title: Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: results of two pilot studies in Belgium.
abstract: BACKGROUND
  Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In 2010 and 2013, Salomon et al. proposed a set of DWs for 220 and 183 health states, respectively. The objective of this study is to develop an approach for mapping EQ-5D utilities to existing GBD 2010 and GBD 2013 DWs, allowing to predict new GBD 2010/2013 DWs based on EQ-5D utilities.
  
  
  METHODS
  We conducted two pilot studies including respectively four and twenty-seven health states selected from the 220 DWs of the GBD 2010 study. In the first study, each participant evaluated four health conditions using the standard written EQ-5D-5 L questionnaire. In the second study, each participant evaluated four health conditions randomly selected among the twenty-seven health states using a previously developed web-based EQ-5D-5 L questionnaire. The EQ-5D responses were translated into utilities using the model developed by Cleemput et al. A loess regression allowed to map EQ-5D utilities to logit transformed DWs.
  
  
  RESULTS
  Overall, 81 and 393 respondents completed the first and the second survey, respectively. In the first study, a monotonic relationship between derived utilities and predicted GBD 2010/2013 DWs was observed, but not in the second study. There were some important differences in ranking of health states based on utilities versus GBD 2010/2013 DWs. The participants of the current study attributed a relatively higher severity level to musculoskeletal disorders such as 'Amputation of both legs' and a relatively lower severity level to non-functional disorders such as 'Headache migraine' compared to the participants of the GBD 2010/2013 studies.
  
  
  CONCLUSIONS
  This study suggests the possibility to translate any utility derived from EQ-5D scores into a DW, but also highlights important caveats. We observed a satisfactory result of this methodology when utilities were derived from a population of public health students, a written questionnaire and a small number of health states in the presence of a study leader. However the results were unsatisfactory when utilities were derived from a sample of the general population, using a web-based questionnaire. We recommend to repeat the study in a larger and more diverse sample to obtain a more representative distribution of educational level and age.
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200 Belgium.
authors.forename: C
authors.initials: C
authors.lastname: Maertens de Noordhout
authors.affiliation: Department of Public Health and Surveillance, Scientific Institute of Public Health, Rue Juliette Wytsman 14, 1050 Brussels, Belgium.
authors.forename: B
authors.initials: B
authors.lastname: Devleesschauwer
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200 Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Gielens
authors.affiliation: National Institute for Public Health and the Environment, Centre for Health and Society, P.O. Box 1, 3720, BA Bilthoven, The Netherlands.
authors.forename: M H D
authors.initials: MHD
authors.lastname: Plasmans
authors.affiliation: Department of Public Health, Erasmus MC, Dr. Molewaterplein 50, 3015 GE Rotterdam, The Netherlands.|Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98121 USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Haagsma
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain Clos Chapelle-aux-Champs, 30 bte B1.30.15, Brussels, 1200 Belgium.
authors.forename: N
authors.initials: N
authors.lastname: Speybroeck
keywords: DW; EQ-5D; GBD2010; GBD2013; Mapping; Utilities