Comparison of EQ-5D and SF-6D utilities in mental health patients

Abstract

SummaryVarious preference-based measures of health are available for use as an outcome measure in cost-utility analysis. The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients.Baseline data from a Dutch multi-centre randomised trial of 616 patients with mood and/or anxiety disorders were used. Mean and median EQ-5D and SF-6D utilities were compared, both in the total sample and between severity subgroups based on quartiles of SCL-90 scores. Utilities were expected to decline with increased severity.Both EQ-5D and SF-6D utilities differed significantly between patients of adjacent severity groups. Mean utilities increased from 0.51 at baseline to 0.68 at 1.5 years follow-up for EQ-5D and from 0.58 to 0.70 for SF-6D. For all severity subgroups, the mean change in EQ-5D utilities as well as in SF-6D utilities was statistically significant. Standardised response means were higher for SF-6D utilities.We concluded that both EQ-5D and SF-6D discriminated between severity subgroups and captured improvements in health over time. However, the use of EQ-5D resulted in larger health gains and consequent lower cost-utility ratios, especially for the subgroup with the highest severity of mental health problems.

A systematic review, psychometric analysis and qualitative assessment of generic preference-based measures of health in mental health populations and the estimation of mapping functions from widely used specific measures

“…50 Recent years have seen the development of preference-based condition-specific measures, 51 including one for common mental health problems. 52 However, the pressure to use generic measures remains and has started to impact on the scales used in clinical studies and, most recently in the UK, in routine patient-reported outcome measurement.…”

“…In all, there were 22 studies 50, identified with data on the validity and/or responsiveness of the generic HRQoL measures in depression and anxiety for EQ-5D and SF-6D. Fourteen studies 50,129,[136][137][138][139][142][143][144][145][146][147][148][149] had data on the EQ-5D and seven 130,131,[133][134][135]140,141 contained data on the SF-6D. Studies were undertaken in at least 12 countries (a number covered Europe).…”

“…Six studies 139,142,144,[147][148][149] investigated the known-group validity of the EQ-5D across severity groups, five studies 129,136,137,143,145 reported convergent validity of the EQ-5D and 14 studies 50,[130][131][132][133][134][135][136][137][138]140,141,145,146 investigated the responsiveness of the EQ-5D. Two studies 139,142 had known-groups differences in the SF-6D, three 132,134,137 had convergent validity and two 136,145 had responsiveness.…”

Comparing the Performance of the SF-6D and the EQ-5D in Different Patient Groups

“…However, although these instruments all have these characteristics, many researchers have detected discrepancies in the utility values obtained by different instruments, mainly due to differences of the descriptive part of the measure. Indeed, an analysis of some of the studies published in recent years in the area of health economics and the measurement of HRQoL, [32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] including studies with a wide diversity of populations and interventions, shows only a weak or moderate level of agreement between different preferencebased instruments.…”

“…Several studies have been published with comparisons between these two instruments. 33,49,50 However, most studies have been aimed at comparing and analysing the performance of the instruments in the context of a specific disease, 36,38,[40][41][42][43][44]46,48,[51][52][53][54][55][56][57] or among specific groups of people. 32,37,39 Few studies have been devoted to the comparison of the EQ-5D and the SF-6D in the general population, 45,58 along with the comparison of their performances for more than one disease.…”