Study protocol for valuing EQ-5D-3L and EORTC-8D health states in a representative population sample in Sri Lanka

  • PDF / 216,251 Bytes
  • 8 Pages / 595.28 x 793.7 pts Page_size
  • 113 Downloads / 171 Views

DOWNLOAD

REPORT


STUDY PROTOCOL

Open Access

Study protocol for valuing EQ-5D-3L and EORTC-8D health states in a representative population sample in Sri Lanka Sanjeewa Kularatna1,2*, Jennifer A Whitty1,2, Newell W Johnson2 and Paul A Scuffham1,2

Abstract Background: Economic evaluations to inform decisions about allocation of health resources are scarce in Low and Middle Income Countries, including in Sri Lanka. This is in part due to a lack of country-specific utility weights, which are necessary to derive appropriate Quality Adjusted Life Years. The EQ-5D-3L, a generic multi-attribute instrument (MAUI), is most widely used to measure and value health states in high income countries; nevertheless, the sensitivity of generic MAUIs has been criticised in some conditions such as cancer. This article describes a protocol to produce both a generic EQ-5D-3L and cancer specific EORTC-8D utility index in Sri Lanka. Method: EQ-5D-3L and EORTC-8D health states will be valued using the Time Trade-Off technique, by a representative population sample (n = 780 invited) identified using stratified multi-stage cluster sampling with probability proportionate to size method. Households will be randomly selected within 30 clusters across four districts; one adult (≥18 years) within each household will be selected using the Kish grid method. Data will be collected via face-to-face interview, with a Time Trade-Off board employed as a visual aid. Of the 243 EQ-5D-3L and 81,290 EORTC-8D health states, 196 and 84 respectively will be directly valued. In EQ-5D-3L, all health states that combine level 3 on mobility with either level 1 on usual activities or self-care were excluded. Each participant will first complete the EQ-5D-3L, rank and value 14 EQ-5D-3L states (plus the worst health state and “immediate death”), and then rank and value seven EORTC-8D states (plus “immediate death”). Participant demographic and health characteristics will be also collected. Regression models will be fitted to estimate utility indices for EQ-5D-3L and EORTC-8D health states for Sri Lanka. The dependent variable will be the utility value. Different specifications of independent variables will be derived from the ordinal EQ-5D-3L to test for the best-fitting model. Discussion: In Sri Lanka, a LMIC health state valuation will have to be carried out using face to face interview instead of online methods. The proposed study will provide the first country-specific health state valuations for Sri Lanka, and one of the first valuations to be completed in a South Asian Country. Keywords: Low and middle income countries, Utilities, Health state valuation, EQ-5D, EORTC-8D, Time trade-off, QALY

Background The economic evaluation of health interventions has become an integral part of health policy and decision making for the allocation of limited healthcare resources [1]. The objective of economic evaluation is to provide information on the efficiency of health interventions. An * Correspondence: [email protected] 1 Centre for Applied Health Economics, School of Medicin