Mapping analyses to estimate health utilities based on responses to the OM8-30 otitis media questionnaire
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To investigate the statistical relationship between the OM8-30 health-related quality of life measure for children with otitis media with effusion (OME) and measures of health utility (Health Utilities Index [HUI] Mark 3 and Mark 2) and to develop models to estimate HUI3 and HUI2 health utilities from OM8-30 scores.
A placebo-controlled, randomised trial (GNOME) evaluating intranasal mometasone in 217 children with OME provided concurrent responses to OM8-30 and HUI at three time points. Ordinary least squares (OLS), generalised linear models and two-step regression analyses were used to predict HUI3 and HUI2 utilities based on OM8-30 facet and domain scores.
OLS models including all nine OM8-30 facets with or without predicted hearing level (HL) produced the best predictions of HUI3 utilities (mean absolute error: 0.134 with HL and 0.132 without; R 2: 0.63 with HL and 0.596 without). An OLS model predicting HUI3 utilities based on the two OM8-30 domain scores, reported hearing difficulties, predicted HL, age and sex also produced accurate predictions.
Regression equations predicting HUI3 and HUI2 utilities based on OM8-30 facet and domain scores have been developed. These provide an empirical basis for estimating quality-adjusted life years (QALYs) for interventions in children with OME.
KeywordsOtitis media Glue ear Quality of life Health state preference value Utility mapping Cross-walking
Air conduction estimated from tympanometry
Akaike information criterion
Developmental domain of the OM8-30
Ear, nose and throat
Generalised linear model(s)
GPRF [General Practice Research Framework] Nasal steroids for Otitis Media with Effusion
Health-related quality of life
Health Utilities Index
Mean absolute error
Mean absolute error for the validation dataset
Ordinary least squares [regression]
Otitis media questionnaire
Otitis media with effusion
Physical health domain of the OM8-30
Parent quality of life
Reported hearing difficulties
Root mean squared error
The authors would like to thank all researchers who were involved in the GNOME trial, in addition to the children and parents who participated. In particular, we would like to thank Giselle Abangma for preparing the dataset of HUI utilities, Helen Spencer for preparing datasets of OM8-30 question, facet and domain scores and predicted hearing levels and the two anonymous reviewers for their helpful comments on the manuscript. This project was funded by the UK National Institute for Health Research Health Technology Assessment Programme (project number 01/72/02). The views and opinions expressed are those of the authors and do not necessarily reflect those of the Department of Health.
- 2.von Neumann, J., & Morgenstern, O. (1953). Theory of games and economic behavior (3rd ed.). New York: Wiley.Google Scholar
- 4.Drummond, M. F., O’Brien, B., Stoddart, G. L., & Torrance, G. W. (1997). Chapter 6: Cost-utility analysis. Methods for the economic evaluation of health care programmes (2nd ed.). New York: Oxford Medical Publications.Google Scholar
- 6.National Institute for Health and Clinical Excellence. (2008). Guide to the methods of technology appraisal. (http://www.nice.org.uk/media/B52/A7/TAMethodsGuideUpdatedJune2008.pdf).
- 7.Canadian Agency for Drugs and Technologies in Health. (2006). Guidelines for economic evaluation of pharmaceuticals: Canada. 3rd ed. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH) (http://cadth.ca/media/pdf/186_EconomicGuidelines_e.pdf).
- 8.Scottish Medicines Consortium. (2007). Guidance to manufacturers for completion of new product assessment form (NPAF). (http://www.scottishmedicines.org.uk/smc/files/New%20Product%20Assessment%20Form%20(NPAF)Guidance%20NotesCombinedClinical%20and%20Economic(Master%20updated%20June%2007)%20FINAL.doc).
- 9.Brazier, J. E., Yang, Y., Tsuchiya, A., & Rowen, D. L. (2009). A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures. The European Journal of Health Economics. doi: 10.1007/s10198-009-0168-z.
- 19.Mathers, C. D., Lopez, A. D., & Murray, C. J. L. (2006). Chapter 3: The Burden of disease and mortality by condition: Data, methods, and results for 2001. Global burden of disease and risk factors (pp. 45–93). New York: Oxford University Press.Google Scholar
- 28.Williamson, I., Benge, S., Barton, S., Petrou, S., Letley, L., & Fasey, N., et al. (2009). A double-blind randomised placebo controlled trial of topical intra-nasal corticosteroids in 4–11 year old children with persistent bilateral otitis media with effusion in primary care. Health Technology Assessment 13(37), 1–144.Google Scholar
- 29.Williamson, I., Benge, S., Barton, S., Petrou, S., Letley, L., & Fasey, N., et al. (2009). A double-blind randomised placebo controlled trial of topical intra-nasal corticosteroids in 4–11 year old children with persistent bilateral Otitis Media with Effusion in primary care. BMJ (in press).Google Scholar
- 30.Haggard, M., Spencer, H., & Gregori, M. (2007). Internationally Standardised Clinical Description: Can It Be Achieved ENT? ENT News, 16(1), 69–72.Google Scholar
- 31.Furlong, W., Feeny, D., Torrance, G. W., Goldsmith, C. H., DePauw, S., & Zhu, Z., et al. (1998). Multiplicative multi-attribute utility function for the health utilities index mark 3 (HUI3) system: A Technical Report. CHEPA Working Paper Series 98-11.Google Scholar
- 34.Torrance, G. W., Feeny, D. H., Furlong, W. J., Barr, R. D., Zhang, Y., & Wang, Q. (2000). Influence of age, type of audiometry and child’s concentration on hearing thresholds. MRC Multi-centre Otitis Media Study Group. British Journal of Audiology, 34(4), 231–240.Google Scholar
- 35.Torrance, G. W., Feeny, D. H., Furlong, W. J., Barr, R. D., Zhang, Y., & Wang, Q. (2001). Surgery for persistent otitis media with effusion: generalizability of results from the UK trial (TARGET). Trial of Alternative Regimens in Glue Ear Treatment. Clin Otolaryngol. Allied Sciences, 26(5), 417–424.Google Scholar
- 36.Torrance, G. W., Feeny, D. H., Furlong, W. J., Barr, R. D., Zhang, Y., & Wang, Q. (1999). Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion. MRC Multi-Centre Otitis Media Study Group. Clin Otolaryngol. Allied Sciences, 24(4), 294–300.Google Scholar
- 37.Haggard, M., Spencer, H., & Gregori, M. (2006). OM8-30 for assessment and outcome in OME: origins, applications & ultra-short OM2-13 (http://www.bacda.org.uk/Revised%20Jan06%20BACDA%20with%20OM2-131.ppt). Presented at the BACDA 20th Anniversary Meeting, London, 27 January.
- 38.Haggard, M., Spencer, H., & Gregori, M. (2007). Overcoming international differences for clinical comparisons and research. ENT News, 16(3), 68–71.Google Scholar
- 39.MRC Multi-centre Otitis Media Study Group. (2009). Air-conduction estimated from tympanometry (ACET) 1: relationship to measured hearing in OME. International Journal of Pediatric Otorhinolaryngology, 73(1), 21–42.Google Scholar
- 44.Sung, L., Greenberg, M. L., Doyle, J. J., Young, N. L., Ingber, S., Rubenstein, J., et al. (2003). Construct validation of the health utilities index and the child health questionnaire in children undergoing cancer chemotherapy. British Journal of Cancer, 88(8), 1185–1190.CrossRefPubMedGoogle Scholar
- 45.Barr, R. D., Petrie, C., Furlong, W., Rothney, M., & Feeny, D. (1997). Health-related quality of life during post-induction chemotherapy in children with acute lymphoblastic leukemia in remission: an influence of corticosteroid therapy. International Journal of Oncology, 11, 333–339.Google Scholar
- 47.Drummond, M. F., Sculpher, M. J., Torrance, G. W., O’Brien, B. J., & Stoddart, G. L. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). Oxford: Oxford University Press.Google Scholar
- 50.StataCorp. (2008). Stata version 10.0 (http://www.stata.com). College Station, Texas.
- 51.StataCorp. (2007). Regress—Linear regression. Stata base reference manual: Release 10 (pp. 79–101). College Station, TX: StataCorp LP.Google Scholar
- 52.StataCorp. (2007). 20.15: Obtaining robust variance estimates. Stata base reference manual: release 10 (pp. 268–273). College Station, TX: StataCorp LP.Google Scholar
- 53.StataCorp. (2007). GLM—Generalised linear models. Stata base reference manual: Release 10 (pp. 493–522). College Station, TX: StataCorp LP.Google Scholar
- 57.Haggard, M., Spencer, H., Williamson, I., & Benge, S. E. (2008). Caseloads in otitis media: effects of selective referral to secondary care on severity of cases in UK & elsewhere. Podium presentation at the European Society of Paediatric ORL, Budapest June 10, 2008.Google Scholar
- 58.Tsuchiya, A., Brazier, J., McColl, E., & Parkin, D. (2002). Deriving preference-based single indices from non- preference based condition specific instruments: converting AQLQ into EQ-5D indices. HEDS discussion paper.Google Scholar