Skip to main content
Top
Published in: Quality of Life Research 9/2020

Open Access 01-09-2020 | Atopic Dermatitis

Mapping Dermatology Life Quality Index (DLQI) scores to EQ-5D utility scores using data of patients with atopic dermatitis from the National Health and Wellness Study

Authors: Andreas Westh Vilsbøll, Nana Kragh, Julie Hahn-Pedersen, Cathrine Elgaard Jensen

Published in: Quality of Life Research | Issue 9/2020

Login to get access

Abstract

Purpose

To develop a mapping algorithm for generating EQ-5D-5-level (EQ-5D-5L) utility scores from the Dermatology Life Quality Index (DLQI) in patients with atopic dermatitis (AD).

Methods

The algorithm was developed using data from 1232 patients from four countries participating in the National Health and Wellness Study. Spearman’s rank correlation coefficient was used to evaluate the conceptual overlap between DLQI and EQ-5D-5L. Six mapping models (ordinary least squares [OLS], Tobit, three different two-part models, and a regression mixture model) were tested with different specifications to determine model performance and were ranked based on the sum of mean absolute error (MAE), and root mean squared error (RMSE).

Results

The mean DLQI score was 7.23; mean EQ-5D-5L score was 0.78; and there were moderate negative correlations between DLQI and EQ-5D-5L scores (p = − 0.514). A regression mixture model with total DLQI, and age and sex as independent variables performed best for mapping DLQI to EQ-5D-5L (RMSE = 0.113; MAE = 0.079).

Conclusion

This was the first study to map DLQI to EQ-5D-5L exclusively in patients with AD. The regression mixture model with total DLQI, and age and sex as independent variables was the best performing model and accurately predicted EQ-5D-5L. The results of this mapping can be used to translate DLQI data from clinical studies to health state utility values in economic evaluations.
Appendix
Available only for authorised users
Literature
4.
go back to reference Chalmers, J., Thomas, K., Apfelbacher, C., Williams, H., Prinsen, C., Spuls, P., et al. (2018). Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). BJD, 178, e332–2341.CrossRef Chalmers, J., Thomas, K., Apfelbacher, C., Williams, H., Prinsen, C., Spuls, P., et al. (2018). Report from the fifth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative). BJD, 178, e332–2341.CrossRef
7.
go back to reference Heinl, D., Chalmers, J., Nankervis, H., & Apfelbacher, C. (2016). Quality of life instruments used and their relation to patient-reported outcomes: A systematic review. Acta Dermato Venereology, 96(5), 596–605.CrossRef Heinl, D., Chalmers, J., Nankervis, H., & Apfelbacher, C. (2016). Quality of life instruments used and their relation to patient-reported outcomes: A systematic review. Acta Dermato Venereology, 96(5), 596–605.CrossRef
8.
go back to reference Basra, M., Fenech, R., Gatt, R., Salek, M., & Finlay, A. (2008). The Dermatology Life Quality Index 1994–2007: A comprehensive review of validation data and clinical results. BJD, 159, 997–1035. Basra, M., Fenech, R., Gatt, R., Salek, M., & Finlay, A. (2008). The Dermatology Life Quality Index 1994–2007: A comprehensive review of validation data and clinical results. BJD, 159, 997–1035.
10.
go back to reference Finlay, A., & Khan, G. (1994). Dermatology Life Quality Index (DLQI): A simple practical measure for routine clinical use. Clinical and Experimental Dermatology, 19(3), 210–216.PubMedCrossRef Finlay, A., & Khan, G. (1994). Dermatology Life Quality Index (DLQI): A simple practical measure for routine clinical use. Clinical and Experimental Dermatology, 19(3), 210–216.PubMedCrossRef
11.
go back to reference Versteegh, M., Leunis, A., Uyl-de Groot, C., & Stolk, E. (2012). Condition-specific preference-based measures: Benefit or burden? Value in Health, 15, 504–513.PubMedCrossRef Versteegh, M., Leunis, A., Uyl-de Groot, C., & Stolk, E. (2012). Condition-specific preference-based measures: Benefit or burden? Value in Health, 15, 504–513.PubMedCrossRef
12.
go back to reference Rowen, D., Brazier, J., Ara, R., & Zouraq, I. (2017). The role of condition-specific preference-based measures in health technology assessment. PharmacoEconomics, 35(Suppl 1), S33–S41.CrossRef Rowen, D., Brazier, J., Ara, R., & Zouraq, I. (2017). The role of condition-specific preference-based measures in health technology assessment. PharmacoEconomics, 35(Suppl 1), S33–S41.CrossRef
13.
go back to reference Davison, N., Thompson, A., Turner, A., Longworth, L., McElhone, K., Griffiths, C., et al. (2018). Generating EQ-5D-3L utility scores from the Dermatology Life Quality Index: A mapping study in patients with psoriasis. Value in Health, 21, 1010–1018.PubMedCrossRef Davison, N., Thompson, A., Turner, A., Longworth, L., McElhone, K., Griffiths, C., et al. (2018). Generating EQ-5D-3L utility scores from the Dermatology Life Quality Index: A mapping study in patients with psoriasis. Value in Health, 21, 1010–1018.PubMedCrossRef
15.
go back to reference Petrou, S., Rivero-Arias, O., Dakin, H., Longworth, L., Oppe, M., Froud, R., et al. (2015). The MAPS reporting statement for studies mapping onto generic preference-based outcome measures: Explanation and elaboration. PharmacoEconomics, 33, 993–1011.PubMedCrossRef Petrou, S., Rivero-Arias, O., Dakin, H., Longworth, L., Oppe, M., Froud, R., et al. (2015). The MAPS reporting statement for studies mapping onto generic preference-based outcome measures: Explanation and elaboration. PharmacoEconomics, 33, 993–1011.PubMedCrossRef
17.
go back to reference Longworth, L., & Rowen, D. (2013). Mapping to Obtain EQ-5D utility values for use in NICE health technology assessments. Value in Health, 16, 202–210.PubMedCrossRef Longworth, L., & Rowen, D. (2013). Mapping to Obtain EQ-5D utility values for use in NICE health technology assessments. Value in Health, 16, 202–210.PubMedCrossRef
18.
go back to reference Bucholz, I., Janssen, M., Kohlman, T., & Feng, Y. (2018). A systematic review of studies comparing the measurement properties of the three-level and five-level versions of the EQ-5D. PharmacoEconomics, 36, 645–661.CrossRef Bucholz, I., Janssen, M., Kohlman, T., & Feng, Y. (2018). A systematic review of studies comparing the measurement properties of the three-level and five-level versions of the EQ-5D. PharmacoEconomics, 36, 645–661.CrossRef
19.
go back to reference Longworth, L., & Rowen, D. (2011). NICE DSU technical support document 10: The use of mapping methods to estimate health state utility values. Retrieved November 20, 2018 from https://www.nicedsu.org.uk. Longworth, L., & Rowen, D. (2011). NICE DSU technical support document 10: The use of mapping methods to estimate health state utility values. Retrieved November 20, 2018 from https://​www.​nicedsu.​org.​uk.
20.
go back to reference Wailoo, A., Hernandez-Alava, M., Manca, A., Meija, A., Ray, J., Crawford, B., et al. (2017). Mapping to Estimate health-state utility from non-preference-based outcome measures: An ISPOR good practices for outcomes research task force report. Value in Health, 20, 18–27.PubMedCrossRef Wailoo, A., Hernandez-Alava, M., Manca, A., Meija, A., Ray, J., Crawford, B., et al. (2017). Mapping to Estimate health-state utility from non-preference-based outcome measures: An ISPOR good practices for outcomes research task force report. Value in Health, 20, 18–27.PubMedCrossRef
23.
go back to reference Nyberg, F. (2017). Observational study report characterization of moderate-severe atopic dermatitis disease severity and burden in moderate-to-severe AD. A non-interventional cross-sectional burden of disease study among adults with AD in France, Germany, UK, and USA. Nyberg, F. (2017). Observational study report characterization of moderate-severe atopic dermatitis disease severity and burden in moderate-to-severe AD. A non-interventional cross-sectional burden of disease study among adults with AD in France, Germany, UK, and USA.
24.
go back to reference Nyberg, F., Varol, N., & Hansen, J. (2017). Greater severity of atopic dermatitis is associated with poorer patient-reported outcomes among adults with moderate-to-severe atopic dermatitis. Paper presented at the The European Academy of Dermatology and Venereology (EADV) Congress, Geneva, Switzerland, September 13–17, 2017 Nyberg, F., Varol, N., & Hansen, J. (2017). Greater severity of atopic dermatitis is associated with poorer patient-reported outcomes among adults with moderate-to-severe atopic dermatitis. Paper presented at the The European Academy of Dermatology and Venereology (EADV) Congress, Geneva, Switzerland, September 13–17, 2017
27.
go back to reference Altpeter, E., Burnand, B., Capkun, G., et al. (2005). Essentials of good epidemiological practice. Sozial- und Praventivmedizin, 50, 12–27.PubMedCrossRef Altpeter, E., Burnand, B., Capkun, G., et al. (2005). Essentials of good epidemiological practice. Sozial- und Praventivmedizin, 50, 12–27.PubMedCrossRef
28.
go back to reference van Reenen, M., & Janssen, B. (2015). EQ-5D-5L User Guide: Basic information on how to use the EQ-5D-5L instrument. (Version 2.1 ed.). van Reenen, M., & Janssen, B. (2015). EQ-5D-5L User Guide: Basic information on how to use the EQ-5D-5L instrument. (Version 2.1 ed.).
29.
go back to reference van Reenen, M., & Oppe, M. (2015). EQ-5D-3L User Guide: Basic information on how to use the EQ-5D-3L instrument. (Version 5.1 ed.). van Reenen, M., & Oppe, M. (2015). EQ-5D-3L User Guide: Basic information on how to use the EQ-5D-3L instrument. (Version 5.1 ed.).
30.
go back to reference Devlin, N., Shah, K., Feng, Y., Mulhern, B., & van Hout, B. (2017). Valuing health-related quality of life: An EQ-5D-5L value set for England. Health Economics, 1, 16. Devlin, N., Shah, K., Feng, Y., Mulhern, B., & van Hout, B. (2017). Valuing health-related quality of life: An EQ-5D-5L value set for England. Health Economics, 1, 16.
32.
go back to reference Van Hout, B., Janssen, M., Feng, Y., Kohlman, T., Busschback, J., Golicki, D., et al. (2012). Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health, 15, 708–715.PubMedCrossRef Van Hout, B., Janssen, M., Feng, Y., Kohlman, T., Busschback, J., Golicki, D., et al. (2012). Interim scoring for the EQ-5D-5L: Mapping the EQ-5D-5L to EQ-5D-3L value sets. Value in Health, 15, 708–715.PubMedCrossRef
34.
go back to reference Brazier, J., Yang, Y., Tsuchiya, A., & Rowen, D. (2010). A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures. European Journal of Health Economics, 11(2), 215–225.PubMedCrossRef Brazier, J., Yang, Y., Tsuchiya, A., & Rowen, D. (2010). A review of studies mapping (or cross walking) non-preference based measures of health to generic preference-based measures. European Journal of Health Economics, 11(2), 215–225.PubMedCrossRef
35.
go back to reference Rowen, D., Brazier, J., & Roberts, J. (2009). Mapping SF-36 onto the EQ-5D index: How reliable is the relationship. Health and Quality of Life Outcomes, 7, 1–9.CrossRef Rowen, D., Brazier, J., & Roberts, J. (2009). Mapping SF-36 onto the EQ-5D index: How reliable is the relationship. Health and Quality of Life Outcomes, 7, 1–9.CrossRef
36.
go back to reference Hernández Alava, M., Wailoo, A., & Ara, R. (2012). Tails from the peak district: Adjusted limited Dependent Variable Mixture Models of EQ-5D questionnaire health state utility values. Value in Health, 15, 550–561.PubMedCrossRef Hernández Alava, M., Wailoo, A., & Ara, R. (2012). Tails from the peak district: Adjusted limited Dependent Variable Mixture Models of EQ-5D questionnaire health state utility values. Value in Health, 15, 550–561.PubMedCrossRef
39.
go back to reference Dempster, A., Laird, N., & Rubin, D. (1977). Maximum likelihood from incomplete data via the EM algorithm. Journal of the Royal Statistical Society, 39(1), 1–38. Dempster, A., Laird, N., & Rubin, D. (1977). Maximum likelihood from incomplete data via the EM algorithm. Journal of the Royal Statistical Society, 39(1), 1–38.
40.
go back to reference Chai, T., & Draxler, R. (2014). Root mean square error (RMSE) or mean absolute error (MAE)? Arguments against avoiding RMSE in the literature. Geosci Model Dev, 7, 1247–1250.CrossRef Chai, T., & Draxler, R. (2014). Root mean square error (RMSE) or mean absolute error (MAE)? Arguments against avoiding RMSE in the literature. Geosci Model Dev, 7, 1247–1250.CrossRef
41.
go back to reference Team, R. C. (2008). R: A language and environment for statistical computing. Team, R. C. (2008). R: A language and environment for statistical computing.
42.
go back to reference Grün, B., & Leisch, F. (2008). FlexMix Version 2: Finite mixtures with concomitant variables and varying and constant parameters. Journal of Statistical Software, 28(4), 1–35.CrossRef Grün, B., & Leisch, F. (2008). FlexMix Version 2: Finite mixtures with concomitant variables and varying and constant parameters. Journal of Statistical Software, 28(4), 1–35.CrossRef
43.
go back to reference Blome, C., Beikert, F., & Rustenbach, S. (2013). Mapping DLQI on EQ-5D in psoriasis: transformation of skin-specific health-related quality of life into utilities. Archives of Dermatological Research, 305, 197–204.PubMedCrossRef Blome, C., Beikert, F., & Rustenbach, S. (2013). Mapping DLQI on EQ-5D in psoriasis: transformation of skin-specific health-related quality of life into utilities. Archives of Dermatological Research, 305, 197–204.PubMedCrossRef
44.
go back to reference Currie, C., & Conway, P. (2007). PSK11: Evaluation of the association between EQ-5D utlity and dermatology life quality index (DLQI) score in patients with psoriasis. Value in Health, 10, A470–471.CrossRef Currie, C., & Conway, P. (2007). PSK11: Evaluation of the association between EQ-5D utlity and dermatology life quality index (DLQI) score in patients with psoriasis. Value in Health, 10, A470–471.CrossRef
45.
go back to reference Heredi, E., Rencz, F., Balogh, O., Gulacsi, L., Herszenyi, K., Hollo, P., et al. (2014). Exploring the relationship between EQ-5D, DLQI and PASI, and mappi EQ-5D utilities: A cross-sectional study in psoriasis from Hungary. European Journal Health of Economic, 1, S111–119.CrossRef Heredi, E., Rencz, F., Balogh, O., Gulacsi, L., Herszenyi, K., Hollo, P., et al. (2014). Exploring the relationship between EQ-5D, DLQI and PASI, and mappi EQ-5D utilities: A cross-sectional study in psoriasis from Hungary. European Journal Health of Economic, 1, S111–119.CrossRef
46.
go back to reference Norlin, J., Steen, C., Persson, U., & Schmitt-Egenolf, M. (2012). Analysis of three outcome measures in moderate to severe psoriasis: A registry-based study of 2450 patients. British Journal of Dermatology, 166(4), 797–802.PubMedCrossRef Norlin, J., Steen, C., Persson, U., & Schmitt-Egenolf, M. (2012). Analysis of three outcome measures in moderate to severe psoriasis: A registry-based study of 2450 patients. British Journal of Dermatology, 166(4), 797–802.PubMedCrossRef
47.
go back to reference Ali, F., Kay, R., Finlay, A., Piguet, V., Kupfer, J., Dalgard, F., et al. (2017). Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression. Quality of Life Research, 26, 3025–3034.PubMedPubMedCentralCrossRef Ali, F., Kay, R., Finlay, A., Piguet, V., Kupfer, J., Dalgard, F., et al. (2017). Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression. Quality of Life Research, 26, 3025–3034.PubMedPubMedCentralCrossRef
49.
go back to reference Paller, A., Jaworski, J., Simpson, E., Boguniewics, M., Russel, J., Block, J., et al. (2018). Major comorbidities of atopic dermatitis: Beyond allergic disorders. American Journal of Clinical Dermatology, 19(6), 821–838.PubMedCrossRef Paller, A., Jaworski, J., Simpson, E., Boguniewics, M., Russel, J., Block, J., et al. (2018). Major comorbidities of atopic dermatitis: Beyond allergic disorders. American Journal of Clinical Dermatology, 19(6), 821–838.PubMedCrossRef
50.
go back to reference Brunner, P., Silverberg, J., Guttman-Yasky, E., Paller, A., Kabashima, K., & Amagai, M. (2017). Increasing comorbidities suggests that atopic dermatitis is a systemic disorder. Journal of Investigative Dermatology, 137, 18–25.PubMedCrossRef Brunner, P., Silverberg, J., Guttman-Yasky, E., Paller, A., Kabashima, K., & Amagai, M. (2017). Increasing comorbidities suggests that atopic dermatitis is a systemic disorder. Journal of Investigative Dermatology, 137, 18–25.PubMedCrossRef
Metadata
Title
Mapping Dermatology Life Quality Index (DLQI) scores to EQ-5D utility scores using data of patients with atopic dermatitis from the National Health and Wellness Study
Authors
Andreas Westh Vilsbøll
Nana Kragh
Julie Hahn-Pedersen
Cathrine Elgaard Jensen
Publication date
01-09-2020
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 9/2020
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-020-02499-1

Other articles of this Issue 9/2020

Quality of Life Research 9/2020 Go to the issue