Mapping the FACT-G cancer-specific quality of life instrument to the EQ-5D and SF-6D Quality of Life and General Health After Elective Surgery for Cervical Spine Pathologies: Determining a Valid and Responsive Metric of Health State Utility. Mapping between the Roland Morris Questionnaire and generic preference-based measures. Comparison of EQ-5D and SF-6D utilities in mental health patients. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcome Questionnaire in patients with rheumatoid arthritis of the hand Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context SF-6D and EQ-5D result in widely divergent incremental cost-effectiveness ratios in a clinical trial of older women: implications for health policy decisions How do the EQ-5D, SF-6D and the well-being rating scale compare in patients with ankylosing spondylitis? Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures Testing alternative regression models to predict utilities: mapping the QLQ-C30 onto the EQ-5D-5L and the SF-6D Cost-utility estimates in depression: does the valuation method matter? Comparison of the SF-6D and the EQ-5D in patients with coronary heart disease Mapping the cancer-specific EORTC QLQ-C30 to the preference-based EQ-5D, SF-6D, and 15D instruments. Mapping utility scores from a disease-specific quality-of-life measure in bariatric surgery patients. Does Selecting Covariates Using Factor Analysis in Mapping Algorithms Improve Predictive Accuracy? A Case of Predicting EQ-5D-5L and SF-6D Utilities from the Women's Health Questionnaire. The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort. A comparison of the measurement properties and estimation of minimal important differences of the EQ-5D and SF-6D utility measures in patients with systemic sclerosis. An empirical comparison of EQ-5D and SF-6D in liver transplant patients. Mapping SF-36 onto the EQ-5D index: how reliable is the relationship? Rapid and sustained improvement in health-related quality of life and utility for 72 weeks in patients with ankylosing spondylitis receiving etanercept. EQ-5D in a general population survey – A description of the most commonly reported EQ-5D health states using the SF-36 Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care. Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada.
Objective To help facilitate economic evaluations of oncology treatments , we mapped responses on cancer-specific instrument to generic preference-based measures . Methods Cancer patients ( n = 367 ) completed one cancer-specific instrument , the FACT-G , and two preference-based measures , the  EQ-5D and SF-6D . Responses were r and omly divided to form development ( n = 184 ) and cross-validation ( n = 183 ) sample s. Relationships between the instruments were estimated using ordinary least squares ( OLS ) , generalized linear models ( GLM ) , and censored least absolute deviations ( CLAD ) regression approaches . The performance of each model was assessed in terms of how well the responses to the cancer-specific instrument predicted EQ-5D and SF-6D utilities using mean absolute error ( MAE ) and root mean squared error ( RMSE ) . Results Physical , functional , and emotional well-being domain scores of the FACT-G best explained the EQ-5D and SF-6D . In terms of accuracy of prediction as measured in RMSE , the CLAD model performed best for the EQ-5D ( RMSE = 0.095 ) whereas the GLM model performed best for the SF-6D ( RMSE = 0.061 ) . The GLM predicted SF-6D scores matched the observed values more closely than the CLAD and OLS . Conclusion Our results demonstrate that the estimation of both EQ-5D and SF-6D utility indices using the FACT-G responses can be achieved . The CLAD model for the EQ-5D and the GLM model for the SF-6D are recommended . Thus , it is possible to estimate quality -adjusted life years for economic evaluation from studies where only cancer-specific instrument have been administered BACKGROUND As part of the Affordable Care Act , health utility metrics are being investigated to define a cost-effective , value-based health care model . EuroQOL-5D ( EQ-5D ) and Short Form-6D ( SF-6D ) are commonly used quality -of-life instruments . Domains in the EQ-5D question naire are thought to be less responsive in measuring quality of life after cervical surgery . OBJECTIVE To evaluate the validity and responsiveness of SF-6D and EQ-5D in determining health and quality of life after elective cervical spine surgery . METHODS A total of 420 patients undergoing elective cervical spine surgery over a period of 2 years were enrolled in a prospect i ve longitudinal registry . Patient-reported outcomes Neck Disability Index ( NDI ) , EQ-5D , and SF-12 were recorded . Based on previously published equations , SF-6D was calculated using NDI and SF-12 scores . Patients were asked whether " surgery met their expectations " ( meaningful improvement ) . The validity and relative responsiveness of SF-6D ( NDI ) , SF-6D ( SF-12 ) , and EQ-5D to discriminate between meaningful and nonmeaningful improvement were calculated . RESULTS Sixty-six percent of patients ( 277 ) reported a level of improvement after surgery that met their expectations ( meaningful improvement ) . SF-6D ( NDI ) ( area under the curve [ AUC ] = 0.69 ) was a more valid discriminator of meaningful improvement compared with the SF-6D ( SF-12 ) ( AUC = 0.65 ) and EQ-5D ( AUC = 0.62 ) . SF-6D ( NDI ) was also a more responsive measure compared with SF-6D ( SF-12 ) and EQ-5D ( st and ardized response mean difference : 0.66 , 0.48 , and 0.44 , respectively ) . CONCLUSION SF-6D is a more valid and responsive measure of general health and quality of life compared with EQ-5D . SF-6D derived from disease-specific disability scores was more valid and responsive than that derived from the generic preference-based SF-12 . Cost-effective studies should use SF-6D as a measure of QALY after cervical spine surgery OBJECTIVES The Rol and Morris Question naire ( RMQ ) is a widely used health status measure for low back pain ( LBP ) . It is not preference-based , and there are currently no established algorithms for mapping between the RMQ and preference-based health-related quality -of-life measures . Using data from r and omized controlled trials of treatment for LBP , we sought to develop algorithms for mapping between RMQ scores and health utilities derived using either the EuroQol five-dimensional question naire ( EQ-5D ) or the six-dimensional health state short form ( derived from Medical Outcomes Study 36-Item Short-Form Health Survey ) ( SF-6D ) . METHODS This study is based on data from the Back Skills Training Trial in which data were collected from 701 patients at baseline and subsequently at 3 , 6 , and 12 months postr and omization using a range of outcome measures , including the  RMQ , the EQ-5D , and the Short Form 12 item Health Survey ( SF-12 ) ( from which SF-6D utilities can be derived ) . We used baseline trial data to estimate models using both direct and response mapping approaches to predict EQ-5D and SF-6D health utilities and dimension responses . A multistage model selection process was used to assess the predictive accuracy of the models . We then explored different techniques and mapping models that made use of repeated follow-up observations in the data . The estimated mapping algorithms were vali date d using external data from the UK Back Pain Exercise and Manipulation trial . RESULTS A number of models were developed that accurately predict health utilities in this context . The best performing model for RMQ to EQ-5D mapping was a beta regression with Bayesian quasi-likelihood estimation that included 24 dummy variables for RMQ responses , age , and sex as covariates ( mean squared error 0.0380 ) based on repeated data . The model selected for RMQ to SF-6D mapping was a finite mixture model that included the overall RMQ score , age , sex , RMQ score squared , age squared , and an interaction term for age and RMQ score as covariates ( mean squared error 0.0114 ) based on repeated data . CONCLUSIONS It is possible to reasonably predict EQ-5D and SF-6D health utilities from RMQ scores and responses using regression methods . Our regression equations provide an empirical basis for estimating health utilities when EQ-5D or SF-6D data are not available . They can be used to inform future economic evaluations of interventions targeting LBP Various  preference-based measures of health are available for use as an outcome measure in cost-utility analysis . The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients . Baseline data from a Dutch multi-centre r and omised trial of 616 patients with mood and /or anxiety disorders were used . Mean and median  EQ-5D  and  SF-6D utilities were compared , both in the total sample and between severity subgroups based on quartiles of SCL-90 scores . Utilities were expected to decline with increased severity . Both EQ-5D and SF-6D utilities differed significantly between patients of adjacent severity groups . Mean utilities increased from 0.51 at baseline to 0.68 at 1.5 years follow-up for EQ-5D and from 0.58 to 0.70 for SF-6D . For all severity subgroups , the mean change in EQ-5D utilities as well as in SF-6D utilities was statistically significant . St and ardised response means were higher for SF-6D utilities . We concluded that both EQ-5D and SF-6D discriminated between severity subgroups and captured improvements in health over time . However , the use of EQ-5D result ed in larger health gains and consequent lower cost-utility ratios , especially for the subgroup with the highest severity of mental health problems Background The aim of this study was to assess the psychometric properties , namely acceptability , validity , reliability , interpretability and responsiveness of the EuroQol EQ-5D ( EQ-5D visual analogue ( VAS ) and EQ-5D ( utility ) ) , Short Form 12 Dimensions ( SF-12 ) , SF-6D and Michigan H and Outcome Question naire ( MHQ ) in patients with rheumatoid arthritis ( RA ) of the h and . Methods The empirical investigation was based upon data from a r and omised controlled trial of 488 adults with rheumatoid arthritis who had pain and dysfunction of the h and s and /or wrists . Participants completed the EQ-5D , SF-12 and MHQ at baseline and at 4 and 12 months follow up . Acceptability was measured using completion rates over time ; construct validity using the “ known groups ” approach , based on pain troublesomeness ; convergent validity using spearman ’s rho correlation ( ρ ) ; reliability using internal consistency ( Cronbach ’s alpha ) ; interpretability using minimal important differences ( MID ) ; and responsiveness using effect sizes and st and ardised response means ( SRM ) stratified by level of self-rated improvement in h and and wrist function or level of self-rated benefit and satisfaction from trial treatments . Results At baseline , the study population had a mean age of 62.4 years , a mean MHQ score of 52.1 and included 76 % women . The EQ-5D ( utility ) had the highest completion rates across time points . All instruments discriminated between pre-specified groups based on pain troublesomeness . Convergent validity analysis indicated that the MHQ score correlated strongly with the EQ-5D ( ρ = 0.65 ) and SF-6D ( ρ = 0.63 ) utility scores . The MHQ was most responsive at detecting change in indicators of RA pain severity between baseline and 4 months , whilst minimal important differences varied considerably across PROMs . Conclusions The instruments evaluated in this study displayed varying psychometric properties in the context of RA of the h and . The selection of a preferred instrument in evaluative studies should ultimately depend on the relative importance placed on individual psychometric properties and the importance placed on generation of health utilities for economic evaluation purpose Background Multi-attribute utility measures are preference-based health-related quality of life measures that have been developed to inform economic evaluations of health care interventions . The objective of this study was to compare the empirical validity of two multi-attribute utility measures ( EQ-5D and SF-6D ) based on hypothetical preferences in a large maternity population in Engl and . Methods Women who participated in a r and omised controlled trial of additional postnatal support provided by trained community support workers represented the study population for this investigation . The women were asked to complete the EQ-5D descriptive system ( which defines health-related quality of life in terms of five dimensions : mobility , self care , usual activities , pain/discomfort and anxiety/depression ) and the SF-36 ( which defines health-related quality of life , using 36 items , across eight dimensions : physical functioning , role limitations ( physical ) , social functioning , bodily pain , general health , mental health , vitality and role limitations ( emotional ) ) at six months postpartum . Their responses were converted into utility scores using the York A1 tariff set and the SF-6D utility algorithm , respectively . One-way analysis of variance was used to test the hypothetically-constructed preference rule that each set of utility scores differs significantly by self-reported health status ( categorised as excellent , very good , good , fair or poor ) . The degree to which EQ-5D and SF-6D utility scores reflected alternative dichotomous configurations of self-reported health status and the Edinburgh Postnatal Depression Scale score was tested using the relative efficiency statistic and receiver operating characteristic ( ROC ) curves . Results The mean utility score for the EQ-5D was 0.861 ( 95 % CI : 0.844 , 0.877 ) , whilst the mean utility score for the SF-6D was 0.809 ( 95 % CI : 0.796 , 0.822 ) , representing a mean difference in utility score of 0.052 ( 95 % CI : 0.040 , 0.064 ; p < 0.001 ) . Both measures demonstrated statistically significant differences between subjects who described their health status as excellent , very good , good , fair or poor ( p < 0.001 ) , as well as monotonically decreasing utility scores ( test for linear trend : p < 0.001 ) . The SF-6D was between 29.1 % and 423.6 % more efficient than the EQ-5D at detecting differences in self-reported health status , and between 129.8 % and 161.7 % more efficient at detecting differences in the Edinburgh Postnatal Depression Scale score . In addition , the SF-6D generated higher area under the curve ( AUC ) scores generated by the ROC curves than the EQ-5D , indicating greater discriminatory power , although in all but one analysis the differences in AUC scores between the measures were not statistically significant . Conclusion This study provides evidence that the SF-6D is an empirically valid and efficient alternative multi-attribute utility measure to the EQ-5D , and is capable of discriminating between external indicators of maternal health Summary Using two instruments ( SF-6D and EQ-5D ) to estimate quality adjusted life years ( QALYs ) , we conducted an economic evaluation of a 12-month r and omized controlled trial with a 12-month follow-up study in older women to evaluate the value for money of two doses of resistance training compared with balance and tone classes . We found that the incremental QALYs estimated from the SF-6D were two- to threefold greater than those estimated from the EQ-5D . Introduction Decision makers must continually choose between existing and new interventions . Hence , economic evaluations are increasingly prevalent . The impact of quality -adjusted life year ( QALY ) estimates using different instruments on the incremental cost-effectiveness ratios ( ICERs ) is not well understood in older adults . Thus , we compared ICERs , in older women , estimated by the EuroQol-5D ( EQ-5D ) and the Short Form-6D ( SF-6D ) to discuss implication s on decision making . Methods Using both the EQ-5D and the SF-6D , we compared the incremental cost per QALY gained in a r and omized controlled trial of  resistance training in 155 community-dwelling women aged 65 to 75 years . The 12-month r and omized controlled trial included a subsequent 12-month follow-up . Our focus , the follow-up study , included 123 of the 155 participants from the Brain Power study ; 98 took part in the economic evaluation ( twice-weekly balance and tone exercises , n = 28 ; once-weekly resistance training , n = 35 ; twice-weekly resistance training , n = 35 ) . Our primary outcome measure was the incremental cost per QALY gained of once- or twice-weekly resistance training compared with balance and tone exercises . Results At cessation of the follow-up study , the incremental QALY was −0.051 ( EQ-5D ) and −0.144 ( SF-6D ) for the once-weekly resistance training group and −0.081 ( EQ-5D ) and −0.127 ( SF-6D ) for the twice-weekly resistance training group compared with balance and tone classes . Conclusion The incremental QALYs estimated from the SF-6D were two- to threefold greater than those estimated from the EQ-5D . Given the large magnitude of difference , the choice of preference-based utility instrument may substantially impact health care decisions Purpose : To compare aspects of validity of EuroQol—5 Dimensions ( EQ-5D ) and Short-Form—6 Dimensions ( SF-6D ) , two indirect utility instruments , and the well-being rating scale ( RS ) in ankylosing spondylitis ( AS ) . Methods : EQ-5D , SF-6D and RS were available for 254 patients fulfilling modified New York criteria . 134 patients were part of an observational cohort and 120 were part of a r and omised controlled trial ( RCT ) . Aspects of validity assessed were truth ( agreement and correlation with external health measures ) and discrimination ( differentiation between health states , repeatability and detection of treatment effect ) . Results : Median ( range ) values were 0.69 ( −0.08–1.00 ) for the EQ-5D , 0.65 ( 0.35–0.95 ) for the SF-6D and 0.65 ( 0.14–1.00 ) for the RS . Agreement ( intraclass correlation coefficient ) was moderate ( 0.46–0.55 ) . Instruments correlated equally with disease activity , functioning and quality of life . The SF-6D showed smaller average differences in utility between patients with better and worse disease compared with the EQ-5D and the RS . The smallest detectable difference ( SDD ) ( in the control group of RCT ) was 0.36 , 0.17 and 0.33 for EQ-5D , SF-6D and RS , respectively . The ability to detect treatment effect ( in the intervention trial ) showed st and ardised effect sizes that were moderate for EQ-5D and SF-6D ( 0.63 and 0.64 ) and low for the RS ( 0.23 ) . Conclusion : In patients with AS , EQ-5D , SF-6D and the RS correlate equally well with external measures of health , but have different psychometric properties . The SDD is most favourable for the SF-6D , but it discriminates less well between patients with different disease severities . The RS has a poorer ability to detect treatment effects . It is difficult to recommend one of the instruments Background Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies . Aim To compare two widely used preference measures , the EQ-5D and SF-6D , in terms of their dimensions and health utility values . Method EQ-5D and SF-6D data collected from 114 patients with depression , who participated in a cluster , r and omised controlled trial to evaluate a collaborative care intervention in UK , primary care practice s.  Utilities were examined across the whole sample and by level of depression severity using the PHQ-9 . Results Depression was associated with disutility at baseline . At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D . Health gains were observed in patients in remission from depression and those with the mildest level of depression severity . Conclusions Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period ; larger health gain was observed for the EQ-5D Purpose The purpose of the study was to compare alternative statistical techniques to find the best approach for converting QLQ-C30 scores onto EQ-5D-5L and SF-6D utilities , and to estimate the mapping algorithms that best predict these health state utilities . Methods 772 cancer patients described their health along the  cancer-specific instrument ( QLQ-C30 )  and two generic preference-based instruments ( EQ-5D-5L and SF-6D ) . Seven alternative regression models were applied : ordinary least squares , generalized linear model , extended estimating equations ( EEE ) , fractional regression model , beta binomial ( BB ) regression , logistic quantile regression and censored least absolute deviation .  Normalized mean absolute error ( NMAE ) , normalized root mean square error ( NRMSE ) , r-squared ( r2 ) and concordance correlation coefficient ( CCC ) were used as model performance criteria . Cross-validation was conducted by r and omly splitting internal data set into two equally sized groups to test the generalizability of each model . Results In predicting EQ-5D-5L utilities , the BB regression performed best . It gave better predictive accuracy in terms of all criteria in the full sample , as well as in the validation sample . In predicting SF-6D , the EEE performed best . It outperformed in all criteria : NRMSE = 0.1004 , NMAE = 0.0798 , CCC = 0.842 and r2 = 72.7 % in the full sample , and NRMSE = 0.1037 , NMAE = 0.0821 , CCC = 0.8345 and r2 = 71.4 % in cross-validation . Conclusions When only QLQ-C30 data are available , mapping provides an alternative approach to obtain health state utility data for use in cost-effectiveness analyses . Among seven alternative regression models , the BB and the EEE gave the most accurate predictions for EQ-5D-5L and SF-6D , respectively BACKGROUND Depression imposes a substantial burden on society . In view of the economic burden of depression , studies evaluating depression treatment increasingly incorporate a cost-utility analysis . Outcomes of these analyses are used by decision makers to prioritize healthcare . Although generic preference-based instruments have been recommended for measuring utility , depression research often uses a disease-specific method , based on depression-free days ( DFD ) , to measure utilities . AIMS OF THE STUDY The objective of this study was to compare utility measurement techniques in the context of a r and omized controlled trial . In particular , we studied the agreement between QALYs measured with the  EuroQol ( EQ-5D ) , the Short Form 6D ( SF-6D ) , and the DFD method , using the EQ-5D as the reference method . We also studied whether the use of different techniques leads to different conclusions for decision makers . METHODS Data were derived from the Depression in Elderly with Long-Term Afflictions ( DELTA ) study . This r and omized controlled trial was design ed to study the effectiveness and cost-effectiveness of a minimal psychological intervention for chronically ill patients with co-occurring minor or mild to moderate major depression . The  EQ-5D , SF-6D and Beck Depression Inventory  ( to estimate DFDs ) were assessed at baseline , and at three , six and twelve months after baseline . RESULTS Poor agreement was found between the EQ-5D and DFD ( Kendall 's Tau : 0.33 ; ICC : 0.21 ( 95 % CI:-0.07 - 0.45 ) ) and moderate agreement between the EQ-5D and SF-6D ( Kendall 's Tau : 0.60 ; ICC : 0.47 ( 95 % CI : 0.36 - 0.57 ) ) . The incremental cost-utility ratio led to similar conclusions for decision makers across techniques . DISCUSSION In conclusion , utilities from the disease-specific DFD method should not be compared directly with utilities derived from the EQ-5D . Although a disease-specific method might yield similar cost-utility ratios as generic instruments , generic instruments remain the preferred option for prioritizing healthcare . Limitations of this study include the presence of minor depression and chronic illnesses in our study population . IMPLICATION S Generic instruments remain preferred for cost-utility analyses , especially when results are used to prioritize healthcare . If the DFD method is a way forward , further research is required to vali date utility weights assigned to the DFDs Background The SF-6D was derived from the SF-36 . A single summary score is obtained allegedly preserving the descriptive richness and sensitivity to change of the SF-36 into utility measurement . We compared the SF-6D and EQ-5D on domain content , scoring distribution , pre-treatment and change scores . Methods The SF-6D and the EQ-5D were completed prior to intervention and 1 , 3 , 6 and 12 months post-intervention in a study enrolling 561 patients with symptomatic coronary stenosis . Patients were r and omized to off-pump coronary artery bypass surgery ( CABG ) , st and ard on-pump CABG , or percutaneous transluminal coronary angioplasty ( PTCA ) .  Baseline and change over time scores were compared using parametric and non-parametric tests . Results The relative contribution of similar domains measuring daily functioning to the utility scores differed substantially . SF-6D focused more on social functioning , while EQ-5D gave more weight to physical functioning . Pain and mental health had similar contributions . The scoring range of the EQ-5D was twice the range of the SF-6D . Before treatment , EQ-5D and SF-6D mean scores appeared similar ( 0.64 versus 0.63 , p = 0.09 ) . Median scores , however , differed substantially ( 0.69 versus 0.60 ) , a difference exceeding the minimal important difference of both instruments . Agreement was low , with an intra-class correlation of 0.45.Finally , we found large differences in measuring change over time . The SF-6D recorded greater intra-subject change in the PTCA-group . Only the EQ-5D recorded significant change in the CABG-groups . In the latter groups changes in SF-6D domains cancelled each other out . Conclusion Although both instruments appear to measure similar constructs , the EQ-5D and SF-6D are quite different . The low agreement and the differences in median values , scoring range and sensitivity to change after intervention show that the EQ-5D and SF-6D yield incomparable scores in patients with coronary heart disease OBJECTIVES To estimate models , via ordinary least squares regression , for predicting Euro Qol 5D ( EQ-5D ) , Short Form 6D ( SF-6D ) , and 15D utilities from scale scores of the European Organization for Research and Treatment of Cancer Quality of Life Question naire ( EORTC QLQ-C30 ) . METHODS Forty-eight gastric cancer patients , split up into equal subgroups by age , sex , and chemotherapy scheme , were interviewed , and the survey included the QLQ-C30 , SF-36 , EQ-5D , and 15D instruments , along with sociodemographic and clinical data . Model predictive ability and explanatory power were assessed by root mean square error ( RMSE ) and adjusted R(2 ) values , respectively . Pearson 's r between predicted and reported utility indices was compared . Three r and om sub sample s , half in size the initial sample , were created and used for " external " validation of the modeling equations . RESULTS Explanatory power was high , with adjusted R(2 ) reaching 0.909 , 0.833 , and 0.611 for 15D , SF-6D , and EQ-5D , respectively . After normalization of RMSE to the range of possible values , the prediction errors were 12.0 , 5.4 , and 5.6 % for EQ-5D , SF-6D , and 15D , respectively . The estimation equations produced a range of utility scores similar to those achievable by the st and ard scoring algorithms . Predicted and reported indices from the validation sample s were comparable thus confirming the previous results . CONCLUSIONS Evidence on the ability of QLQ-C30 scale scores to validly predict 15D and SF-6D utilities , and to a lesser extent , EQ-5D , has been provided . The modeling equations must be tried in future studies with larger and more diverse sample s to confirm their appropriateness for estimating quality -adjusted life-year in cancer-patient trials including only the QLQ-C30 OBJECTIVES To develop algorithms for a conversion of disease-specific quality -of-life into health state values for morbidly obese patients before or after bariatric surgery . METHODS A total of 893 patients were enrolled in a prospect i ve cross-sectional multicenter study . In addition to demographic and clinical data , health-related quality -of-life ( HRQoL ) data were collected using the disease-specific Moorehead-Ardelt II question naire ( MA-II ) and two generic question naires , the EuroQoL-5D ( EQ-5D ) and the Short Form-6D ( SF-6D ) . Multiple regression models were constructed to predict EQ-5D- and SF-6D-based utility values from MA-II scores and additional demographic variables . RESULTS The mean body mass index was 39.4 , and 591 patients ( 66 % ) had already undergone surgery . The average EQ-5D and SF-6D scores were 0.830 and 0.699 . The MA-IIwas correlated to both utility measures ( Spearman 's r = 0.677 and 0.741 ) . Goodness-of-fit was highest ( R(2 ) = 0.55 in the validation sample ) for the following item-based transformation algorithm : utility ( MA-II-based ) = 0.4293 + ( 0.0336 x MA1 ) + ( 0.0071 x MA2 ) + ( 0.0053 x MA3 ) + ( 0.0107 x MA4 ) + ( 0.0001 x MA5 ) . This EQ-5D-based mapping algorithm outperformed a similar SF-6D-based algorithm in terms of mean absolute percentage error ( P = 0.045 ) . CONCLUSIONS Because the mapping algorithm estimated utilities with only minor errors , it appears to be a valid method for calculating health state values in cost-utility analyses . The algorithm will help to define the role of bariatric surgery in morbid obesity BACKGROUND In addition to theoretical justifications , many statistical methods have been used for selecting covariates to include in algorithms mapping nonutility measures onto utilities . However , it is not clear whether using exploratory factor analysis ( EFA ) as one such method improves the predictive ability of these algorithms . OBJECTIVE This question is addressed within the context of mapping a non-utility-based outcome , the core 23-item Women 's Health Question naire ( WHQ-23 ) , onto two utility instruments : five-level EuroQol five-dimensional question naire ( EQ-5D-5L ) and the six-dimensional health state short form ( derived from short form 36 health survey ) ( SF-6D ) . METHODS Data on all three outcomes were collected from 455 women from the Australian general population participating in a study assessing attitudes toward in vitro fertilization . Statistical methods for selecting covariates included stepwise regression ( SW ) , including all covariates ( Include all ) , multivariable fractional polynomial ( MFP ) , and EFA . The predictive accuracy of 108 regression models was assessed using five criteria : mean absolute error , root mean squared error , correlation , distribution of predicted utilities , and proportion of predictions with absolute errors of less than 0.0.5 . Validation of " primary " models was carried out on r and om sample s of the in vitro fertilization study . RESULTS The best results for EQ-5D-5L and SF-6D predictions were obtained from models using SW , " Include all , " and MFP covariate- selection approaches . Root mean squared error ( 0.0762 - 0.1434 ) and mean absolute error ( 0.0590 - 0.0924 ) estimates for these models were within the range of published estimates . EFA was outperformed by other covariate- selection methods . CONCLUSIONS It is possible to predict valid utilities from the WHQ-23 using regression methods based on SW , " Include all , " and MFP covariate- selection techniques BACKGROUND AND OBJECTIVE It is well established that there are problems with the EQ-5D . This is due to the original scoring methods used and how negative time trade-off ( TTO ) values were treated . A revised scoring method has been published . This article applies this to an inflammatory arthritis cohort . The objective is to examine the impact of a revised scoring system for the EQ-5D ( UK ) TTO on the utility estimates and in the case of rheumatoid arthritis , to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio ( ICER ) results of an economic model . METHODS A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring , which uses an episodic r and om utility model to deal with negative TTO values . Differences in utility scores were compared and the new mapping coefficients were obtained . These were then used in an economic model to examine the impact on the ICER . RESULTS In rheumatoid arthritis , the overall change is less for the revised EQ-5D scoring than with the original EQ-5D ( TTO ) but greater than the SF-6D : EQ-5D UK -0.22 ( 95 % confidence interval [ CI ] -0.30 to -0.15 ) , revised EQ-5D UK -0.16 ( 95 % CI -0.21 to -0.10 ) and SF-6D -0.08 ( 95 % CI -0.11 to -0.05 ) . A similar trend is seen in the psoriatic arthritis group . The economic model produced different ICERs , when different utility measures were used ; EQ-5D ( TTO ) € 42,402 , SF-6D € 111,788 , and revised EQ-5D ( TTO ) € 57,747 . CONCLUSION In the context of inflammatory arthritis , this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model OBJECTIVES To compare measurement properties of the EQ-5D and SF-6D utility measures , to assess the association and agreement between these measures and to estimate minimal important differences ( MID ) in patients with systemic sclerosis ( SSc ) . METHODS Both measures were assessed twice in an observational prospect i ve design over a 12-month period ( n=211 ) .  Spearman 's rank correlation between the EQ-5D and SF-6D was calculated at baseline . Agreement was assessed using Lin 's concordance coefficient ( LCC ) and a Bl and -Altman plot . MIDs were estimated using three anchors ; the global rating of change item ( SF-36 ) and changes on the Health Assessment Question naire-Disability Index ( HAQ-DI ) of ≥0.14 and ≥0.22 . RESULTS At baseline , the mean EQ-5D and SF-6D scores were 0.64 ( SD=0.25 ) and 0.65 ( SD=0.11 ) , respectively . The correlation between EQ-D and SF-6D scores was r=0.74 . Agreement was moderate ( LCC=0.49 ) , and the Bl and -Altman plot showed a mean difference of 0.003 but wide limits of agreement ( -0.38 to 0.39 ) and a structural bias for lower scores . The mean MID estimate for the EQ-5D was 0.08 for the improved subgroup , and -0.13 for the deteriorated subgroup . For the SF-6D , the MID estimate was 0.05 for the improved and -0.04 for the deteriorated subgroup . CONCLUSIONS Although there was a marked correlation between the measures , the moderate agreement implies that EQ-5D and SF-6D scores can not be used interchangeably . The MID estimates we provided can be used to calculate sample sizes for clinical trials involving SSc patients , and in interpreting the relevance and importance of treatment effects There remains disagreement about the preferred utility-based measure of health-related quality of life for use in constructing quality -adjusted life years ( QALYs ) . The recent development of a new measure , the SF-6D , has highlighted this issue . The SF-6D and EuroQol EQ-5D measure health-related utilities on a scale where 0 represents death and 1 represents full health , and both have utility scores generated from r and om sample s of the general UK population . This study explored whether , in a large sample of liver transplant patients , the two instruments provide similar results . The empirical data highlight important variation in the results generated from the use of the two instruments . The data are consistent with a view that the SF-6D does not describe health states at the lower end of the utility scale but is more sensitive than EQ-5D in detecting small changes towards the top of the scale Background Mapping from health status measures onto generic preference-based measures is becoming a common solution when health state utility values are not directly available for economic evaluation . However the accuracy and reliability of the models employed is largely untested , and there is little evidence of their suitability in patient data sets . This paper examines whether mapping approaches are reliable and accurate in terms of their predictions for a large and varied UK patient data set . Methods SF-36 dimension scores are mapped onto the EQ-5D index using a number of different model specifications . The predicted EQ-5D scores for subsets of the sample are compared across inpatient and outpatient setting s and medical conditions . This paper compares the results to those obtained from existing mapping functions . Results The model including SF-36 dimensions , squared and interaction terms estimated using r and om effects GLS has the most accurate predictions of all models estimated here and existing mapping functions as indicated by MAE ( 0.127 ) and MSE ( 0.030 ) . Mean absolute error in predictions by EQ-5D utility range increases with severity for our models ( 0.085 to 0.34 ) and for existing mapping functions ( 0.123 to 0.272 ) . Conclusion Our results suggest that models mapping the SF-36 onto the EQ-5D have similar predictions across inpatient and outpatient setting and medical conditions . However , the models overpredict for more severe EQ-5D states ; this problem is also present in the existing mapping functions OBJECTIVE To examine the longterm effect of etanercept ( ETN ) therapy on health-related quality of life ( HRQOL ) and utility in patients with ankylosing spondylitis . METHODS Patients completing a 24-week placebo-controlled trial were continued on ETN in a 72-week open-label extension study . Short Form-36 ( SF-36 ) , EuroQOL-5D ( EQ-5D ) , and EuroQOL visual analog scale ( EQ-VAS ) scores were collected at open-label baseline and every 12 weeks thereafter . Mental and physical component scores ( MCS and PCS ) of the SF-36 , EQ-5D and SF-6D utility scores , and quality -adjusted life-years ( QALY ) were calculated . RESULTS 257 patients [ 129 previous placebo ( PLA ) and 128 ETN recipients ] enrolled in this open-label extension study , and 85 % completed the 72-week followup . PCS , EQ-5D and SF-6D utilities , and EQ-VAS were significantly lower at open-label baseline in the previous PLA group ( PLA/ETN group ) than in the previous ETN group ( ETN/ETN group ; all p < 0.001 ) . At week 12 , PCS and MCS , EQ-5D and SF-6D utility scores , and EQ-VAS were similar in the PLA/ETN and ETN/ETN groups . As expected , mean change in EQ-5D in the PLA/ETN group was significantly greater than that for SF-6D ( 0.18 vs 0.06 ; p < 0.0001 ) . HRQOL and utility improvements were maintained in both groups for up to 72 weeks . The average 72-week QALY gain per person in the PLA/ETN group was 0.24 and 0.10 for EQ-5D and SF-6D , respectively . CONCLUSION Patients continuing ETN therapy sustained HRQOL and utility improvements attained during the original PLA-controlled trial . Patients previously taking PLA  showed rapid and sustained improvements in HRQOL and utility and substantial QALY gain with ETN therapy The importance of study ing health-related quality of life in the general population has increasingly been emphasized . From a public health perspective , this benefits the identification of population inequalities in health status . One of the currently most popular instruments is the EQ-5D . Evaluations of the EQ-5D generally focus on the overall preference-based index . As this index has a built-in value , exploration of the information from the underlying health states is also important . In this study , the ten most commonly reported EQ-5D health states are described using the SF-36 . Data collected in 1999 by question naires mailed to a r and om sample aged 20–74 in south-eastern Sweden were used ( n = 9489 ) . Almost 43 % reported the best possible EQ-5D health state and 78 % were accounted for by three EQ-5D health states . The EQ-5D health state classification was largely reflected by the SF-36 , with the EQ-5D items mobility , usual activities , pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning , role limitations due to physical health problems , bodily pain , and mental health , respectively . However , within the same level of EQ-5D ( i.e. , moderate problems ) there was a rather large variation of SF-36 scale scores , particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP BACKGROUND Lifestyle interventions reduce cardiovascular risk and risk of diabetes mellitus , but reports on long-term effects on quality of life ( QOL ) and health care utilization are rare . We investigated the impact of a primary health care-based lifestyle intervention program on QOL and cost-effectiveness over 3 years . METHODS A total of 151 men and women , aged 18 to 65 years , at moderate to high risk for cardiovascular disease , were r and omly assigned to either lifestyle intervention with st and ard care or st and ard care alone . Intervention consisted of supervised exercise sessions and diet counseling for 3 months , followed by regular group meetings over a 3-year period . Change in QOL was measured with EuroQol ( 5-dimensional EuroQol-5D [ EQ-5D ] and EuroQol-VAS [ EQ-VAS ] ) , the 36-Item Short-Form Health Survey ( SF-36 ) , and the 6-dimensional Short-Form 6D ( SF-6D ) . The health economic evaluation was performed from a societal view and a treatment perspective . In a cost-utility analysis , the costs , gained quality -adjusted life-years ( QALYs ) , and savings in health care were considered . Cost-effectiveness was also described using the net monetary benefit method . RESULTS Significant differences between the groups over the 3-year period were shown in the EQ-VAS ( P = .002 ) , SF-6D ( P = .01 ) , and SF-36 ( P = .04 ) physical component summary but not in the EQ-5D ( P = .24 ) or SF-36 ( P = .37 ) mental component summary . The net savings were $ 47 per participant . Costs per gained QALY , savings not counted , were $ 1668 to $ 4813 . Probabilities of cost-effectiveness were 89 % to 100 % when the amount of $ 50,000 was used as stakeholder 's threshold of willingness to pay for a gained QALY . CONCLUSION Lifestyle intervention in primary care improves QOL and is highly cost-effective in relation to st and ard care . Trial Registration clinical trials.gov Identifier : NCT00486941 OBJECTIVES The purpose s of this analysis were to evaluate the construct validity of the EQ-5D and compare responses on the EQ-5D with the Physical Component Summary ( PCS-12 ) and Mental Component Summary ( MCS-12 ) scores of the SF-12 Health Survey . METHODS Data were collected via a survey instrument mailed to 4,200 r and omly selected subjects in the province of Alberta , Canada . The instrument contained the EQ-5D and SF-12 health surveys , with additional questions eliciting clinical and demographic information from the respondents . RESULTS 1,555 respondents returned mailed question naires ; 606 question naires were returned undeliverable . The SF-12 summary scores were calculated for 1,380 respondents . Analysis of the EQ-5D responses by demographic variables found significant differences among categories of age , gender , and self-reported chronic medical conditions . Corresponding dimensions and summary scores were more strongly related ( eg , mobility and PCS-12 ; F ratio = 598.3 , P < 0.001 ) than dissimilar dimensions ( eg , mobility and MCS-12 ; F ratio = 18.8 , P < 0.001 ) . The EQ-5D index scores were moderately correlated with SF-12 summary scores ( r = 0.41 for MCS-12 and r = 0.68 for PCS-12 ) . For subjects reporting no problems on the EQ-5D , PCS-12 and MCS-12 scores were significantly lower for people reporting medical problems or feelings of depression . CONCLUSIONS The results of this investigation generally supported the validity of the EQ-5D . However , an important ceiling effect was observed for the EQ-5D in this sample . The combination of the EQ-5D and SF-12 provides relatively broad coverage of important health domains and scores for various purpose
The EQ-5D and SF-36 achieved mixed results in the quantitative testing against psychometric criteria .
The qualitative analysis suggests this is because they provide a very limited coverage of themes identified by people with mental health problems .
BACKGROUND Generic preference-based measures of health like the EQ-5D and SF-6D ( ® ) are increasingly being used in economic evaluation and outcome assessment .
However , there are concerns as to whether or not these generic measures are appropriate for use in people with mental health problems .
OBJECTIVES The EQ-5D and SF-36 ( ® ) ( including its derivatives the SF-12 ( ® ) and SF-6D ) were assessed using the psychometric criteria of validity and responsiveness using quantitative and qualitative methods .
Another aim was to estimate mapping functions between the EQ-5D and SF-6D and condition-specific measures , where appropriate .