Introduction of measurement methods of health utility for cancer patients / 中国药房

Cancer is one of the major fatal diseases that seriously threaten human health， and its burden needs to be solved urgently. Health technology assessment （HTA） can provide scientific evidence-based basis for cancer diagnosis， treatment， prevention and related policy formulation. Cost-utility analysis is the gold standard for economic evaluation in HTA， and the accurate measurement of its health utility is one of the key elements to determine the accuracy of its results. This article focuses on systematic introduction of direct measures， multi-attribute health utility scales， and mapping methods in the field of cancer measurement and reviews their applications in cancer patients. Among them， direct measures are complex， costly， and require a high level of subject knowledge； multi-attribute health utility measures are currently the preferred method for measuring health utility in cancer patients； with the continuous development and refinement of disease-specific utility measures in multi-attribute health utility instruments， the mapping method may gradually decrease in future applications. This paper can provide a reference for the selection of health utility measurement tools for HTA in the field of cancer， and provide evidence-based basis for optimizing resource allocation and policy formulation in the field of cancer.

Mapping the Constitution in Chinese Medicine Questionnaire to SF-6Dv1 / 中医杂志

ObjectiveTo construct and evaluate the transformation model of the Constitution in Chinese Medicine Questionnaire （CCMQ） to SF-6Dv1 health utility and broaden the applications of CCMQ. MethodsThe data of CCMQ and SF-6Dv1 were collected from 595 participants at baseline， 3 months and 6 months after the comprehensive intervention suitable for the corresponding traditional Chinese medicine （TCM） constitution. The estimation and validation datasets were constructed， and four statistical algorithms including the ordinary least squares （OLS）， MM robust regression （MM）， censored least absolute deviations （CLAD） and the Tobit model were used to create alternative models. The mean absolute error （MAE）， root mean square error （RMSE） and intraclass correlation coefficient （ICC） were used to evaluate the prediction performance of the model. ResultsThe constitution scores of all TCM constitutions by CCMQ was significantly correlated with the SF-6Dv1 health utility value measured at three timepoints； the health utility value of the SF-6Dv1 was positively correlated with gentleness type （r=0.596， r=0.578， r=0.606， all P＜0.05） and negatively correlated with eight unbalanced constitutions （r=-0.586~-0.301， all P＜0.05）. The MM established based on the subscale scores of CCMQ was the optimal mapping model， and the MAE， RMSE， and ICC values were 0.0741， 0.0930 and 0.766， respectively. Gentleness type， qi-deficiency type， phlegm-wetness type， qi-constraint type， and age were the primary factors included in the model. The measured and predicted value of SF-6Dv1 had a moderate positive correlation （r=0.673， r=0.617， P＜0.05） and a good consistency as shown by the Bland-Altman plot. ConclusionBy using MM， the CCMQ can be transformed into SF-6Dv1 health utility value for health economics analysis.

Quantifying health utilities of young adult orthodontic patients using the time trade-off method: a cross-sectional study

ABSTRACT Objective: To study the feasibility of time trade-off (TTO) method in quantifying health utility ratings in different types of malocclusion. Material and Methods: In this cross-sectional study, 70 orthodontic patients aged 18 years or above, reporting for treatment/consultation, were included and interviewed. Malocclusion-related health utilities were assessed through the TTO method, and oral health-related quality of life was measured with the help of Orthognathic Quality of Life Questionnaire (OQLQ). Angle's classification of malocclusion was recorded. Bivariate analyses and multivariate Poisson's regression were done to find out an association between the oral health utility values, OQLQ and demographic and clinical characteristics. Results: Patients with skeletal Class III malocclusion had lower health utility values than those with Class I and Class II malocclusions (p=0.013). Poisson's regression showed that Angle's Class II division 1 (0.90, CI 0.84 to 0.97), Class III (0.68, CI 0.59 to 0.95) and Skeletal malocclusion (0.79, CI 0.71 to 0.87) and OQLQ scores (1.0, CI 1 to 1.003) were found to be significant predictors of TTO utility scores. Conclusions: TTO utilities were found to be valid and well correlated with clinical findings. Health utilities could serve as useful and reliable markers of health-related quality of life (HRQL) among individuals or communities and help cost-effective preventive or intervention programs planning.

RESUMO Objetivo: Estudar a viabilidade do método Time trade-off (TTO) para quantificar escores de valoração da saúde em diferentes tipos de má oclusão. Material e Métodos: Neste estudo transversal, foram incluídos e entrevistados 70 pacientes ortodônticos com idade igual ou superior a 18 anos, que compareceram para tratamento/consulta. A valoração da saúde em relação à má oclusão foi avaliada por meio do método TTO e a qualidade de vida relacionada à saúde bucal foi medida com a ajuda do Questionário de Qualidade de Vida Ortognática (Orthognathic Quality of Life Questionnaire, OQLQ). A classificação da má oclusão segundo Angle foi registrada, e análises bivariadas e regressão multivariada de Poisson foram feitas para verificar qualquer associação entre os escores de valoração da saúde bucal, OQLQ e características demográficas e clínicas. Resultados: Os pacientes com má oclusão esquelética de Classe III apresentaram escores de valoração da saúde mais baixos do que aqueles com má oclusão de Classe I e Classe II (p=0,013). A regressão de Poisson mostrou que a Classe II de Angle divisão 1 (0,90, IC 0,84 a 0,97), Classe III (0,68, IC 0,59 a 0,95), má oclusão esquelética (0,79, IC 0,71 a 0,87) e os escores do OQLQ (1,0, IC 1 a 1,003) foram considerados preditores significativos dos escores de valoração pelo método TTO. Conclusões: Os escores do TTO foram considerados válidos e bem correlacionados com os achados clínicos, e podem servir como marcadores úteis e confiáveis da qualidade de vida relacionada à saúde (health-related quality of life, HRQL) entre indivíduos ou comunidades, e ajudar no planejamento de programas de prevenção ou de intervenção, com uma boa relação custo-benefício.

Application of adjusted limited dependent variable mixed model in the mapping of pharmacoeconomic health utility scale / 中国药房

OBJ ECTIVE To introduce adjusted limited dependent variable mixed model （ALDVMM）and study its application in mapping research ，so as to provide reference for pharmacoeconomic evaluation that needs to obtain health utility value through mapping. METHODS Using the method of literature research ，ALDVMM was introduced from the aspects of development background，model principle ，model determination and test ，model advantages and the current application of the model in empirical research. RESULTS & CONCLUSIONS ALDVMM is a mixed model developed by foreign scholars for the truncation and multimodality phenomenon of EuroQoL group ’s 5D（EQ-5D）at the health utility value 1. Compared with the traditional model，ALDVMM is feasible and has more advantages ，and can more effectively and flexibly capture the actual distribution of EQ-5D and deal with the boundary value problem ，which is helpful to obtain the health utility value more accurately and efficiently and carry out high-quality pharmacoeconomic evaluation.

Bibliometric Study on Health Utility Value Obtained by Mapping Method in Pharmacoeconomic Evaluation / 中国药房

OBJECTIVE：To know about the research status of health utility value obtained by mapping method in pharmacoeconomic evaluation ，and to provide reference for bibliometric study in pharmacoeconomic evaluation . METHODS ： Using“Mapping method ”“Health utility value ”“Cost-utility”“Utility point system ”as Chinese and English keywords ，retrieved from CNKI ，Wanfang database ，PubMed，Medline，Ebsco，Ovid and Wiley database ，empirical journal documents published from the inception to Dec. 31st，2018 about using mapping method to obtain health utility value were collected. The bibliometrics was used to statistically analyze basic information of included literature ，the construction and test of the model ，the type of the best model and so on. RESULTS ：The 124 included documents were all published in English journal. In the construction and testing of the mapping model ，the most frequently used econometric methods ，performance evaluation indicators and model testing methods were ordinary least squares （OLS），mean absolute error （MAE）and residual normality test ，application frequency of which were 97 times（31.60％），89 times（24.93％）and 62 times（21.09％）. There are 117 articles that define the best mapping model ，of which 101 articles（86.32％）have the best direct mapping effect. Most of the non-utility measurement scales adopted specific scales （92 articles，77.97％），and a few literatures adopted the universal scale （26 articles，22.03％）. The most utility measurement scales were 3-level European 5-dimensional health scale （79 articles，66.95％）. CONCLUSIONS ：The domestic empirical researches that use the mapping method to obtain health utility values need to be developed yet. A series of mapping models successfully developed by foreign scholars not only provide the feasibility of using non-utility measurement scales for cost-utility analysis ，but also provide more ideas for China to choose the corresponding econometric methods ，evaluation indicators and mapping methods in the empirical research of the mapping method in the future.

Review of generic preference-based scales for health-related quality of life at the universal scale / 中国卫生政策研究

Objective: To conduct an ample review of the existing generic preference-based measures for health-related quality of life around the globe. Methods: Databases including PubMed，Embase，CNKI and WanFang Data, literature retrieval and information extraction were carried out on relevant studies of the universal health utility scale published until April 2020 worldwide，and all the existing generic health utility measures were identified. The original development articles included in the measures were further searched to extract the basic information of the measures，the conduction process，and the structure of the health state descriptive system. All of the dimensions included in the measures were summarized and analyzed from three aspects of physical (physiological)，mental (psychological)，and societal，respectively. Results: Through searching and screening，a total of 36 articles (both in Chinese and English literatures) were obtained, among which 18 generic preference-based measures were identified and 30 original search and development articles of these 18 measures were extracted. The number of dimensions of these 18 measures varied between the range of 3~15，the number of levels under each dimension ranged between 2 and 7，and the total number of health states that could be described by these measures amounted between 64 and 2.37 × 1023.The dimensions describing the physiological aspect in health were involved by all of 18 measures，while the dimensions describing psychological health and societal aspects in health were involved by only 16 and 10 measures，respectively. The physiological，psychological and societal dimensions included 10，4, and 5 specific categories，respectively. Two ways of conducting the health state descriptive system were identified, which were mainly based on the existing data and materials，and through the construction of the items pool combined with psychometric methods to determine the included dimensions of the measures. Conclusion :In recent years，more emphasis on the measurement of mental and societal health on the basis of physiological aspect was included in the newly developed measures，and the construction process of the health state descriptive system is becoming more and more standardized.

Introduction of 15D Instrument Application / 中国卫生经济

It systematically summarized Finland's 15D instrument's development,content and its application status in health eco-nomic evaluation field,so as to provide references for implementing economic evaluation research in China,especially for health utilitymeasurement and cost-utility analysis.

Introduction of Applications for AQoL Instruments / 中国卫生经济

It made a brief introduction to a series of AQo (assessment of quality of life) instruments,which was consisted of the developments,features,utility tariffs and applications about AQoL-4D,AQoL-6D,AQoL-7D and AQoL-8D,so as to provide basic support for health economic evaluations,especially for health utility measurements and cost-utility analysis in China.

Overview of the Mapping Method and Relevant Models in Health Utility Values Measurement / 中国药房

OBJECTIVE:To provide methodological reference for converting non-utility scale measurement results into health utility values. METHODS:Referring to domestic and foreign literatures,mapping methods and relevant models in health utility measurement were summarized. The effect of each model on probability mapping was introduced by taking the Medical outcomes study 12-item short form health survey measurement results converting into the EuroQol group's 5-domain utility values as exam-ple.RESULTS:The mapping methods can be adopted to obtain the health utility values by establishing the mapping relationship be-tween non-utility scale and utility scale. The common models included ordinary least square(OLS)model,censored least absolute deviations(CLAD)model,Tobit model,multinomial Logistic regression(MNL)model,Bayesian networks(BN)model,etc. OLS model was relatively simple with a good predictive validity,but it would be limited by the ceiling effect;Tobit model was not limit-ed by the ceiling or floor effect,when the error term satisfied the variance homogeneity and normality,prediction result of Tobit model was better than OLS model;CLAD model can be used for the situation of Tobit model unsuitable for non-variance homoge-neity of the error term;MNL model firstly determined a health state by regression analysis and then determined its utility value;the prediction validity of BN model was good and it didn't involved many assumptions and restrictions condition in econometrics, but the construction of BN model was greatly influenced by domain experts. Main methods for the calculation of health utility value with MNL or BN model were Monte Carlo simulation method,expected-utility method,most-likely probability methed,etc. We can carry out the model performance evaluation by using the R2,the adjusted R2,the mean error,the mean squared error and the mean absolute error,and then select the optimal model to calculate health utility values. CONCLUSIONS:Due to the advantages and disadvantages of each mapping model,it is necessary to select different mapping models based on the actual conditions.

Overview of the Mapping Method and Relevant Models in Health Utility Values Measurement / 中国药房

OBJECTIVE:To provide methodological reference for converting non-utility scale measurement results into health utility values. METHODS:Referring to domestic and foreign literatures,mapping methods and relevant models in health utility measurement were summarized. The effect of each model on probability mapping was introduced by taking the Medical outcomes study 12-item short form health survey measurement results converting into the EuroQol group's 5-domain utility values as exam-ple.RESULTS:The mapping methods can be adopted to obtain the health utility values by establishing the mapping relationship be-tween non-utility scale and utility scale. The common models included ordinary least square(OLS)model,censored least absolute deviations(CLAD)model,Tobit model,multinomial Logistic regression(MNL)model,Bayesian networks(BN)model,etc. OLS model was relatively simple with a good predictive validity,but it would be limited by the ceiling effect;Tobit model was not limit-ed by the ceiling or floor effect,when the error term satisfied the variance homogeneity and normality,prediction result of Tobit model was better than OLS model;CLAD model can be used for the situation of Tobit model unsuitable for non-variance homoge-neity of the error term;MNL model firstly determined a health state by regression analysis and then determined its utility value;the prediction validity of BN model was good and it didn't involved many assumptions and restrictions condition in econometrics, but the construction of BN model was greatly influenced by domain experts. Main methods for the calculation of health utility value with MNL or BN model were Monte Carlo simulation method,expected-utility method,most-likely probability methed,etc. We can carry out the model performance evaluation by using the R2,the adjusted R2,the mean error,the mean squared error and the mean absolute error,and then select the optimal model to calculate health utility values. CONCLUSIONS:Due to the advantages and disadvantages of each mapping model,it is necessary to select different mapping models based on the actual conditions.

Assessment of Quality of Life during Treatment of Pediatric Oncology Patients.

Background: The objective of this study was to assess health-related quality of life (HRQOL) of pediatric cancer patients and their parents in North India. Materials and Methods: Seventy-fi ve cancer children were assessed for HRQOL, using Lansky play performance scale and health utility index-2 (HUI-2). Fifty-seven patients were followedup after 4 months after therapy and reassessed. Their parents were also assessed using World Health Organisation (WHO) QOL BREF. Seventy fi ve controls were also assessed and compared. Results: Lansky and HUI-2 scores of patients, as well as WHO QOL BREF of parents were signifi cantly poor in cancer patients when compared to controls. There was signifi cant improvement after therapy in patients with lymphomas and miscellaneous tumors. Pain and self-care were found to be maximally affected domains on HUI-2. Conclusions: Large prospective multicenter studies may be undertaken and hence that need based interventions can be planned.