Responsiveness of EQ-5D utility indices in alcohol-dependent patients.
BACKGROUND
The EQ-5D provides community-based preference weights (utilities) for calculating quality adjusted life years (QALYs) in cost-utility analysis. This study aimed to analyze the responsiveness of EQ-5D-based utilities in patients with alcohol dependence.


METHODS
In an observational longitudinal cohort study of alcohol-dependent patients (N=52), three different EQ-5D-based utilities (EQ-Index United Kingdom, United States, and Germany) were calculated and compared with the scores of the WHOQOL-BREF (mental domain), HoNOS (total score), and GAF at baseline and at 18 months. Patients were categorized with more/same/less problems according to their self reported consumption of alcohol (patient-based anchor) and their problem status due to alcohol consumption using a question of the HoNOS scale (clinician-based anchor). Effect sizes (ES) were used to compare longitudinal changes in scores within each group; regression analysis was used to derive difference scores in health status associated with a shift from "same" to "less" problems according to the two anchors.


RESULTS
ES were rather trivial to medium for all EQ-5D indices (ranging from |0.10| to |0.59|) related to a shift from "same" to "less" problems in the two anchors. Differences in scores of the EQ-5D indices revealing a shift from "same" to "less" problems according to the two anchors were not significant.


CONCLUSIONS
These results suggest that the EQ-5D indices are less responsive and require larger patient samples to detect meaningful clinical differences compared to the other used instruments. Additional research is needed to compare societal and clinical views on relevant change in health status in this patient group.
Günther
Oliver H
OH
Health Economics Research Unit, University of Leipzig, Johannisallee 20, 04317 Leipzig, Germany. oliver.guenther@medizin.uni-leipzig.de
Roick
Christiane
C
Angermeyer
Matthias C
MC
König
Hans-Helmut
HH
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000150:complications / Q000523:psychology*; D001007:Anxiety / Q000150:complications / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D010146:Pain / Q000150:complications; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D012919:Social Behavior; D011795:Surveys and Questionnaires