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Can mapping algorithms based on raw scores overestimate QALYs gained by treatment? A comparison of mappings between the Roland–Morris Disability Questionnaire and the EQ-5D-3L based on raw and Differenced Score Data
Tools
Madan, Jason, Khan, Kamran, Petrou, Stavros and Lamb, S. E. (Sallie E.) (2017) Can mapping algorithms based on raw scores overestimate QALYs gained by treatment? A comparison of mappings between the Roland–Morris Disability Questionnaire and the EQ-5D-3L based on raw and Differenced Score Data. PharmacoEconomics, 35 (5). pp. 549-559. doi:10.1007/s40273-016-0483-z ISSN 1170-7690.
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WRAP_wms_clinical_trials-110117-rmqmappe2016dec2016_clean.pdf - Accepted Version - Requires a PDF viewer. Download (715Kb) |
Official URL: http://dx.doi.org/10.1007/s40273-016-0483-z
Abstract
Introduction
Mapping algorithms are increasingly being used to predict health-utility values based on responses or scores from non-preference-based measures, thereby informing economic evaluations.
Objectives
We explored whether predictions in the EuroQol 5-dimension 3-level instrument (EQ-5D-3L) health-utility gains from mapping algorithms might differ if estimated using differenced versus raw scores, using the Roland–Morris Disability Questionnaire (RMQ), a widely used health status measure for low back pain, as an example.
Methods
We estimated algorithms mapping within-person changes in RMQ scores to changes in EQ-5D-3L health utilities using data from two clinical trials with repeated observations. We also used logistic regression models to estimate response mapping algorithms from these data to predict within-person changes in responses to each EQ-5D-3L dimension from changes in RMQ scores. Predicted health-utility gains from these mappings were compared with predictions based on raw RMQ data.
Results
Using differenced scores reduced the predicted health-utility gain from a unit decrease in RMQ score from 0.037 (standard error [SE] 0.001) to 0.020 (SE 0.002). Analysis of response mapping data suggests that the use of differenced data reduces the predicted impact of reducing RMQ scores across EQ-5D-3L dimensions and that patients can experience health-utility gains on the EQ-5D-3L ‘usual activity’ dimension independent from improvements captured by the RMQ.
Conclusion
Mappings based on raw RMQ data overestimate the EQ-5D-3L health utility gains from interventions that reduce RMQ scores. Where possible, mapping algorithms should reflect within-person changes in health outcome and be estimated from datasets containing repeated observations if they are to be used to estimate incremental health-utility gains.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Medical care, Cost of, Medical care -- Evaluation, Therapeutics -- Effectivness, Algorithms | ||||||||
Journal or Publication Title: | PharmacoEconomics | ||||||||
Publisher: | Adis International Ltd. | ||||||||
ISSN: | 1170-7690 | ||||||||
Official Date: | May 2017 | ||||||||
Dates: |
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Volume: | 35 | ||||||||
Number: | 5 | ||||||||
Page Range: | pp. 549-559 | ||||||||
DOI: | 10.1007/s40273-016-0483-z | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 12 January 2017 | ||||||||
Date of first compliant Open Access: | 6 January 2018 | ||||||||
Funder: | Birmingham Science City, Advantage West Midlands (AWM), Wolfson Foundation (WF) |
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