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Comparing EQ-5D-5L, PROPr, SF-6D and TTO utilities in patients with chronic skin diseases

Ákos Szabó, Valentin Brodszky and Fanni Rencz ()
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Ákos Szabó: Corvinus University of Budapest
Valentin Brodszky: Corvinus University of Budapest
Fanni Rencz: Corvinus University of Budapest

The European Journal of Health Economics, 2025, vol. 26, issue 4, No 8, 627-639

Abstract: Abstract Objectives We aim to compare the measurement properties of three indirect (EQ-5D-5L, PROPr, SF-6D) and one direct (time trade-off, TTO) utility assessment methods in patients with chronic skin diseases. Methods 120 patients with physician-diagnosed chronic skin diseases (psoriasis 39%, atopic dermatitis 27%, acne 19%) completed a cross-sectional survey. Respondents completed the EQ-5D-5L, PROMIS-29+2 and SF-36v1 questionnaires and a 10-year TTO task for own current health. Utilities were computed using the US value sets. Ceiling, convergent and known-group validity were compared across the utilities derived with these four methods. Known-groups were defined based on general, physical and mental health. The agreement between utilities was assessed using intraclass correlation coefficients (ICC). Results Mean utilities for the EQ-5D-5L, PROPr, SF-6D and TTO were 0.79, 0.47, 0.76 and 0.89. In corresponding order, the ceiling was 28%, 0%, 2% and 65%. The SF-6D showed excellent agreement with the EQ-5D-5L (ICC = 0.770). PROPr demonstrated poor agreement with the EQ-5D-5L (ICC = 0.381) and fair with SF-6D utilities (ICC = 0.445). TTO utilities showed poor agreement with indirectly assessed utilities (ICC = 0.058–0.242). The EQ-5D-5L better discriminated between known groups of general and physical health, while the SF-6D and PROPr outperformed the EQ-5D-5L for mental health problems. Conclusion There is a great variability in utilities across the four methods in patients with chronic skin conditions. The EQ-5D-5L, despite its higher ceiling, appears to be the most efficient in discriminating between patient groups for physical health aspects. Our findings inform the choice of instrument for quality-adjusted life year calculations in cost-utility analyses.

Keywords: EQ-5D-5L; SF-6D; PROPr; TTO; Utility; Health-related quality of life; Validity; Psychometrics (search for similar items in EconPapers)
JEL-codes: I10 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01728-5

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