title: The DEP-6D, a new preference-based measure to assess health states of dependency.
abstract: In medical literature there are numerous multidimensional scales to measure health states for dependence in activities of daily living. However, these scales are not preference-based and are not able to yield QALYs. On the contrary, the generic preference-based measures are not sensitive enough to measure changes in dependence states. The objective of this paper is to propose a new dependency health state classification system, called DEP-6D, and to estimate its value set in such a way that it can be used in QALY calculations. DEP-6D states are described as a combination of 6 attributes (eat, incontinence, personal care, mobility, housework and cognition problems), with 3-4 levels each. A sample of 312 Spanish citizens was surveyed in 2011 to estimate the DEP-6D preference-scoring algorithm. Each respondent valued six out of the 24 states using time trade-off questions. After excluding those respondents who made two or more inconsistencies (6% out of the sample), each state was valued between 66 and 77 times. The responses present a high internal and external consistency. A random effect model accounting for main effects was the preferred model to estimate the scoring algorithm. The DEP-6D describes, in general, more severe problems than those usually described by means of generic preference-based measures. The minimum score predicted by the DEP-6D algorithm is -0.84, which is considerably lower than the minimum value predicted by the EQ-5D and SF-6D algorithms. The DEP-6D value set is based on community preferences. Therefore it is consistent with the so-called 'societal perspective'. Moreover, DEP-6D preference weights can be used in QALY calculations and cost-utility analysis.
authors.affiliation: Department of Applied Economics, University of Vigo, As Lagoas-Marcosende s/n, 36310 Vigo, Spain; GRiEE/ECOBAS, Spain; Institute of Biomedical Research, Vigo, Spain. Electronic address: emiguez@uvigo.es.
authors.forename: E
authors.initials: E
authors.lastname: Rodríguez-Míguez
authors.affiliation: Department of Applied Economics, University of Murcia, Campus de Espinardo, 30100 Murcia, Spain. Electronic address: dionisos@um.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Abellán-Perpiñán
authors.affiliation: Department of Applied Economics, University of Vigo, As Lagoas-Marcosende s/n, 36310 Vigo, Spain. Electronic address: xalvarez@uvigo.es.
authors.forename: X C
authors.initials: XC
authors.lastname: Alvarez
authors.affiliation: Department of Applied Economics, University of Vigo, As Lagoas-Marcosende s/n, 36310 Vigo, Spain. Electronic address: xmgzlez@uvigo.es.
authors.forename: X M
authors.initials: XM
authors.lastname: González
authors.affiliation: Department of Economics, University of Santiago de Compostela, Avda. do Burgo s/n, Campus Norte, 15782 Santiago de Compostela, Spain. Electronic address: ar.sampayo@usc.es.
authors.forename: A R
authors.initials: AR
authors.lastname: Sampayo
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D015203:Reproducibility of Results; D013030:Spain; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: DEP-6D; Dependency; Preference-based measures; QALY; Spain; Time trade-off