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Patient Experience-based Value Sets: Are They Stable?

A Simon Pickard1, Yu-Ting Hung, Fang-Ju Lin

  • 1*Department of Pharmacy Systems, Outcomes and Policy, and Center for Pharmacoepidemiology Pharmacoeconomic Research, College of Pharmacy, University of Illinois at Chicago †Department of Medical Research, China Medical University Hospital, Taichung, Taiwan ‡Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago §Graduate Institute of Clinical Pharmacy, College of Medicine ∥Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.

Medical Care
|October 14, 2017
PubMed
Summary
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Patient health value sets are not stable and change after knee replacement surgery. Post-surgery health states are valued lower than pre-surgery, impacting clinical decision-making.

Area of Science:

  • Health Economics
  • Patient-Reported Outcomes
  • Quality of Life Measurement

Background:

  • Societal preference weights are crucial for resource allocation.
  • Patient-experienced health state values are vital for clinical decisions, but context sensitivity is a concern.

Purpose of the Study:

  • To estimate EQ-5D value sets using visual analog scale (VAS) ratings.
  • To compare health state valuations before and after knee replacement surgery.

Main Methods:

  • Utilized Patient Reported Outcome Measures data from UK National Health Service (2009-2012).
  • Employed generalized least squares regression models for EQ-5D-3 level value set derivation.
  • Validated model performance using a separate sample.

Related Experiment Videos

Main Results:

  • Analyzed 90,450 preoperative and postoperative valuations.
  • Pre-surgery: anxiety/depression most impacted VAS values; Post-surgery: pain/discomfort had a greater impact.
  • Post-surgical health problems led to larger value decrements across multiple dimensions compared to pre-surgical states.

Conclusions:

  • Patient-experienced value sets are context-dependent and not stable over time.
  • Lower post-surgery valuations compared to pre-surgery can inform patient-doctor decision-making.