Determining the value of hand surgery through mapping algorithms.

Area of Science:

• Health Economics
• Patient-Reported Outcomes
• Psychometrics

Background:

• Health state utility values are crucial for calculating quality-adjusted life years (QALYs).
• Traditionally, generic measures like the EuroQol 5-Dimension (EQ-5D) scale are used.
• No hand-specific measures were available to derive these utility values.

Purpose of the Study:

• To develop and evaluate mapping algorithms to estimate EQ-5D utility index from the Patient Evaluation Measure (PEM).
• To assess the feasibility of using hand-specific Patient Reported Outcome Measures (PROMs) for utility value estimation.

Main Methods:

• Utilized matched PEM and EQ-5D 5-Level data from 2043 patients.
• Developed transfer-to-utility models.
• Assessed model performance using 1000-fold bootstrap validation.

Main Results:

• Presented various mapping algorithms to derive utility values from the PEM, a hand-specific PROM.
• The best-performing models exhibited clinically relevant population-level prediction errors.
• Indicated potential limitations in accurately predicting generic utility from hand-specific data.

Conclusions:

• Mapping hand-specific PROMs onto generic preference-based measures may not be appropriate for clinical use.
• The prediction errors suggest caution when interpreting utility values derived through such mapping.
• Further research may be needed to explore alternative methods for deriving utility values from condition-specific PROMs.