title: Comparison of generic, condition-specific, and mapped health state utility values for multiple myeloma cancer.
abstract: OBJECTIVE
  Resource allocation informed by cost-utility analysis requires that the benefits be comparable across patient groups and interventions. One option is to recommend the use of one generic utility measure, but this raises the issue of comparability when the preferred measure is inappropriate or unavailable. Many cancer trials do not include generic measures such as the EuroQol five-dimensional (EQ-5D) questionnaire and instead include condition-specific measures and use these to generate utility estimates. We analyze the comparability of generic, condition-specific, and mapped utility values for a multiple myeloma cancer patient data set.
  
  
  METHODS
  Generic EQ-5D, condition-specific EORTC-8D, and EQ-5D utility values mapped from the EORTC QLQ-C30 were compared by using psychometric and statistical analysis to determine discrimination across severity groups, responsiveness, and agreement.
  
  
  RESULTS
  Generic, condition-specific, and mapped utility estimates were responsive over time and show discriminative validity. The EQ-5D had higher responsiveness and detected a greater change across severity groups and treatment periods than did the EORTC-8D but has a higher proportion of responses at full health (12.8%). Differences in the EQ-5D and the EORTC-8D were due at least in part to differences in the classification system. Mapped EQ-5D estimates had a smaller SD and do not reflect the severe range of health states reported by using the EQ-5D.
  
  
  CONCLUSIONS
  Our findings suggest that condition-specific EORTC-8D or mapped EQ-5D utility estimates are broadly comparable to directly obtained EQ-5D utilities for a multiple myeloma patient data set. However, EORTC-8D estimates captured changes in quality of life for patients in mild health states that were not captured by the EQ-5D, but estimated lower utility gains than did the use of the EQ-5D directly.
authors.affiliation: Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, UK. d.rowen@sheffield.ac.uk
authors.forename: Donna
authors.initials: D
authors.lastname: Rowen
authors.forename: Tracey
authors.initials: T
authors.lastname: Young
authors.forename: John
authors.initials: J
authors.lastname: Brazier
authors.forename: Sabine
authors.initials: S
authors.lastname: Gaugris
mesh_terms: D004644:Emotions; D015276:Health Care Rationing; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D009101:Multiple Myeloma / Q000523:psychology*; D010146:Pain / Q000523:psychology; D011594:Psychometrics; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D006113:United Kingdom