title: SF-6D and EQ-5D result in widely divergent incremental cost-effectiveness ratios in a clinical trial of older women: implications for health policy decisions.
abstract: CONCLUSIONS
  Using two instruments (SF-6D and EQ-5D) to estimate quality adjusted life years (QALYs), we conducted an economic evaluation of a 12-month randomized controlled trial with a 12-month follow-up study in older women to evaluate the value for money of two doses of resistance training compared with balance and tone classes. We found that the incremental QALYs estimated from the SF-6D were two- to threefold greater than those estimated from the EQ-5D.
  
  
  BACKGROUND
  Decision makers must continually choose between existing and new interventions. Hence, economic evaluations are increasingly prevalent. The impact of quality-adjusted life year (QALY) estimates using different instruments on the incremental cost-effectiveness ratios (ICERs) is not well understood in older adults. Thus, we compared ICERs, in older women, estimated by the EuroQol-5D (EQ-5D) and the Short Form-6D (SF-6D) to discuss implications on decision making.
  
  
  METHODS
  Using both the EQ-5D and the SF-6D, we compared the incremental cost per QALY gained in a randomized controlled trial of resistance training in 155 community-dwelling women aged 65 to 75 years. The 12-month randomized controlled trial included a subsequent 12-month follow-up. Our focus, the follow-up study, included 123 of the 155 participants from the Brain Power study; 98 took part in the economic evaluation (twice-weekly balance and tone exercises, n = 28; once-weekly resistance training, n = 35; twice-weekly resistance training, n = 35). Our primary outcome measure was the incremental cost per QALY gained of once- or twice-weekly resistance training compared with balance and tone exercises.
  
  
  RESULTS
  At cessation of the follow-up study, the incremental QALY was -0.051 (EQ-5D) and -0.144 (SF-6D) for the once-weekly resistance training group and -0.081 (EQ-5D) and -0.127 (SF-6D) for the twice-weekly resistance training group compared with balance and tone classes.
  
  
  CONCLUSIONS
  The incremental QALYs estimated from the SF-6D were two- to threefold greater than those estimated from the EQ-5D. Given the large magnitude of difference, the choice of preference-based utility instrument may substantially impact health care decisions.
authors: Centre for Clinical Epidemiology and Evaluation, VCH Research Institute, The University of British Columbia, Research Pavilion, 7th floor, 828 West 10th Avenue, Vancouver, BC, V5Z 1M9, Canada. Jennifer.davis@ubc.ca
authors: J C
authors: JC
authors: Davis
authors: T
authors: T
authors: Liu-Ambrose
authors: K M
authors: KM
authors: Khan
authors: M C
authors: MC
authors: Robertson
authors: C A
authors: CA
authors: Marra
mesh_terms: D000368:Aged; D002170:Canada; D003362:Cost-Benefit Analysis; D003657:Decision Making; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006291:Health Policy; D006801:Humans; D010043:Outcome and Process Assessment, Health Care / Q000379:methods; D004856:Postural Balance; D011594:Psychometrics; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D055070:Resistance Training / Q000191:economics*