Exploring the Impact of Adding a Respiratory Dimension to the EQ-5D-5L

Martine Hoogendoorn, Mark Oppe, Melinde R. S. Boland, Lucas M. A. Goossens, Elly A. Stolk and Maureen P. M. H. Rutten– van Mölken
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Martine Hoogendoorn: Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Zuid-Holland, the Netherlands
Mark Oppe: Executive Office, EuroQol Research Foundation, Rotterdam, Zuid-Holland, the Netherlands
Melinde R. S. Boland: Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Zuid-Holland, the Netherlands
Lucas M. A. Goossens: Erasmus School of Health Policy and Management, Erasmus University, Rotterdam, Zuid-Holland, the Netherlands
Elly A. Stolk: Executive Office, EuroQol Research Foundation, Rotterdam, Zuid-Holland, the Netherlands
Maureen P. M. H. Rutten– van Mölken: Institute for Medical Technology Assessment, Erasmus University, Rotterdam, Zuid-Holland, the Netherlands

Medical Decision Making, 2019, vol. 39, issue 4, 393-404

Abstract: Objectives. To evaluate the impact of adding a respiratory dimension (a bolt-on dimension) to the EQ-5D-5L health state valuations. Methods. Based on extensive regression and principal component analyses, 2 respiratory bolt-on candidates were formulated: R1, limitations in physical activities due to shortness of breath, and R2, breathing problems. Valuation interviews for the selected bolt-ons were performed with a representative sample from the Dutch general public using the standardized interview protocol and software of the EuroQol group. Hybrid models based on the combined time-tradeoff (TTO) and discrete choice experiment (DCE) data were estimated to assess whether the 5 levels of the respiratory bolt-on led to significant changes in utility values. Results. For each bolt-on candidate, slightly more than 200 valuation interviews were conducted. Mean TTO values and DCE choice probabilities for health states with a level 4 or 5 for the respiratory dimension were significantly lower compared with the same health states in the Dutch EQ-5D-5L valuation study without the respiratory dimension. Results of hybrid models showed that for the bolt-on “limitations in physical activities,†the utility decrements were significant for level 3 (–0.055), level 4 (–0.087), and level 5 (–0.135). For “breathing problems,†the utility decrements for the same levels were greater (–0.086, –0.219, and –0.327, respectively). Conclusions. The addition of each of the 2 respiratory bolt-ons to the EQ-5D-5L had a significant effect on the valuation of health states with severe levels for the bolt-on. The bolt-on dimension “breathing problems†showed the greatest utility decrements and therefore seems the most appropriate respiratory bolt-on dimension.

Keywords: EQ-5D; respiratory symptoms; bolt-on; valuation study; pilot (search for similar items in EconPapers)
Date: 2019
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:39:y:2019:i:4:p:393-404

DOI: 10.1177/0272989X19847983

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