New and ongoing areas of research

In the EuroQol Group

New research

• International 5L valuation – Discussed already • EQ-5D-Y – Youth version • Disease specific adaptations – ‘Bolt on’ additional dimensions

EQ-5D-Y: Youth

EQ-5D-Y: Youth

• Translations – Available in more than 20 languages – Youth between 7-12 years • Proxy versions – In development

Administration seems OK

But not yet a value set

• How should value the health states – Children?

– Parents?

– The general public?

• How do you include: – Development backlog?

– The remarkable coping skills children?

Are values different

• Do we value health states different?

– For ourselves – For someone other like ourselves – For a 10-year child • New paper of the 2012 Meeting

Values for children 10% lower

Feedback from the 2012 meeting

• Small number of health states • Still VAS – Does this also apply for TTO?

– Complication: • How to apply TTO for health states of children?

• Descriptive system EQ-5d-Y is different!

Bolt-on

• Do we miss dimensions?

• In the past: EQ-6D – Mobility; – Daily activity and self care; – Work performance – Family and leisure performance – Pain/discomfort – Present mood • First attempts – EQ-5D+cog: addition of cognition?

EQ-5D+cog

• Used in DALY WHO project – Cognition was recognized as important • Lot of discussion – Is it necessary?

– Who is making the value set?

– An unofficial set exist • Based on mapping DALY project • Is used… – But gives confusion • No official status

Why not other dimensions?

• Developed already – Psoriasis – Vision

VF-14 by Visual acuity in macular degeneration

120 100 80 60 114 40 20 0 -20 N = 11 2.01 thru hi 43 1.31 thru 2.00

37 0.61 thru 1.30

23 0.31 thru 0.60

24 lo thru 0.30

Better-seeing Eye VA (distant, LogMAR)

EQ-5D by Visual acuity in macular degeneration

1.2

1.0

.8

.6

.4

107 124 147 .2

132 91 120 202 71 0.0

102 -.2

N = 11 2.01 thru hi 43 1.31 thru 2.00

37 0.61 thru 1.30

23 0.31 thru 0.60

24 lo thru 0.30

Better-seeing Eye VA (distant, LogMAR)

Hearing

Evidence on EQ-5D: some examples

Schizophrenia Bipolar disorder Vision Depression and anxiety Some cancers Skin Personality disorder

Psoriasis

Estimation of utilities

• Used standard EQ-5D-3L TTO protocol • General public interviews in UK only – N = 300 • Sub-set of 49 states were included using orthogonal design

Results

• OLS and random effects models estimated – Interaction terms; collapsing levels • Both dimensions have a significant impact • Some inconsistencies in the data • The largest gap is between level 3 and 4 (moderate and severe)

Modeling TTO values Psoriasis

Discussion 2012 meeting

• No real problem when seen as pilot – Convenience sample – TTO not standardised • Methodological complications – Things get complicated for responders fast • 223451 versus 122345 • Cognition overload – 5 7 = 78.125 health states • Similar values for 4 th and 5 th • Modeling stressed to the limit?

levels