from the Dutch general public using the standardized interview protocol and software of the EuroQol group. Hybrid models based on the combined time-tradeoff (TTO) and discrete choice experiment (DCE) data were estimated to assess whether the 5 levels of the respiratory bolt-on led to significant changes in utility values.Results. For each bolt-on candidate, slightly more than 200 valuation interviews were conducted. Mean TTO values and DCE choice probabilities for health states with a level 4 or 5 for the respiratory dimension were significantly lower compared with the same health states in the Dutch EQ-5D-5L valuation study without the respiratory dimension. Results of hybrid models showed that for the bolt-on "limitations in physical activities, " the utility decrements were significant for level 3 (–0.055), level 4 (–0.087), and level 5 (–0.135). For "breathing problems, " the utility decrements for the same levels were greater (–0.086, –0.219, and –0.327, respectively).Conclusions. The addition of each of the 2 respiratory bolt-ons to the EQ-5D-5L had a significant effect on the valuation of health states with severe levels for the bolt-on. The bolt-on dimension "breathing problems" showed the greatest utility decrements and therefore seems the most appropriate respiratory bolt-on dimension.