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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2012

Open Access 01-12-2012 | Research article

A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

Authors: Fiammetta Maria Bozzani, Yasmene Alavi, Mireia Jofre-Bonet, Hannah Kuper

Published in: BMC Ophthalmology | Issue 1/2012

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Abstract

Background

Economic viability of treatments for primary open-angle glaucoma (POAG) should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs) most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified.

Methods

A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off) and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25) were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods.

Results

Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08) whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively). The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001); most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D.

Conclusions

The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages.
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Literature
1.
Resnikoff S, Pascolini D, Etya'ale D, et al: Global data on visual impairment in the year 2002. Bulletin of the World Health Organization. 2004, 82: 844-851.PubMedPubMedCentral
2.
3.
Kuper H, Jofre-Bonet M, Gilbert C: Economic evaluation for ophtalmologists. Ophtalmic Epidemiol. 2006, 13: 393-401. 10.1080/09286580600760539.CrossRef
4.
Brazier J, Deverill M, Green C, et al: A review of the use of health status measures in economic evaluation. Health Technol Assess. 1999, 3 (9):
5.
Kymes SM: An introduction to decision analysis in the economic evaluation of the prevention and treatment of vision-related disease. Ophtalmic Epidemiol. 2008, 15: 76-83. 10.1080/09286580801939346.CrossRef
6.
McKean-Cowdin R, Varma R, Wu J, et al: Severity of visual field loss and health-related quality of life. Am J Ophthalmol. 2007, 143: 1013-1023. 10.1016/j.ajo.2007.02.022.CrossRefPubMedPubMedCentral
7.
Jaeschke R, Singer J, Guyatt GH: Measurement of health status. Ascertaining the minimal clinically important difference. Contr Clin Trials. 1989, 10: 407-415. 10.1016/0197-2456(89)90005-6.CrossRef
8.
Aspinall PA, Johnson ZK, Azuara-Blanco A, et al: Evaluation of quality of life and priorities of patients with glaucoma. Invest Ophthalmol Vis Sci. 2008, 49: 1907-1915. 10.1167/iovs.07-0559.CrossRefPubMed
9.
Broman AT, Munoz B, Rodriguez J, et al: The impact of visual impairment and eye disease on vision-related quality of life in a Mexican-American population: proyecto VER. Invest Ophtalmol Vis Sci. 2002, 43: 3393-3398.
10.
Evans K, Law SK, Walt J, et al: The quality of life impact of peripheral versus central vision loss with a focus on glaucoma versus age-related macular degeneration. Clin Ophtalmol. 2009, 3: 433-445.CrossRef
11.
Gupta V, Srinivasan G, Mei SS, et al: Utility values among glaucoma patients: an impact on the quality of life. Br J Ophthalmol. 2005, 89: 1241-1244. 10.1136/bjo.2005.068858.CrossRefPubMedPubMedCentral
12.
Jampel HD: Glaucoma patients' assessment of their visual function and quality of life. Trans Am Ophtalmol Soc. 2001, 99: 301-317.
13.
Mills RP: Correlation of quality of life with clinical symptoms and signs at the time of glaucoma diagnosis. Trans Am Ophtalmol Soc. 1998, 96: 753-812.
14.
Kopec JA, Willison KD: A comparative review of four preference-weighted measures of health-related quality of life. J Clin Epidemiol. 2003, 56: 317-325. 10.1016/S0895-4356(02)00609-1.CrossRefPubMed
15.
Dolan P, Lee H, Kling D, et al: How does NICE value health?. BMJ. 2009, 339: 371-373.CrossRef
16.
Payakachat N, Summers KH, Pleil AM, et al: Predicting EQ-5D utility scores from the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ) in patients with age-related macular degeneration. Qual Life Res. 2009, 18: 801-813. 10.1007/s11136-009-9499-6.CrossRefPubMed
17.
Hernandez R, Rabindranath K, Fraser C, et al: Screening for open angle glaucoma: systematic review of cost-effectiveness studies. J Glaucoma. 2008, 17: 159-168. 10.1097/IJG.0b013e31814b9693.CrossRefPubMed
18.
Rein DB, Wirth KE, Johnson CA, et al: Estimating quality-adjusted life-year losses associated with visual field deficits using methodological approaches. Ophthalmic Epidemiol. 2007, 14: 258-264. 10.1080/01658100701473267.CrossRefPubMed
19.
Kobelt G, Jonsson B, Bergstrom A, et al: Cost-effectiveness analysis in glaucoma: what drives utility? Results from a pilot study in Sweden. Acta Ophthalmol Scand. 2006, 84: 363-371. 10.1111/j.1600-0420.2005.00621.x.CrossRefPubMed
20.
Nelson P, Aspinall P, Papasouliotis O, et al: Quality of life in glaucoma and its relationship with visual function. J Glaucoma. 2003, 12: 139-150. 10.1097/00061198-200304000-00009.CrossRefPubMed
21.
Ramulu P: Glaucoma and disability: which tasks are affected and at what stage of disease?. Curr Op Ophthalmol. 2009, 20: 92-98. 10.1097/ICU.0b013e32832401a9.CrossRef
22.
Tosh J, Brazier J, Evans P, Longworth L: HEDS Discussion paper 11/03. A review of generic preference-based measures of health-related quality of life in visual disorders. 2011, The University of Sheffield
23.
Alavi Y, Jofre-Bonet M, Bunce C, et al: Developing and algorithm to convert routine measures of vision into utility values for glaucoma.Ophtalmic. Epidemiology. 2011, 18: 233-243.
24.
Crabb DP, Viswanathan AC: Integrated visual fields: a new approach to measuring the binocular field of view and visual disability. Graefes Arch Clin Exp Ophthalmol. 2005, 243: 210-216. 10.1007/s00417-004-0984-x.CrossRefPubMed
25.
Birt CM, Shin DH, Samudrala V, et al: Analysis of reliability indices from Humphrey visual field tests in an urban glaucoma population. Ophthalmology. 1997, 104: 1126-1130.CrossRefPubMed
26.
Schulze-Bonsel K, Feltgen N, Burau H, et al: Visual acuities "hand motion" and "counting fingers" can be quantified with the Freiburg visual acuity test. Invest Ophthalmol Vis Sci. 2006, 47: 1236-1240. 10.1167/iovs.05-0981.CrossRefPubMed
27.
28.
Office for National Statistics: Deriving NS-SEC: Self-coded method. The National Statistics socio-economic Classification: User Manual. 2005, Pallgrave Macmillan, London
29.
Rabin R, de Charro F: EQ-5D: a measure of health status from EuroQol group. Ann Med. 2001, 33: 337-343. 10.3109/07853890109002087.CrossRefPubMed
30.
31.
Wilson MR, Coleman AL, Yu F, et al: Functional status and well being in patients with glaucoma as measured by the Medical Outcomes Study Short Form-36 questionnaire. Ophthalmology. 1998, 109: 1018-1022.CrossRef
32.
33.
Brown MM, Brown GC, Sharma S, et al: Quality of life associated with visual loss: a time tradeoff utility analysis comparison with medical health states. Ophthalmology. 2003, 110: 1076-1081. 10.1016/S0161-6420(03)00254-9.CrossRefPubMed
34.
Brown GC, Brown MM, Sharma S, Beauchamp G, Hollands H: The reproducibility of ophthalmic utility values. Trans Am Ophtalmol Soc. 2001, 99: 109-203.
35.
Hollands H, Lam M, Pater J, Albiani D, Brown GC, Brown M, et al: Reliability of the time trade-off technique of utility assessment in patients with retinal disease. Can J Ophthalmol-J Can D Ophtalmologie. 2001, 36: 202-209.CrossRef
36.
Brown GC, Sharma S, Brown MM, Kistler J: Utility values and age-related macular degeneration. Arch Ophtalmol. 2000, 118: 47-51. 10.1001/archopht.118.1.47.CrossRef
37.
Schiffman RM, Walt JG, Jacobsen G, Doyle JJ, Lebovics G, Sumner W: Utility assessment among patients with dry eye disease. Ophthalmology. 2003, 110: 1412-1419. 10.1016/S0161-6420(03)00462-7.CrossRefPubMed
38.
Sharma S, Brown GC, Brown MM, Hollands H, Robins R, Shah GK: Validity of the time trade-off and standard gamble methods of utility assessment in retinal patients. Br J Ophtalmol. 2002, 86: 493-496. 10.1136/bjo.86.5.493.CrossRef
39.
40.
National Institute for Health and Clinical Excellence (NICE): Guide to the methods of technology appraisal. 2008, London: National Institute for Health and Clinical Excellence
41.
Herdman M, Gudex C, Lloyd A, Janssen MF, Kind P, Parkin D, Bonsel G, Badia X: Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5 L). Qual Life Res. 2011, 20: 1727-1736. 10.1007/s11136-011-9903-x.CrossRefPubMedPubMedCentral
42.
Walters SJ, Brazier JE: Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res. 2005, 14: 1523-1532. 10.1007/s11136-004-7713-0.CrossRefPubMed
43.
Tosh J, Brazier J, Evans P, Longworth L: A review of generic preference-based measures of health-related quality of life in visual disorders. Value in Health. 2012, 15: 118-127. 10.1016/j.jval.2011.08.002.CrossRefPubMedPubMedCentral
44.
Espallargues M, Czoski-Murray CJ, Bansback NJ, et al: The impact of age-related macular degeneration on health status utility values. Invest Ophthalmol Vis Sci. 2005, 46: 4016-4023. 10.1167/iovs.05-0072.CrossRefPubMed
45.
Harrison MJ, Davies LM, Bansback NJ, et al: The validity and responsiveness of generic utility measures in rheumatoid arthritis: a review. J Rheumatol. 2008, 35: 592-602.PubMed
46.
Szende A, Leidy NK, et al: Estimating health utilities in patients with asthma and COPD: evidence on the performance of EQ-5D and SF-6D. Qual Life Res. 2009, 18: 267-272. 10.1007/s11136-008-9429-z.CrossRefPubMed
47.
Dolan P: Thinking about it: thoughts about health and valuing QALYs. Book Thinking about it: thoughts about health and valuing QALYs. 2010, City
48.
Black N, Browne J, van der Meulen J, et al: Is there overutilisation of cataract surgery in England?. Br J Ophtalmol. 2009, 93: 13-17. 10.1136/bjo.2007.136150.CrossRef
49.
Ravens-Sieberer U, Wille N, Badia X, et al: Feasibility, reliability, and validity of the EQ-5D-Y: results from a multinational study. Qual Life Res. 2010, 19: 887-897. 10.1007/s11136-010-9649-x.CrossRefPubMedPubMedCentral
50.
Robinson A, Dolan P, Williams A: Valuing health states using the VAS and TTO: what lies behind the numbers?. Soc Sci Med. 1997, 45: 1289-1297. 10.1016/S0277-9536(97)00057-9.CrossRefPubMed
51.
Lee BS, Kymes SM, Nease RF, et al: The impact of anchor point on utilities for 5 common ophthalmic diseases. Ophthalmology. 2008, 115: 898-903 e894. 10.1016/j.ophtha.2007.06.008.CrossRefPubMed
52.
Kind P, Hardman G, Macran S: UK population norms for EQ-5D. Book UK population norms for EQ-5D. 1999
53.
Brazier J, Roberts J, Deverill M: The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002, 21: 271-292. 10.1016/S0167-6296(01)00130-8.CrossRefPubMed
Metadata
Title
A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma
Authors
Fiammetta Maria Bozzani
Yasmene Alavi
Mireia Jofre-Bonet
Hannah Kuper
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2012
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/1471-2415-12-43

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