title: SF-6D utility values for the better- and worse-seeing eye for health states based on the Snellen equivalent in patients with age-related macular degeneration.
abstract: OBJECTIVE
  Economic evaluations in wet age-related macular degeneration (ARMD) is hampered as often utility values for solely one eye are used, mostly the better-seeing eye (BSE). Moreover, frequently chosen methods rely on patient values and/or disease specific measures, while economic evaluations prefer generic quality of life (QoL) measures based on societal preferences. The generic QoL utility instrument EQ-5D has shown to be insensitive for differences in visual acuity. The aim of this study was therefore to provide societal utility values, using the generic SF-6D, for health states acknowledging both BSE and worse-seeing eye (WSE).
  
  
  METHODS
  SF-6D utility values of 191 ARMD patients (≥65 years) with 153 follow-up measures at 1 year were used to fill health states defined by the combination of BSE and WSE using Snellen equivalents; no visual loss (≥20/40), mild-moderate (<20/40->20/200) and severe (≤20/200).
  
  
  RESULTS
  QoL utilities were estimated for the SF-6D, ranging from 0.740 for ARMD patients without visual loss to 0.684 for patients with a combination of mild-moderate visual loss in their BSE and severe visual loss in their WSE.
  
  
  CONCLUSIONS
  Societal utility values are provided for ARMD patients using the generic QoL instrument SF-6D for visual acuity health states based on both BSE and WSE. The range of the values is smaller than previous elicited utilities with the disease-specific VisQoL. Besides, the utility values are placed on a more realistic position on the utility scale, and SF-6D utility values avoid the problem associated with the interpretation of disease-specific utility values.
authors.affiliation: Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.|Erasmus Medical Center, Department of Psychiatry, section Medical Psychology and Psychotherapy, Rotterdam, the Netherlands.
authors.forename: Martijn S
authors.initials: MS
authors.lastname: Visser
authors.affiliation: Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.
authors.forename: Sankha
authors.initials: S
authors.lastname: Amarakoon
authors.affiliation: Rotterdam Ophthalmic Institute, Rotterdam, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Missotten
authors.affiliation: Erasmus Medical Center, Department of Psychiatry, section Medical Psychology and Psychotherapy, Rotterdam, the Netherlands.
authors.forename: Reinier
authors.initials: R
authors.lastname: Timman
authors.affiliation: Erasmus Medical Center, Department of Psychiatry, section Medical Psychology and Psychotherapy, Rotterdam, the Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Busschbach
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006304:Health Status; D006801:Humans; D008268:Macular Degeneration / Q000175:diagnosis*; D008297:Male; D011594:Psychometrics; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis*