SF-6D utility values for the better- and worse-seeing eye for health states based on the Snellen equivalent in patients with age-related macular degeneration

• Published in: PloS one 2017-02, Vol.12 (2), p.e0169816
• Main Authors: Visser, Martijn S, Amarakoon, Sankha, Missotten, Tom, Timman, Reinier, Busschbach, Jan J
• Format: Article
• Language: English
• Subjects: Acuity; Age; Age related diseases; Aged; Aged, 80 and over; Analysis; Biology and Life Sciences; Clinical trials; Computer and Information Sciences; Diabetes; Diabetic retinopathy; Elderly; Equivalence; Eye; Female; Health; Health aspects; Health economics; Health Status; Humans; Macular degeneration; Macular Degeneration - diagnosis; Male; Medicine and Health Sciences; Morbidity; Patients; Physiological aspects; Psychiatry; Psychometrics; Psychotherapy; Quality of Life; Quality-Adjusted Life Years; Questionnaires; Social Sciences; Studies; Utilities; Visual acuity; Visual Acuity - physiology; Wet Macular Degeneration - diagnosis
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0169816

Economic evaluations in wet age-related macular degeneration (ARMD) is hampered as often utility values for solely one eye are used, mostly the better-seeing eye (BSE). Moreover, frequently chosen methods rely on patient values and/or disease specific measures, while economic evaluations prefer generic quality of life (QoL) measures based on societal preferences. The generic QoL utility instrument EQ-5D has shown to be insensitive for differences in visual acuity. The aim of this study was therefore to provide societal utility values, using the generic SF-6D, for health states acknowledging both BSE and worse-seeing eye (WSE). SF-6D utility values of 191 ARMD patients (≥65 years) with 153 follow-up measures at 1 year were used to fill health states defined by the combination of BSE and WSE using Snellen equivalents; no visual loss (≥20/40), mild-moderate (20/200) and severe (≤20/200). QoL utilities were estimated for the SF-6D, ranging from 0.740 for ARMD patients without visual loss to 0.684 for patients with a combination of mild-moderate visual loss in their BSE and severe visual loss in their WSE. Societal utility values are provided for ARMD patients using the generic QoL instrument SF-6D for visual acuity health states based on both BSE and WSE. The range of the values is smaller than previous elicited utilities with the disease-specific VisQoL. Besides, the utility values are placed on a more realistic position on the utility scale, and SF-6D utility values avoid the problem associated with the interpretation of disease-specific utility values.