Can EQ-5D-3L utility values of low back pain patients be validly predicted by the Oswestry Disability Index for use in cost-effectiveness analyses?

Abstract

Purpose To assess whether regression modeling can be used to predict EQ-5D-3L utility values from the Oswestry Disability Index (ODI) in low back pain (LBP) patients for use in cost-effectiveness analysis. Methods EQ-5D-3L utility values of LBP patients were estimated using their ODI scores as independent variables using regression analyses, while adjusting for case-mix variables. Six different models were estimated: (1) Ordinary Least Squares (OLS) regression, with total ODI score, (2) OLS, with ODI item scores as continuous variables, (3) OLS, with ODI item scores as ordinal variables, (4) Tobit model, with total ODI score, (5) Tobit model, with ODI item scores as continuous variables, and (6) Tobit model, with ODI item scores as ordinal variables. The models’ performance was assessed using explained variance (R2) and root mean squared error (RMSE). The potential impact of using predicted instead of observed EQ-5D-3L utility values on cost-effectiveness outcomes was evaluated in two empirical cost-effectiveness analysis. Results Complete individual patient data of 18,692 low back pain patients were analyzed. All models had a more or less similar R2 (range 45–52%) and RMSE (range 0.21–0.22). The two best performing models produced similar probabilities of cost-effectiveness for a range of willingness-to-pay (WTP) values compared to those based on the observed EQ-5D-3L values. For example, the difference in probabilities ranged from 2 to 5% at a WTP of 50,000 €/QALY gained. Conclusion Results suggest that the ODI can be validly used to predict low back pain patients’ EQ-5D-3L utility values and QALYs for use in cost-effectiveness analyses.

Comparing Preoperative Quality of Life Questionnaire in Lumbar Stenosis

“…21 The damage caused by this pathology to patients' quality of life is well known, reaching the biopsychosocial sphere. 4,11,[22][23][24][25] Quality-of-life questionnaires are a feasible, effective, and routinely used instrument to monitor the evolution of patients undergoing treatment for spinal pathologies. [23][24][25][26][27] For Higginson et al, to be clinically useful, an instrument that assesses the quality of life should be easy to understand and quick to respond to.…”

“…4,11,[22][23][24][25] Quality-of-life questionnaires are a feasible, effective, and routinely used instrument to monitor the evolution of patients undergoing treatment for spinal pathologies. [23][24][25][26][27] For Higginson et al, to be clinically useful, an instrument that assesses the quality of life should be easy to understand and quick to respond to. 25,28 The great challenge in creating quality-of-life assessment instruments with a small number of items is the difficulty in transforming them into multidimensional instruments.…”

Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: Study protocol for a randomised controlled trial

“…In addition, primary outcome (pain intensity) will also be collected after every 4 weeks of intervention. All indicators will be selected in assessing outcomes for estimating treatment success for CLBP [35][36][37], concentrating on pain intensity, psychology, QOL and functioning disability.…”

Effect of different weekly frequencies of Chen-style Tai Chi in elders with chronic non-specific low back pain: study protocol for a randomised controlled trial

“…In addition, primary outcome (the changes of LBP intensity at rest) will also be collected every week 4 and week 8 after the intervention started. All indicators will be selected in assessing outcomes for estimating treatment success for CLBP [ 36 – 38 ], concentrating on pain intensity, psychology, QOL and functioning disability.…”