The validity of EQ-5D US preference weights in liver transplant candidates and recipients

Abstract

Health utility instruments assess patients' valuation of specific health states, which can be converted to quality-adjusted life years for cost-utility analysis. Data from the EQ-5D, a generic health-related quality of life questionnaire from EuroQoL, can be reported as 5 health status scores or as a single health preference weight (HPW). US population-based HPWs were published by colleagues in 2005 (Med Care 2005;43:203-220). Our aim was to test the validity of US EQ-5D HPWs and health status scores in liver transplant patients. EQ-5D scores were converted to HPWs with Shaw et al.'s model. Data were stratified by measurement period: pretransplant period, early posttransplant period (Յ12 months), intermediate posttransplant period (13-36 months), and late posttransplant period (Ͼ36 months). EQ-5D scores were compared to specific, hypothesized Short Form 36 Health Survey, Center for Epidemiologic Studies Depression Scale, and Beck Anxiety Inventory scores that were identified a priori on the basis of construct similarity. Criterion-related and construct validity were tested with nonparametric methods. Two hundred eighty-five adults participated (113 in the pretransplant period, 60 in the early posttransplant period, 47 in the intermediate posttransplant period, and 65 in the late posttransplant period), and follow-up averaged 36 Ϯ 36 months. Eighty-one percent of the hypothesized relationships between EQ-5D and gold-standard scales were strong (r Ն ͉0.5͉, P Ͻ 0.001), and the remainder were moderate (r Ͼ ͉0.3͉, P Ͻ 0.001). Differences between pretransplant and posttransplant EQ-5D HPWs were statistically significant. In conclusion, EQ-5D dimensions and the health utility index generated from Shaw's US population preference weights demonstrated criterion-related and construct validity in liver transplant patients. It is a valid instrument for cost-utility analysis in this setting. Liver Transpl 15:88-95, 2009.

Patients undergoing subacute rehabilitation have accurate expectations of their health-related quality of life at discharge

“…The EQ-5D has a range of empirical evidence supporting its internal, external, concurrent and construct validity across a wide variety of populations and patient groups; including older adults [22,23,25,26,28-33]. There is also a substantial volume of evidence supporting various aspects of its reliability [22,27,31,32,34].…”

The challenges of liver transplantation for hepatocellular carcinoma on cirrhosis

“…Priorities may be different depending on whether patients are ranked according to efficiency (net cost per QALY) or equity consideration, based on individualized patient‐specific indexes [97,98]. In fact, the particular model of LT for HCC should be a good benchmark to quantify the extent of efficiency loss (in terms of lost QALY and increased costs) when equity concerns are routed to prevail over efficiency end‐points to comply and capture public preferences in the allocation of the donated livers.…”

Health‐related quality of life, uncertainty and coping strategies in solid organ transplant recipients during shielding for the COVID‐19 pandemic

“…EQ‐5D‐5L domains and index scores were compared with the general population in England using the Health Survey for England 2017 (HSE), which comprised a multi‐stage, stratified, random probability sample of 7997 adult respondents. Disease‐specific comparison was achieved with four post‐transplant cohorts, after crosswalk from EQ‐5D‐5L to EQ‐5D‐3L according to NICE guidelines [34–37]. These four cohorts consisted of patients that were in the early or late post‐operative period following either renal or liver transplantation and were compared with subgroups of the study population accordingly [34,35,38,39].…”