title: Estimating health state utility values for comorbid health conditions using SF-6D data.
abstract: BACKGROUND
  When health state utility values for comorbid health conditions are not available, data from cohorts with single conditions are used to estimate scores. The methods used can produce very different results and there is currently no consensus on which is the most appropriate approach.
  
  
  OBJECTIVE
  The objective of the current study was to compare the accuracy of five different methods within the same dataset.
  
  
  METHODS
  Data collected during five Welsh Health Surveys were subgrouped by health status. Mean short-form 6 dimension (SF-6D) scores for cohorts with a specific health condition were used to estimate mean SF-6D scores for cohorts with comorbid conditions using the additive, multiplicative, and minimum methods, the adjusted decrement estimator (ADE), and a linear regression model.
  
  
  RESULTS
  The mean SF-6D for subgroups with comorbid health conditions ranged from 0.4648 to 0.6068. The linear model produced the most accurate scores for the comorbid health conditions with 88% of values accurate to within the minimum important difference for the SF-6D. The additive and minimum methods underestimated or overestimated the actual SF-6D scores respectively. The multiplicative and ADE methods both underestimated the majority of scores. However, both methods performed better when estimating scores smaller than 0.50. Although the range in actual health state utility values (HSUVs) was relatively small, our data covered the lower end of the index and the majority of previous research has involved actual HSUVs at the upper end of possible ranges.
  
  
  CONCLUSIONS
  Although the linear model gave the most accurate results in our data, additional research is required to validate our findings.
authors.affiliation: Health Economics and Decision Science, ScHARR, The University of Sheffield, Sheffield, UK. r.m.ara@sheffield.ac.uk
authors.forename: Roberta
authors.initials: R
authors.lastname: Ara
authors.forename: John
authors.initials: J
authors.lastname: Brazier
mesh_terms: D015897:Comorbidity; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D011237:Predictive Value of Tests; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014852:Wales / Q000453:epidemiology