Mapping the Peds QLTM 4.0 onto CHU-9D: a cross-sectional study in functional dyspepsia population from China.

Objective: The study aims to develop a mapping algorithm from the Pediatric Quality of Life Inventory™ 4. 0 (Peds QL 4.0) onto Child Health Utility 9D (CHU-9D) based on the cross-sectional data of functional dyspepsia (FD) children and adolescents in China. Methods: A sample of 2,152 patients with FD completed both the CHU-9D and Peds QL 4.0 instruments. A total of six regression models were used to develop the mapping algorithm, including ordinary least squares regression (OLS), the generalized linear regression model (GLM), MM-estimator model (MM), Tobit regression (Tobit) and Beta regression (Beta) for direct mapping, and multinomial logistic regression (MLOGIT) for response mapping. Peds QL 4.0 total score, Peds QL 4.0 dimension scores, Peds QL 4.0 item scores, gender, and age were used as independent variables according to the Spearman correlation coefficient. The ranking of indicators, including the mean absolute error (MAE), root mean squared error (RMSE), adjusted R2, and consistent correlation coefficient (CCC), was used to assess the predictive ability of the models. Results: The Tobit model with selected Peds QL 4.0 item scores, gender and age as the independent variable predicted the most accurate. The best-performing models for other possible combinations of variables were also shown. Conclusion: The mapping algorithm helps to transform Peds QL 4.0 data into health utility value. It is valuable for conducting health technology evaluations within clinical studies that have only collected Peds QL 4.0 data.

Defining the Health Utility Value of Medical Management of Chronic Rhinosinusitis: A Prospective Pilot Study.

The extent to which medical management of chronic rhinosinusitis (CRS) may improve health utility value (HUV) remains unknown. We conducted a prospective pilot study to longitudinally assess HUV via the EQ-5D-5L questionnaire in patients with CRS who were receiving medical therapy but did not undergo sinus surgery. The primary study outcome was HUV at 12-month follow-up; secondary end points included HUV at baseline and 3- and 24-month follow-up. Our study enrolled 115 patients who received the following medical treatments: saline irrigations (n = 83, 72.2%), steroid sprays (n = 93, 80.9%), antihistamines (n = 64, 55.7%), steroid irrigations (n = 29, 25.2%), and oral antibiotics (n = 58, 50.4%). There was a statistically significant improvement (mean, +0.073; P = .003) in HUV at 12 months (minimum clinically important difference, 0.055) as compared with baseline. However, there was no statistically significant trend in HUV over time between baseline and 24-month follow-up (P = .3033). These findings can inform cost-effectiveness research as new medical therapies for CRS emerge.

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.

Current Status of Research on the Mapping Function of Health Utility Values in the Asia Pacific Region: A Systematic Review.

OBJECTIVES: This systematic review aimed to analyze the published studies on the use of the mapping method between generic scales and disease-specific scales as well as between 2 universal scales. METHODS: A systematic literature search was conducted using PubMed, ScienceDirect, Web of Science, CNKI, Weipa Database, Wanfang Database, and HERC Database to collect articles about the application of the mapping method to the measurement of health utility value from January 2000 to December 2019. RESULTS: Overall, 59 articles met the inclusion requirements, and most of them were a mapping study between a disease-specific scale and a generic scale. Then all these articles were classified by the following study types: a clear functional relationship; unclear functional relationship; disease-specific scale and universality; mapping between generic scales and disease-specific scales, and mapping between universal scales. Most studies derived the best mapping model from the ordinary least squares regression, and fewer studies chose to use new regression methods. Sample sizes in the retrieved studies generally affected the reliability of the study results. CONCLUSIONS: In recent years, as more attention has been paid to the research of the mapping method, a large number of problems have followed, such as the selection of scale types, the coverage of the study sample, and the selection of evaluation index of model performance and sample size. It is hoped that these problems can be properly solved in the future research.

Unbiased Measure of General Quality of Life in Chronic Rhinosinusitis Reveals Disease Modifiers.

INTRODUCTION: Chronic rhinosinusitis (CRS) is associated with a significant decrease in general health-related quality of life (QOL). The EuroQol 5-dimensional questionnaire measures general health-related quality of life through a health utility value (EQ-5D HUV)-based on five domains reflecting mobility, self-care, activities of daily life, pain/discomfort, and anxiety/depression-and an unbiased visual analog scale (EQ-5D VAS). We sought to identify characteristics of CRS patients with a high EQ-5D HUV but low EQ-5D VAS score. MATERIALS AND METHODS: Retrospective cross-sectional study of 300 CRS patients with EQ-5D HUV equal to 1.0 (reflecting perfect health). All patients completed a 22-item Sinonasal Outcome Test (SNOT-22)-from which nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated, as well as the EQ-5D. Low EQ-5D VAS was defined as a score less than 80. RESULTS: On multivariate analysis, low EQ-5D VAS was associated with only the SNOT-22 sleep subdomain score (odds ratio [OR] = 1.07, 95%CI: 1.02-1.12, P = .003). Comorbid asthma was also associated with lower EQ-5D VAS (OR = 2.16, 95%CI: 1.02-4.59, P = .045). In contrast, polyps were negatively associated with having a lower EQ-5D VAS (OR = 0.34, 95%CI: 0.17-0.69, P = .003). CONCLUSION: There are patients with perfect general health-related QOL according to a health utility value-based methodology (like the EQ-5D HUV) who report low general health-related QOL on an unbiased measure like the EQ-5D VAS. In CRS patients with perfect EQ-5D HUV, poor sleep and asthma were associated with low QOL on the EQ-5D VAS, while polyps were negatively associated with low QOL. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1206-1211, 2021.

The impact of depressive symptoms on health value in patients with gynecologic cancer: A comparison with physical symptoms and performance status.

OBJECTIVE: The importance of managing depressive symptoms is frequently underestimated in the clinic. In this study, the effects of depressive symptoms on health utility value (HUV) in gynecologic cancer patients are evaluated. In addition, the effects were compared with those of performance status and physical symptoms. METHODS: Patient-reported outcome data from 274 gynecologic cancer patients were prospectively collected. HUV was measured using the 3-level version of the EuroQoL 5-dimension descriptive system (EQ-5D-3L) and the EuroQoL visual analog scale (EQ-VAS). The Patient Health Questionnaire-9 (PHQ-9) was used to measure the severity of depressive symptoms. The impact of depressive symptoms on HUV was analyzed using the generalized linear model. RESULTS: Moderate-severe depressive symptoms were significantly associated with a decrease in HUV in gynecologic cancer patients (p < 0.0001 for the EQ-5D-3L and EQ-VAS). Severe fatigue and severe pain were also associated with a decrease in HUV (p = 0.018 and p < 0.0001 for the EQ-5D-3L and EQ-VAS; p < 0.0001 for the EQ-5D-3L, respectively), and the effect sizes were comparable to that of moderate-severe depressive symptoms. In addition to the patients with moderate-severe depressive symptoms, the patients with mild depressive symptoms also experienced a significant decrease in HUV (p < 0.0001 for the EQ-5D-3L and EQ-VAS). The effect size for mild depressive symptoms was comparable to those for mild fatigue or mild pain. CONCLUSIONS: Even mild depressive symptoms may significantly compromise HUV in gynecologic cancer patients, and the effect is comparable to that of performance status or physical symptoms. Gynecologic oncologists should put more effort into properly preventing, detecting, and managing depressive symptoms.

Health state utilities for metastatic breast cancer in Taiwan.

BACKGROUND: New developments in medications for metastatic breast cancer (MBC) can be of great benefit to patients, but unfortunately these medicines also increase expenditures. Cost-utility analyses (CUAs) are needed to allocate health resources properly, and health utility values are required to calculate quality-adjusted life years in those CUAs. OBJECTIVE: The aims of this study were to measure health utility values for several MBC-related health states and certain breast cancer treatment-related grade 3/4 adverse drug reactions (ADRs). In addition, we examined whether different methods and respondents' characteristics would influence the utility values elicited. METHODS: A cross-sectional survey was conducted. The visual analogue scale (VAS) and time trade-off (TTO) methods were used to measure health utilities. Four MBC and nine ADR health states were selected for evaluation based on literature review and expert opinion. Information about respondents' demographic and clinical characteristics were collected to examine the relationship between utilities and participant characteristics. RESULTS: A total of 102 patients participated in this study. The TTO-elicited values were higher than the VAS-derived scores except for two MBC-related health states. Among the MBC health states assessed, the TTO preference score ranged from 0.04 (palliative MBC) to 0.62 (responding MBC). For grade 3/4 ADRs, the mean TTO-derived utility values ranged from 0.35 (nausea/vomiting) to 0.79 (fatigue). The ranking of the preference scores derived from the VAS was similar to that of the TTO-elicited scores. CONCLUSION: This study obtained health state utility values for MBC and grade 3/4 ADRs using both the TTO and the VAS, which provides useful data for future CUAs.

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.

Does cognitive decline decrease health utility value in older adult patients with cancer?

AIM: Cognitive decline is common among older adults with cancer. The present study aimed to investigate the impact of cognitive decline on health utility value in older adults suffering from cancer. METHODS: Consecutive patients aged 65 years or older with a primary diagnosis of malignant lymphoma or multiple myeloma were recruited. Patients were asked to complete the EuroQoL-5 (EQ-5D) scale to measure health utility and the Mini-Mental State Examination to assess cognitive decline. The potential impact of cognitive decline was investigated with univariate analysis. A multivariate regression analysis was conducted to control for potential confounding factors. RESULTS: Complete data were obtained from 87 patients, 29% of whom had cognitive decline. The mean ± SE EQ-5D score for patients with cognitive decline was significantly lower than that for those without cognitive decline (0.67 ± 0.04 vs 0.79 ± 0.03, t = 2.38, P = 0.02). However, multiple regression analysis showed that cognitive decline was not significantly associated with EQ-5D scores. Female sex and lower performance scores (worse physical condition) were significantly associated with EQ-5D scores. CONCLUSIONS: Cognitive decline may be involved in decreased health utility value in older adult patients with cancer. However, this effect does not seem to be independent, and the patient's physical condition may be a relevant confounding factor.

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.