Patient versus general population health state valuations: a case study of non-specific low back pain.
The purpose of this study was twofold: (1) to compare non-specific low back pain (LBP) patients' health state valuations with those of the general population, and (2) to explore how aspects of health-related quality of life as measured by the EQ-5D-3L impact non-specific LBP patient valuations.



Data were used of a randomized controlled trial, including 483 non-specific LBP patients. Outcomes included the EQ-VAS and the EQ-5D-3L. Patient valuations were derived from the EQ-VAS. Population valuations were derived from the EQ-5D-3L using a Dutch VAS-based tariff. The difference between patient and population valuations was assessed using t tests. An OLS linear regression model was constructed to explore how various aspects of health-related quality of life as measured by the ED-5D-3L impact non-specific LBP patient valuations.



Non-specific LBP patients valued their health states 0.098 (95% CI 0.082-0.115) points higher than the general population. Only 22.2% of the variance in patient valuations was explained by the patients' EQ-5D-3L health states (R2= 0.222). Non-specific LBP patients gave the most weight to the anxiety/depression dimension.



This study demonstrated that non-specific LBP patients value their health states higher than members of the general population and that the choice of valuation method could have important implications for cost-effectiveness analyses and thus for clinical practice.
Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands. j.m.van.dongen@vu.nl.
J M
JM
van Dongen
University of York, Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK.|Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
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B
van denBerg
CEBAM Belgian Center of Evidence-based Medicine vzw, Kapucijnenvoer 33, blik j, 3000, Leuven, Belgium.
G E
GE
Bekkering
Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
M W
MW
van Tulder
Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.|Department of Epidemiology and Biostatistics and the EMGO+ Institute for Health and Care Research, VU University Medical Centre, De Boelelaan 1089a, 1081 HV, Amsterdam, The Netherlands.
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RWJG
Ostelo
D000328:Adult; D003362:Cost-Benefit Analysis / Q000379:methods*; D005260:Female; D006304:Health Status; D006801:Humans; D017116:Low Back Pain / Q000191:economics / Q000628:therapy*; D008297:Male; D000075485:Population Health / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
Cost-effectiveness analysis; EQ-5D-3L; EQ-VAS; Health state valuation; Low back pain