Developing Patient Reported Health Status Valuations

OHE was awarded a £325,000 Policy Research Programme grant by the UK Department of Health in early 2010. The fifteen-month project focuses on a new health status index – the five-level (5L) EQ-5D — that will capture smaller changes in health related quality of life than does the current three-level (3L) instrument. The EQ-5D is arguably the most important patient-reported outcomes measure (PROM) currently in use. In England, for example, it underpins technology appraisals submitted to NICE and is used by the PROMs programme to assess the quality of care provided in different settings.

The research for this grant consists of three sets of studies. The first will map the 5L to 3L values to produce an interim set of values applicable while international research resolves important methodological issues with the 5L approach. The EuroQol Group has similar research underway in Scotland, Poland and The Netherlands. In England, 1,000 patients will be involved who have one of four diagnoses: rheumatoid arthritis, depression, multiple sclerosis or a recent history of myocardial infarction.

The second study will focus on improving Time Trade Off (TTO) methodology, focusing on Lead and Lag Time TTO (LT-TTO). TTO helps translate EQ-5D indexes into values that can underpin health care allocation and access decisions. The research objective is to develop a better understanding of the characteristics of the data generated by LT-TTO, improve data collection tools, and provide information for selecting the particular variant of LT-TTO to be used in subsequent research.

The third study builds on the second, with the aim of investigating alternatives for addressing issues for valuation presented by the increase from 243 states under 3L to 3,125 under 5L. Specifically, a hybrid approach using LT-TTO and discrete-choice methods will be tested. This study is part of a multi-country study that also involves Argentina, China, Canada, The Netherlands, Singapore, Spain and the United States.

The research programme will yield both an interim value set for the EQ-5D-5L, and methodological improvements in approaches to valuation that can be used to produce new national value sets for use in economic evaluation.

Investigators on the grant are Prof Nancy Devlin, OHE; Dr Andrew Lloyd, Oxford Outcomes Ltd; Prof Aki Tsuchiya, University of Sheffield; and Mr Koonal Shah, OHE.

Official project title: An interim EQ-5D-5L value set for England and development of EQ-5D-5L valuation methods

  • Comparing variants and lead and lag time TTO

    The objective of this research was to develop a better understanding of the characteristics of the data generated by LT-TTO, improve data collection tools, and provide information for selecting the particular variant of LT-TTO to be used in subsequent research.

    Now available as OHE Research Paper 10/02, the results of this research already are having an important impact.  Research to pilot the use of the methods reported in our paper now is underway in four countries.  An additional four countries will use our results as the basis for further methodological research.  These studies, coordinated by the EuroQol Group, will lay the foundations for future EQ-5D-5L value sets studies.