Multinational Evidence of the Applicability and Robustness of Discrete Choice Modeling for Deriving EQ-5D-5L Health-State Values

• Published in: Medical care 2014-11, Vol.52 (11), p.935-943
• Main Authors: Krabbe, Paul F.M., Devlin, Nancy J., Stolk, Elly A., Shah, Koonal K., Oppe, Mark, van Hout, Ben, Quik, Elise H., Pickard, A. Simon, Xie, Feng
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Bayes Theorem; Canada - epidemiology; Choice Behavior; Computer software; Constant coefficients; Correlation analysis; Cross cultural studies; Data collection; Data models; Design efficiency; Economic models; England - epidemiology; Experiments; Female; Health outcomes; Health Status Indicators; Humans; Male; Middle Aged; Models, Psychological; Netherlands - epidemiology; Original; Patient care; Patient Preference - psychology; Patient Preference - statistics & numerical data; Regression coefficients; United States - epidemiology; Values; Washing; Young Adult
• ISSN: 0025-7079; 1537-1948
• DOI: 10.1097/MLR.0000000000000178

Aims: To investigate the feasibility of discrete choice experiments for valuing EQ-5D-5L states using computer-based data collection, the consistency of the estimated regression coefficients produced after modeling the preference data, and to examine the similarity of the values derived across countries. Methods: Data were collected in Canada, England, The Netherlands, and the United States (US). Interactive software was developed to standardize the format of the choice tasks across countries, except for face-to-face interviewing in England. The choice task required respondents to choose between 2 suboptimal health states. A Bayesian design was used to generate 200 pairs of states that were randomly grouped into 20 blocks. Each respondent completed 1 block of 10 pairs. A main-effects probit model was used to estimate regression coefficients and to derive values. Results: Approximately 400 respondents participated from each country. The mean time to perform 1 choice task was between 29.2 (US) and 45.2 (England) seconds. All regression coefficients were statistically significant, except level 2 for Usual Activities in The Netherlands (P = 0.51). Predictions for the complete set of 3125 EQ-5D-5L health states were similar for the 4 countries. Intraclass correlation coefficients between the countries were high: from 0.80 (England vs. US) through 0.98 (Canada vs. US). Conclusions: Derivation of value sets from the general population using computer-based choice tasks for the EQ-5D-5L is feasible. Parameter estimates were generally consistent and logical, and health-state values were similar across the 4 countries.