Relative disutilities of 47 risk factors and conditions assessed with seven preference-based health status measures in a national U.S. sample: toward consistency in cost-effectiveness analyses.
BACKGROUND
Preference-based health measures yield summary scores that are compatible with cost-effectiveness analyses. There is limited comparative information, however, about how different measures weight health conditions in the U.S. population.


METHODS
We examined data from 11,421 adults in the 2000 Medical Expenditure Panel Survey, a nationally representative sample of the U.S. general population, using information on sociodemographics (age, gender, race/ethnicity, income, and education), health status (EQ-5D, EQ-VAS, and SF-12), 4 risk factors (smoking, overweight, obesity, and lacking health insurance), and 43 conditions. From the EQ-5D, we derived summary scores using U.K. [EQ(UK)] and U.S. weights. From the SF-12 we derived SF-6D, and regression-predicted EQ-5D (U.S. and U.K. weights) and Health Utility Index scores. Each of the 7 preference measures was regressed on each of the 47 problems (risk factors and conditions) to determine the disutility associated with the problem, adjusting for socio-demographics.


RESULTS
The adjusted disutilities averaged across the 47 problems for the 7 preference measures ranged from 0.059 for the SF-6D to 0.104 for the EQ(UK). Correlations between each of the measures of the adjusted disutilities ranged from 0.85-1.0. Standardization, using linear regression, attenuated between measure differences in disutilities.


CONCLUSIONS
Absolute incremental cost-effectiveness analyses of a given problem would likely vary depending on the measure used, whereas the relative ordering of incremental cost-effectiveness analyses of a series of problems would likely be similar regardless of the measure chosen, as long as the same measure is used in each series of analyses. Absolute consistency across measures may be enhanced by standardization.
Franks
Peter
P
Department of Family and Community Medicine, Center for Health Services Research in Primary Care, University of California, Davis, Sacramento, CA 95817, USA. pfranks@ucdavis.edu
Hanmer
Janel
J
Fryback
Dennis G
DG
D000328:Adult; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States