What is the value of social values? The uselessness of assessing health-related quality of life through preference measures.
BACKGROUND
The use of preference-based measures in the evaluation of health outcomes has extended considerably over the last decade. Their alleged advantage over other types of general instruments in the evaluation of health related quality of life (HRQOL), supposedly lies in the fact that preference measures incorporate values or utilities that reflects the value of social preferences through health states. The objective of this study was to determine whether the use of social preference weights or utilities makes any real difference when calculating scores for the Euroqol (EQ5-D) questionnaire, a HRQOL preference-based measure.


METHODS
Responses to the EQ5-D of a sample of 10,972 patients from 10 countries enrolled in an observational study of the treatment of schizophrenia in Europe were used for this purpose. Two different methods of scoring the EQ-5D where compared: 'weighting the items' of the questionnaire through the UK official weight coefficients, and 'non-weighting the items'. Pearson's, Spearman's, and two-way mixed parametric intraclass correlation coefficients were used to estimate the association of the scores obtained in both ways.


RESULTS
The association between weighted and unweighted Euroqol scores was extremely high (Pearson's r = 0.91), as was the association between their ranks (Spearman's rho = 0.93). The intraclass correlation coefficient obtained (0.89) also suggested that the concordance between the score distributions was prominent.


CONCLUSIONS
A non-weighted approach to score the EQ5-D is enough to explain a high proportion of variance in scores obtained through the use of utilities. The differential contribution of weights based on population preference values is therefore minimal and, in our opinion, negligible.
Prieto
Luis
L
Health Outcomes Research Unit, Eli Lilly & Co, Spain, Av, de la Industria, 30, 28108 Alcobendas, SPAIN. prieto_luis@lilly.com
Sacristán
José A
JA
D003627:Data Interpretation, Statistical; D006305:Health Status Indicators; D006801:Humans; D011788:Quality of Life; D012945:Social Values; D011795:Surveys and Questionnaires