Rural population’s preferences matter: a value set for the EQ-5D-3L health states for China’s rural population

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Abstract

Purpose

To develop an EQ-5D-3L social value set based on Chinese rural population’s preferences using the time trade-off (TTO) method, and to compare the differences in preferences on health states between China urban and rural population.

Methods

Between Sep 2013 and Nov 2013, a total of 1201 participants were recruited from rural areas of five Chinese cities (Beijing, Chengdu, Guiyang, Nanjing, and Shenyang) using a quota sampling method. Each respondent valued 13 health states using the TTO, and a total of 97 EQ-5D-3L health states were directly valued for estimating the value set. Various models with different specifications were explored at both aggregate and individual levels. The final model was determined by a set of predefined selection criteria.

Findings

An ordinary least square model at the aggregate level included 10 dummy variables for specifying the level 2 and 3 for each dimension and an N3 term presenting any dimension on level 3 was selected as the final model. The final model provides a value set ranges from − 0.218 to 0.859. The predicted utility values were highly correlated with but consistently lower than that of the published Chinese EQ-5D-3L value set (for urban population).

Conclusion

The availability of the China rural value set provides a set of social preferences weights for researchers and policy decision-makers for use in China rural area.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-01917-x.

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Most cited references 35

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Modeling valuations for EuroQol health states.

Paul Dolan (1997)

It has become increasingly common for preference-based measures of health-related quality of life to be used in the evaluation of different health-care interventions. For one such measure, The EuroQol, designed to be used for these purposes, it was necessary to derive a single index value for each of the 243 health states it generates. The problem was that it was virtually impossible to generate direct valuations for all of these states, and thus it was necessary to find a procedure that allows the valuations of all EuroQol states to be interpolated from direct valuations on a subset of these. In a recent study, direct valuations were elicited for 42 EuroQol health states (using the time trade-off method) from a representative sample of the UK population. This article reports on the methodology that was adopted to build up a "tariff" of EuroQol values from this data. A parsimonious model that fits the data well was defined as one in which valuations were explained in terms of the level of severity associated with each dimension, an intercept associated with any move away from full health, and a term that picked up whether any dimension in the state was at its most severe level. The model presented in this article appears to predict the values of the states for which there are direct observations and, thus, can be used to interpolate values for the states for which no direct observations exist.

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Valuing health‐related quality of life: An EQ ‐5 D ‐5 L value set for E ngland

Nancy J Devlin, Koonal K Shah, Yan Feng … (2017)

Abstract A new version of the EQ‐5D, the EQ‐5D‐5L, is available. The aim of this study is to produce a value set to support use of EQ‐5D‐5L data in decision‐making. The study design followed an international research protocol. Randomly selected members of the English general public completed 10 time trade‐off and 7 discrete choice experiment tasks in face‐to‐face interviews. A 20‐parameter hybrid model was used to combine time trade‐off and discrete choice experiment data to generate values for the 3,125 EQ‐5D‐5L health states. Valuation data are available for 996 respondents. Face validity of the data has been demonstrated, with more severe health states generally given lower values. Problems with pain/discomfort and anxiety/depression received the greatest weight. Compared to the existing EQ‐5D‐3L value set, there are considerably fewer “worse than dead” states (5.1%, compared with over one third), and the minimum value is higher. Values range from −0.285 (extreme problems on all dimensions) to 0.950 (for health states 11211 and 21111). Results have important implications for users of the EQ‐5D‐5L both in England and internationally. Quality‐adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated.

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US valuation of the EQ-5D health states: development and testing of the D1 valuation model.

James W Shaw, Jeffrey A Johnson, Stephen Coons (2005)

The EQ-5D is a brief, multiattribute, preference-based health status measure. This article describes the development of a statistical model for generating US population-based EQ-5D preference weights. A multistage probability sample was selected from the US adult civilian noninstitutional population. Respondents valued 13 of 243 EQ-5D health states using the time trade-off (TTO) method. Data for 12 states were used in econometric modeling. The TTO valuations were linearly transformed to lie on the interval [-1, 1]. Methods were investigated to account for interaction effects caused by having problems in multiple EQ-5D dimensions. Several alternative model specifications (eg, pooled least squares, random effects) also were considered. A modified split-sample approach was used to evaluate the predictive accuracy of the models. All statistical analyses took into account the clustering and disproportionate selection probabilities inherent in our sampling design. Our D1 model for the EQ-5D included ordinal terms to capture the effect of departures from perfect health as well as interaction effects. A random effects specification of the D1 model yielded a good fit for the observed TTO data, with an overall R of 0.38, a mean absolute error of 0.025, and 7 prediction errors exceeding 0.05 in absolute magnitude. The D1 model best predicts the values for observed health states. The resulting preference weight estimates represent a significant enhancement of the EQ-5D's utility for health status assessment and economic analysis in the US.

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Author and article information

Contributors

Hongyan Wu:

ORCID: http://orcid.org/0000-0002-7338-2172

why_vivian@163.com

Journal

Journal ID (nlm-ta): Health Qual Life Outcomes

Journal ID (iso-abbrev): Health Qual Life Outcomes

Title: Health and Quality of Life Outcomes

Publisher: BioMed Central (London )

ISSN (Electronic): 1477-7525

Publication date (Electronic): 29 January 2022

Publication date PMC-release: 29 January 2022

Publication date Collection: 2022

Volume: 20

Electronic Location Identifier: 14

Affiliations

[1 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, National School of Development, , Peking University, ; Beijing, 100871 China

[2 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Institute for Global Health and Development, , Peking University, ; Beijing, 100871 China

[3 ]GRID grid.24696.3f, ISNI 0000 0004 0369 153X, Department of Pharmacy, Beijing Tiantan Hospital, , Capital Medical University, ; Beijing, 100070 China

[4 ]GRID grid.24695.3c, ISNI 0000 0001 1431 9176, Centre for Evidence-Based Chinese Medicine, , Beijing University of Chinese Medicine, ; Beijing, 100029 China

[5 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Global Health and Population, , Harvard T.H. Chan School of Public Health, ; Boston, MA 02215 USA

[6 ]GRID grid.266093.8, ISNI 0000 0001 0668 7243, Department of Political Science, , University of California, ; Irvine, CA 92697 USA

[7 ]GRID grid.413458.f, ISNI 0000 0000 9330 9891, School of Medicine and Health Management, , Guizhou Medical University, ; Guiyang, 550025 China

[8 ]GRID grid.413458.f, ISNI 0000 0000 9330 9891, Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, , Guizhou Medical University, ; Guiyang, 550025 China

Author information

Hongyan Wu http://orcid.org/0000-0002-7338-2172

Article

Publisher ID: 1917

DOI: 10.1186/s12955-022-01917-x

PMC ID: 8800217

PubMed ID: 35093084

SO-VID: e19aacce-8daf-4bdb-8a95-4332a7a12a56

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 23 July 2021

Date accepted : 12 January 2022

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, national natural science foundation of china;

Award ID: no.71463007

Award ID: no.71273015

Award Recipient : Gordon G. Liu Hongyan Wu

Funded by: FundRef http://dx.doi.org/10.13039/501100004001, guizhou science and technology department;

Award ID: 2013 no.3068

Award Recipient : Hongyan Wu

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: eq-5d,china,rural resident,time trade-off,quality of life,value set

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: eq-5d, china, rural resident, time trade-off, quality of life, value set

Rural population’s preferences matter: a value set for the EQ-5D-3L health states for China’s rural population

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China Occupational Medicine

Most cited references 35

Modeling valuations for EuroQol health states.

Valuing health‐related quality of life: An EQ ‐5 D ‐5 L value set for E ngland

US valuation of the EQ-5D health states: development and testing of the D1 valuation model.

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