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Eur J Health Econ. 2020 Jan 4. doi: 10.1007/s10198-019-01156-w. [Epub ahead of print]

A vision 'bolt-on' increases the responsiveness of EQ-5D: preliminary evidence from a study of cataract surgery.

Author information

1
Department of Biostatistics, Singapore Clinical Research Institute, #02-01, 31 Biopolis Way, Singapore, Singapore.
2
Centre for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, Singapore, Singapore.
3
Tampere Center for Child Health Research, Tampere University, Arvo-building, Tampere, Finland.
4
Department of Ophthalmology, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, Singapore.
5
Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, 8 College Road, Singapore, Singapore.
6
Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, Singapore.
7
Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
8
Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, Singapore. ephln@nus.edu.sg.

Abstract

OBJECTIVES:

(1) To evaluate the effect of adding a vision dimension ('bolt-on') to the 5-level EQ-5D (EQ-5D-5L) and 3-level EQ-5D (EQ-5D-3L) on their responsiveness, and (2) to compare the responsiveness of a vision 'bolt-on' EQ-5D-3L (EQ-5D-3L + V) with SF-6D and Health Utilities Index Mark 3 (HUI3) to the benefit of cataract surgery.

METHODS:

Sixty-three patients were assessed before and after their cataract surgery using the EQ-5D-3L, EQ-5D-5L, SF-6D, HUI3, as well as a 3-level and a 5-level vision dimension. Preference-based indices were calculated using available value sets for EQ-5D-3L, EQ-5D-3L + V, EQ-5D-5L, SF-6D, and HUI3, and non-preference-based indices were calculated using the sum-score method for EQ-5D-5L and EQ-5D-5L + V (vision bolt-on EQ-5D-5L). Responsiveness was assessed using the standardized response mean (SRM) and F-statistic.

RESULTS:

Among preference-based indices, mean changes from pre to post-surgery in EQ-5D-3L + V and EQ-5D-3L indices were 0.031 and 0.018, respectively. The mean changes for EQ-5D-5L, SF-6D and HUI3 indices were 0.020, 0.012 and 0.105, respectively. The SRM (F-statistic) for EQ-5D-3L + V and EQ-5D-3L indices were 0.458 (13.2) and 0.098 (0.6), respectively. The responsiveness of EQ-5D-3L + V was better than EQ-5D-5L, SF-6D; the responsiveness of HUI3 was better than all other measures. Using non-preference-based indices, mean change for EQ-5D-5L + V and EQ-5D-5L were 0.067 and 0.017, respectively. The corresponding SRM (F-statistic) were 0.709 (31.7) and 0.295 (5.4).

CONCLUSIONS:

Preliminary evidence from our study suggests that a vision 'bolt-on' may increase the responsiveness of EQ-5D-3L and EQ-5D-5L to change in health outcomes experienced by patients undergoing cataract surgery. In absence of the preference-based vision bolt-on EQ-5D-5L index, HUI3 was the most responsive measure.

KEYWORDS:

Bolt-on; Cataract; EQ-5D; Responsiveness; Vision

PMID:
31902023
DOI:
10.1007/s10198-019-01156-w

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