Population norms for the EQ-5D-3L: a cross-country analysis of population surveys for 20 countries.

This study provides EQ-5D population norms for 20 countries (N = 163,838), which can be used to compare profiles for patients with specific conditions with data for the average person in the general population in a similar age and/or gender group. Descriptive EQ-5D data are provided for the total population, by gender and by seven age groups. Provided index values are based on European VAS for all countries, based on TTO for 11 countries and based on VAS for 10 countries. Important differences exist in EQ-5D reported health status across countries after standardizing for population structure. Self-reported health according to all five dimensions and EQ VAS generally decreased with increasing age and was lower for females. Mean self-rated EQ VAS scores varied from 70.4 to 83.3 in the total population by country. The prior living standards (GDP per capita) in the countries studied are correlated most with the EQ VAS scores (0.58), while unemployment appeared to be significantly correlated in people over the age of 45 only. A country's expenditure on health care correlated moderately with higher ratings on the EQ VAS (0.55). EQ-5D norms can be used as reference data to assess the burden of disease of patients with specific conditions. Such information, in turn, can inform policy-making and assist in setting priorities in health care.

Estimating health utilities in patients with asthma and COPD: evidence on the performance of EQ-5D and SF-6D.

OBJECTIVE: The objective of this study was to understand systematic differences in utility values derived from the EQ-5D and the SF-6D in two respiratory populations with heterogeneous disease severity. METHODS: This study involved secondary analysis of data from two cross-sectional surveys of patients with asthma (N = 228; Hungary) and COPD (N = 176; Sweden). Disease severity was defined according to GINA and GOLD guidelines for asthma and COPD, respectively. EQ-5D and SF-6D scores and their distributional characteristics were compared across the two samples by disease severity level. RESULTS: Within each patient population, mean EQ-5D and SF-6D scores were similar for the overall group and for those with moderate disease. Mean scores varied for patients with mild and severe disease. EQ-5D versus SF-6D scores in the asthma group by severity levels were 0.89 versus 0.80, 0.70 versus 0.73, 0.63 versus 0.64, and 0.51 versus 0.63, respectively. EQ-5D versus SF-6D scores in the COPD group by severity levels were 0.85 versus 0.80, 0.73 versus 0.73, 0.74 versus 0.73, and 0.53 versus 0.62, respectively. CONCLUSIONS: Results suggest the EQ-5D and SF-6D do not yield consistent utility values in patients with asthma and COPD due to differences in underlying valuation techniques and the EQ-5D's limited response options relative to mild disease.

Health-related quality of life assessment in adult haemophilia patients: a systematic review and evaluation of instruments.

The objective of this study was to review and evaluate the performance of health-related quality of life (HRQL) and other health status measures used in studies of adult haemophilia and provide recommendations for future research. A systematic literature review was performed to identify HRQL and health status measures used in haemophilia. Literature was identified using medical databases, Internet and manual searches. The search was restricted to articles published in English since 1986. Ninety-six abstracts were located; 19 relevant articles were selected for detailed review. Three main types of HRQL measures were identified: generic psychometric-based HRQL (SF-36 and SF-12), utility-based HRQL [EQ-5D and Health Utilities Index (HUI)], and musculoskeletal-specific HRQL (Arthritis Impact Measurement Scale 2, AIMS 2) instruments. No patient-rated haemophilia-specific HRQL instrument was found. The SF-36, the EQ-5D, and the HUI were able to discriminate haemophilia patient subgroups with respect to disease severity and HIV comorbidity status. Sixteen additional scales were identified that were used to measure the different aspects of physical, psychological, and social functioning of patients. There were no clinical studies of haemophilia carried out that employed HRQL instruments, thus responsiveness of these instruments could not be evaluated. The variety of instruments used in haemophilia studies highlights the need for a tool that can capture the full impact of haemophilia and its treatment on patients' HRQL. Developing such a tool poses the unique challenge of accounting for common comorbidities, such as HIV and chronic hepatitis that may have a greater HRQL impact than the underlying disease.