RESULTS ( 1 ) EQ-5D was valid and responsive for skin conditions and most cancers ; in vision , its performance varied according to aetiology ; and performance was poor for hearing impairments .
The HUI3 performed well for hearing and vision disorders .
It also performed well in cancers although evidence was limited and there was no evidence in skin conditions .
Response mapping using all the domain scores was the best performing model for the EORTC QLQ-C30 .
In an exploratory analysis , a limited dependent variable mixture model performed better than an equivalent linear model .
3 ) The exploratory valuation study found that bolt-on items for vision , hearing and tiredness had a significant impact on values of the health states , but the direction and magnitude of differences depended on the severity of the health state .
The vision bolt-on item had a statistically significant impact on EQ-5D health state values and a full valuation model was estimated .
EQ-5D performs well in studies of cancer and skin conditions .
Mapping techniques provide a solution to predict EQ-5D values where EQ-5D has not been administered .
For conditions where EQ-5D was found to be inappropriate , including some vision disorders and for hearing , bolt-ons provide a promising solution .
BACKGROUND The National Institute for Health and Care Excellence recommends the use of generic preference-based measures ( GPBMs ) of health for its Health Technology Assessment s ( HTAs ) .
However , these data may not be available or appropriate for all health conditions .
OBJECTIVES To determine whether GPBMs are appropriate for some key conditions and to explore alternative methods of utility estimation when data from GPBMs are unavailable or inappropriate .
( 2 ) Potential modelling approaches to ' map ' EQ-5D values from condition-specific and clinical measures of health [ European Organisation for Research and Treatment of Cancer Quality -of-life Question naire Core 30 ( EORTC QLQ-C30 ) and Functional Assessment of Cancer Therapy - General Scale ( FACT-G ) ] are compared for predictive ability and goodness of fit using two separate data sets . (
Is there overutilisation of cataract surgery in England?
Objectives : Following a 3.7-fold increase in the rate of cataract surgery in the UK between 1989 and 2004 , concern has been raised as to whether this has been accompanied by an excessive decline in the threshold such that some operations are inappropriate . The objective was to measure the impact of surgery on a representative sample of patients so as to determine whether or not overutilisation of surgery is occurring . Design : Prospect i ve cohort assessed before and 3 months after surgery . Setting : Ten providers ( four NHS hospitals , three NHS treatment centres , three independent sector treatment centres ) from across Engl and . Participants : 861 patients undergoing first eye ( 569 ) or second eye ( 292 ) cataract surgery  provided preoperative data of whom 745 ( 87 % ) completed postoperative question naires . Main outcome measures : Patient-reported visual function ( VF-14 ) ; general health status and quality of life ( EQ5D ) ; postoperative complications ; overall view of the operation and its impact . Results : Overall , visual function improved ( mean VF-14 score increased from 83.2 ( SD 17.3 ) to 93.7 ( SD 13.2 ) ) . Self-reported general health status deteriorated ( 20.3 % fair or poor before surgery compared with 25 % afterwards ) which was reflected in the mean EQ5D score ( 0.82 vs 0.79 ; p = 0.003 ) . At least one complication was reported by 66 ( 8.9 % ) patients , though this probably overestimated the true incidence . If the appropriateness of surgery is based on an increase in VF-14 score of 5.5 ( that corresponds to patients ’ reporting being “ a little better ” ) , 30 % of operations would be deemed inappropriate . If an increase of 12.2 ( patients ’ reports of being “ much better ” ) is adopted , the proportion inappropriate is 49 % . Using a different approach to determining a minimally important difference , the proportion inappropriate would be closer to 20 % . Although visual function ( VF-14 ) scores were unchanged or deteriorated in 25 % of patients , 93.1 % rated the results of the operation as “ good , ” “ very good ” or “ excellent , ” and 93.5 % felt their eye problem was “ better . ” This partly reflects inadequacies in the validity of the VF-14 . Conclusions : Improvement in the provision of cataract surgery has been accompanied by a reduction in the visual function threshold . However , method ological difficulties in measuring the impact of cataract surgery on visual function and quality of life mean it is impossible to determine whether or not overutilisation of cataract surgery is occurring
RESULTS ( 1 ) EQ-5D was valid and responsive for skin conditions and most cancers ; in vision , its performance varied according to aetiology ; and performance was poor for hearing impairments .
The HUI3 performed well for hearing and vision disorders .
It also performed well in cancers although evidence was limited and there was no evidence in skin conditions .
Response mapping using all the domain scores was the best performing model for the EORTC QLQ-C30 .
In an exploratory analysis , a limited dependent variable mixture model performed better than an equivalent linear model .
3 ) The exploratory valuation study found that bolt-on items for vision , hearing and tiredness had a significant impact on values of the health states , but the direction and magnitude of differences depended on the severity of the health state .
The vision bolt-on item had a statistically significant impact on EQ-5D health state values and a full valuation model was estimated .
EQ-5D performs well in studies of cancer and skin conditions .
Mapping techniques provide a solution to predict EQ-5D values where EQ-5D has not been administered .
For conditions where EQ-5D was found to be inappropriate , including some vision disorders and for hearing , bolt-ons provide a promising solution .
BACKGROUND The National Institute for Health and Care Excellence recommends the use of generic preference-based measures ( GPBMs ) of health for its Health Technology Assessment s ( HTAs ) .
However , these data may not be available or appropriate for all health conditions .
OBJECTIVES To determine whether GPBMs are appropriate for some key conditions and to explore alternative methods of utility estimation when data from GPBMs are unavailable or inappropriate .
( 2 ) Potential modelling approaches to ' map ' EQ-5D values from condition-specific and clinical measures of health [ European Organisation for Research and Treatment of Cancer Quality -of-life Question naire Core 30 ( EORTC QLQ-C30 ) and Functional Assessment of Cancer Therapy - General Scale ( FACT-G ) ] are compared for predictive ability and goodness of fit using two separate data sets . (