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Determinants of time trade-off valuations for EQ-5D-5L health states: data from the Canadian EQ-5D-5L valuation study

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Abstract

Background

Previous studies suggest that population subgroups have different perceptions of health, as well as different preferences for hypothetical health states.

Objective

To identify determinants of health states preferences elicited using time trade-off (TTO) for the 5-level EQ-5D questionnaire (EQ-5D-5L) in Canada.

Methods

Data were from the Canadian EQ-5D-5L Valuation Study, which took place in Edmonton, Hamilton, Montreal, and Vancouver. Each respondent valued 10 of 86 hypothetical health states during an in-person interview using a computer-based TTO exercise. The TTO scores were the dependent variable and explanatory variables including age, sex, marital status, education, employment, annual household income, ethnicity, country of birth, dwelling, study site, health literacy, number of chronic conditions, previous experience with illness, and self-rated health.

Results

Average [standard deviation (SD)] age of respondents (N = 1209) was 48 (17) years, and 45 % were male. In multivariable linear regression models with random effects, adjusted for severity of health states and inconsistencies in valuations, older age [unstandardized regression coefficient (β) = −0.077], male sex (β = 0.042), being married (β = 0.069), and urban dwelling (β = −0.055) were significantly associated with health states scores. Additionally, participants from Edmonton (β = −0.124) and Vancouver (β = −0.156), but not those from Hamilton, had significantly lower TTO scores than those from Montreal.

Conclusions

Socio-demographic characteristics were the main determinants of preferences for EQ-5D-5L health states in this study. Interestingly, preferences were significantly lower in western Canadian cities compared to eastern ones, bringing into question whether a single preference algorithm is suitable for use in all parts of Canada.

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References

  1. Drummond, M. F., O’Brien, B. J., Stoddart, G. L., & Torrance, G. W. (1997). Methods for the economic evaluation of health care programmes (2nd ed.). Oxford: Oxford University Press.

    Google Scholar 

  2. Streiner, D. L., & Norman, G. R. (2003). Health Measurement Scales: A practical guide to their development and use. New York: Oxford University Press.

    Google Scholar 

  3. Feeny, D. (2000). A utility approach to the assessment of health-related quality of life. Medical Care, 38(9), 151–154.

    Google Scholar 

  4. Rabin, R., & de Charro, F. (2001). EQ-5D: A measure of health status from the EuroQol group. Annals of Medicine, 33(5), 337–343.

    Article  CAS  PubMed  Google Scholar 

  5. Dolders, M. G., Zeegers, M. P., Groot, W., & Ament, A. (2006). A meta-analysis demonstrates no significant differences between patient and population preferences. Journal of Clinical Epidemiology, 59(7), 653–664.

    Article  PubMed  Google Scholar 

  6. Peeters, Y., & Stiggelbout, A. M. (2010). Health state valuations of patients and the general public analytically compared: A meta-analytical comparison of patient and population health state utilities. Value Health, 13(2), 306–309.

    Article  PubMed  Google Scholar 

  7. Ubel, P. A., Loewenstein, G., & Jepson, C. (2003). Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Quality of Life Research, 12(6), 599–607.

    Article  PubMed  Google Scholar 

  8. Craig, B. M., Reeve, B. B., Cella, D., Hays, R. D., Pickard, A. S., & Revicki, D. A. (2014). Demographic differences in health preferences in the United States. Medical Care, 52(4), 307–313.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pickard, A. S., Tawk, R., & Shaw, J. W. (2013). The effect of chronic conditions on stated preferences for health. The European Journal of Health Economics, 14(4), 697–702.

    Article  PubMed  Google Scholar 

  10. Shaw, J. W., Johnson, J. A., Chen, S., Levin, J. R., & Coons, S. J. (2007). Racial/ethnic differences in preferences for the EQ-5D health states: results from the U.S. valuation study. Journal of Clinical Epidemiology, 60(5), 479–490.

    Article  PubMed  Google Scholar 

  11. Gandhi, M., Thumboo, J., Luo, N., Wee, H. L., & Cheung, Y. B. (2015). Do chronic disease patients value generic health states differently from individuals with no chronic disease? A case of a multicultural Asian population. Health and Quality of Life Outcomes, 13(1), 1–9.

    Article  Google Scholar 

  12. Kind, P., & Dolan, P. (1995). The effect of past and present illness experience on the valuations of health states. Medical Care, 33(Suppl. 4), AS255–AS263.

    CAS  PubMed  Google Scholar 

  13. Krabbe, P. F., Tromp, N., Ruers, T. J., & van Riel, P. L. (2011). Are patients’ judgments of health status really different from the general population? Health and Quality of Life Outcomes, 11(9), 31.

    Article  Google Scholar 

  14. Little, M. H., Reitmeir, P., Peters, A., & Leidl, R. (2014). The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups. Value in Health, 17(4), 364–371.

    Article  PubMed  Google Scholar 

  15. Albrecht, G. L., & Devlieger, P. J. (1999). The disability paradox: High quality of life against all odds. Social Science and Medicine, 48(8), 977–988.

    Article  CAS  PubMed  Google Scholar 

  16. Xie, F., Pullenayegum, E., Gaebel, K., Bansback, N., Bryan, B., Ohinmaa, A., et al. (2015). A time trade-off-derived value set of EQ-5D-5L for Canada. Medical Care.

  17. Oppe, M., Devlin, N. J., van Hout, B., Krabbe, P. F. M., & de Charro, F. (2014). A programme of methodological research to arrive at the new international EQ-5D-5L valuation protocol. Value in Health, 17(4), 445–453.

    Article  PubMed  Google Scholar 

  18. Herdman, M., Gudex, C., Lloyd, A., Janssen, M., Kind, P., Parkin, D., et al. (2011). Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Quality of Life Research, 20(10), 1727–1736.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Devlin, N. J., Tsuchiya, A., Buckingham, K., & Tilling, C. (2011). A uniform time trade off method for states better and worse than dead: Feasibility study of the ‘lead time’ approach. Health Economics, 20(3), 348–361.

    Article  PubMed  Google Scholar 

  20. Attema, A. E., Versteegh, M. M., Oppe, M., Brouwer, W. B., & Stolk, E. A. (2013). Lead time TTO: Leading to better health state valuations? Health Economics, 22(4), 376–392.

    Article  PubMed  Google Scholar 

  21. Gorber, S. C., Shields, M., Tremblay, M. S., & McDowell, I. (2008). The feasibility of establishing correction factors to adjust self-reported estimates of obesity. Health Reports, 19(3), 71–82.

    Google Scholar 

  22. Berkman, N., Terry, D., & McCormack, L. (2010). Health literacy: What is it? Journal of Health Communication, 15(Suppl 2), 9–19.

    Article  PubMed  Google Scholar 

  23. Chew, L. D., Griffin, J. M., Partin, M. R., Noorbaloochi, S., Grill, J. P., Snyder, A., et al. (2008). Validation of screening questions for limited health literacy in a large VA outpatient population. Journal of General Internal Medicine, 23(5), 561–566.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Fortin, M., Bravo, G., Hudon, C., Vanasse, A., & Lapointe, L. (2005). Prevalence of multimorbidity among adults seen in family practice. The Annals of Family Medicine, 3(3), 223–228.

    Article  PubMed  Google Scholar 

  25. Soroka, S. N. (2007). Canadian perceptions of the health Care system: A report to the Health Council of Canada. Toronto, ON: Health Council of Canada.

    Google Scholar 

  26. Allin, S. (2008). Does equity in healthcare use vary across Canadian Provinces? Healthcare Policy, 3(4), 83–99.

    PubMed  PubMed Central  Google Scholar 

  27. Barua, B. (2013). Provincial Healthcare Index 2013. Vancouver: Fraser Institute.

    Google Scholar 

  28. Dolan, P. (2011). Thinking about it: Thoughts about health and valuing QALYs. Health Economics, 20(12), 1407–1416.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This project was supported by an operating Grant from the Canadian Institutes for Health Research (#MOP 111076) and funding support from the EuroQol Research Foundation. Feng Xie and Eleanor Pullenayegum are supported by Canadian Institutes of Health Research New Investigator Awards (2012–2017). Jeffrey Johnson is a Senior Health Scholar with Alberta Innovates Health Solutions.

Author information

Authors and Affiliations

  1. 2-040 Li Ka Shing Centre for Health Research Innovation, School of Public Health, University of Alberta, Edmonton, AB, T6G 2E1, Canada

    Fatima Al Sayah, Arto Ohinmaa & Jeffrey A. Johnson

  2. Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

    Nick Bansback & Stirling Bryan

  3. School of Rehabilitation, Université de Montréal, Montreal, QC, Canada

    Lise Poissant

  4. Child Health Evaluative Sciences, Hospital for Sick Children, Toronto, ON, Canada

    Eleanor Pullenayegum

  5. Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada

    Feng Xie

  6. Father Sean O’Sullivan Research Centre, St. Joseph’s Healthcare Hamilton, Hamilton, ON, Canada

    Feng Xie

  7. Program for Health Economics and Outcome Measures, Hamilton, ON, Canada

    Feng Xie

Authors
  1. Fatima Al Sayah
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  2. Nick Bansback
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  3. Stirling Bryan
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  4. Arto Ohinmaa
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  5. Lise Poissant
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  6. Eleanor Pullenayegum
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  7. Feng Xie
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  8. Jeffrey A. Johnson
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Corresponding author

Correspondence to Jeffrey A. Johnson.

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Conflict of interest

All authors have no conflicts of interest to declare.

Ethical approval

The Health Research Ethics Boards at the Universities of Alberta, McMaster, and British Columbia and the Ethics Board of the Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal approved the data collection protocols and survey instruments.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Sayah, F.A., Bansback, N., Bryan, S. et al. Determinants of time trade-off valuations for EQ-5D-5L health states: data from the Canadian EQ-5D-5L valuation study. Qual Life Res 25, 1679–1685 (2016). https://doi.org/10.1007/s11136-015-1203-4

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  • DOI: https://doi.org/10.1007/s11136-015-1203-4

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