TY - JOUR
T1 - Mapping Oswestry Disability Index Responses to EQ-5D-3L Utility Values
T2 - Are Cost-Utility Results Valid?
AU - Ben, Ângela Jornada
AU - Pellekooren, Sylvia
AU - Bosmans, Judith E.
AU - Ostelo, Raymond W.J.G.
AU - Maas, Esther T.
AU - El Alili, Mohamed
AU - van Tulder, Maurits W.
AU - Huygen, Frank J.P.M.
AU - Oosterhuis, Teddy
AU - Apeldoorn, Adri T.
AU - van Hooff, Miranda L.
AU - van Dongen, Johanna M.
N1 - Funding Information: Conflict of Interest Disclosures: Dr Ostelo reported receiving grants from ZonMw and WCF outside the submitted work. Dr Huygen reported receiving personal fees from Abbott and Grunenthal outside the submitted work. Dr Huygen has a patent P121304EP00 pending and a patent P121304NL00 pending. Dr Oosterhuis reported receiving grants from ZonMW, Ministry of Social Affairs and employment outside the submitted work. No other disclosures were reported. Funding Information: Conflict of Interest Disclosures: Dr Ostelo reported receiving grants from ZonMw and WCF outside the submitted work. Dr Huygen reported receiving personal fees from Abbott and Grunenthal outside the submitted work. Dr Huygen has a patent P121304EP00 pending and a patent P121304NL00 pending. Dr Oosterhuis reported receiving grants from ZonMW, Ministry of Social Affairs and employment outside the submitted work. No other disclosures were reported.Funding/Support: This study was internally funded by the Vrije Universiteit Amsterdam through the van Meenen middelen. Publisher Copyright: © 2023 International Society for Pharmacoeconomics and Outcomes Research, Inc.
PY - 2023/6
Y1 - 2023/6
N2 - OBJECTIVES: To develop and validate approaches for mapping Oswestry Disability Index (ODI) responses to EQ-5D-3L utility values and to evaluate the impact of using mapped utility values on cost-utility results compared to published regression models.METHODS: Three response mapping approaches were developed in a random sample of 70% of 18,692 patients with low back pain: non-parametric approach (Non-p), non-parametric approach excluding logical inconsistencies (Non-peLI), and ordinal logistic regression (OLR). Performance was assessed in the remaining 30% using R-square (R2), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE). To evaluate whether MAEs and their 95% limits of agreement (95%LA) were clinically relevant, a minimally clinically important difference (MCID) of 0.074 was used. Probabilities of cost-effectiveness estimated using observed and mapped utility values were compared in two economic evaluations.RESULTS: The Non-p performed best (R2=0.43; RMSE=0.22; MAE=0.03; 95%LA=-0.40;0.47) compared to the Non-peLI (R2=0.07; RMSE=0.29; MAE=-0.15; 95%LA=-0.63;0.34), and ORL (R2=0.22; RMSE=0.26; MAE=0.02; 95%LA=-0.49;0.53). MAEs were lower than the MCID for the Non-p and OLR, but not for the Non-peLI. Differences in probabilities of cost-effectiveness ranged from 1-4% (Non-p), 0.1-9% (Non-peLI), and 0.1-20% (OLR).CONCLUSIONS: Results suggest that the developed response mapping approaches are not valid for estimating individual patients' EQ-5D-3L utility values, and - depending on the approach - may considerably impact cost-utility results. The developed approaches did not perform better than previously published regression-based models and are therefore not recommended for use in economic evaluations.
AB - OBJECTIVES: To develop and validate approaches for mapping Oswestry Disability Index (ODI) responses to EQ-5D-3L utility values and to evaluate the impact of using mapped utility values on cost-utility results compared to published regression models.METHODS: Three response mapping approaches were developed in a random sample of 70% of 18,692 patients with low back pain: non-parametric approach (Non-p), non-parametric approach excluding logical inconsistencies (Non-peLI), and ordinal logistic regression (OLR). Performance was assessed in the remaining 30% using R-square (R2), Root Mean Square Error (RMSE), and Mean Absolute Error (MAE). To evaluate whether MAEs and their 95% limits of agreement (95%LA) were clinically relevant, a minimally clinically important difference (MCID) of 0.074 was used. Probabilities of cost-effectiveness estimated using observed and mapped utility values were compared in two economic evaluations.RESULTS: The Non-p performed best (R2=0.43; RMSE=0.22; MAE=0.03; 95%LA=-0.40;0.47) compared to the Non-peLI (R2=0.07; RMSE=0.29; MAE=-0.15; 95%LA=-0.63;0.34), and ORL (R2=0.22; RMSE=0.26; MAE=0.02; 95%LA=-0.49;0.53). MAEs were lower than the MCID for the Non-p and OLR, but not for the Non-peLI. Differences in probabilities of cost-effectiveness ranged from 1-4% (Non-p), 0.1-9% (Non-peLI), and 0.1-20% (OLR).CONCLUSIONS: Results suggest that the developed response mapping approaches are not valid for estimating individual patients' EQ-5D-3L utility values, and - depending on the approach - may considerably impact cost-utility results. The developed approaches did not perform better than previously published regression-based models and are therefore not recommended for use in economic evaluations.
KW - EQ-5D
KW - Oswestry Disability Index
KW - low back pain
KW - response mapping
UR - http://www.scopus.com/inward/record.url?scp=85150252530&partnerID=8YFLogxK
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UR - https://www.ncbi.nlm.nih.gov/pubmed/36773782
U2 - https://doi.org/10.1016/j.jval.2023.01.020
DO - https://doi.org/10.1016/j.jval.2023.01.020
M3 - Article
C2 - 36773782
SN - 1098-3015
VL - 26
SP - 873
EP - 882
JO - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
JF - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research
IS - 6
ER -