Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Mar-Apr;31(2):270-80.
doi: 10.1177/0272989X10380924. Epub 2010 Nov 22.

A longitudinal comparison of 5 preference-weighted health state classification systems in persons with intervertebral disk herniation

Christine M McDonough  1   2 , Tor D Tosteson  1   3 , Anna N A Tosteson  1   4   3 , Alan M Jette  2 , Margaret R Grove  1 , James N Weinstein  1   5   6
Affiliations
Comparative Study

A longitudinal comparison of 5 preference-weighted health state classification systems in persons with intervertebral disk herniation

Christine M McDonough et al. Med Decis Making. 2011 Mar-Apr.

Abstract

Objective: To assess the longitudinal validity of widely used preference-weighted measurement systems for economic studies of intervertebral disk herniation (IDH).

Methods: Using data at baseline and 1 year from 1000 Spine Patient Outcomes Research Trial (SPORT) participants with IDH and complete data, the authors considered the EQ-5D with UK and US values (EQ-5D-UK and EQ-5D-US), 2 versions of the Health Utilities Index (HUI3 and HUI2), the SF-6D, and a regression-estimated quality of well-being score (eQWB). Differences in mean change scores (MCS) were assessed using signed rank tests, and Spearman correlations were calculated for change scores by system pairs. Using the Oswestry Disability Index, symptom satisfaction, progress rating, and self-perceived health ratings as criterion measures, the authors tested for trend in MCS across levels of change in criteria. They calculated floor and ceiling effects, effect size (ES), standardized response mean, and minimal important difference estimates.

Results: All systems demonstrated linear trends with external criteria and moderate to strong correlations between systems. However, differences in performance were evident. SF-6D and eQWB were most responsive (ES: 1.9 and 2.3, respectively), whereas EQ-5D-US and EQ-5D-UK were least responsive (ES: 1.23/1.20). Ceiling and floor effects were noted for all systems within key dimensions and for EQ-5D-UK and EQ-5D-US for overall score. MCS ranged from 0.40 (0.38) for EQ-5D-UK to 0.13 (0.09) for eQWB and differed significantly, except between EQ-5D-US and HUI2.

Conclusions: This research supports the validity of all systems for measuring change in persons with IDH, without finding a clearly superior system. The unique characteristics of each system revealed in this study should guide system choice.

PubMed Disclaimer

Conflict of interest statement

Commercial Support/Conflicts Statement: No conflicts to declare

Figures

Figure 1
Figure 1
a–d Trends in mean change in health state value with levels of progress rating and change in ODI score, symptom satisfaction, and self-perceived health rating.
Figure 1
Figure 1
a–d Trends in mean change in health state value with levels of progress rating and change in ODI score, symptom satisfaction, and self-perceived health rating.
Figure 1
Figure 1
a–d Trends in mean change in health state value with levels of progress rating and change in ODI score, symptom satisfaction, and self-perceived health rating.
Figure 1
Figure 1
a–d Trends in mean change in health state value with levels of progress rating and change in ODI score, symptom satisfaction, and self-perceived health rating.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bloom BS. Use of formal benefit/cost evaluations in health system decision making. American Journal of Managed Care. 2004 May;10(5):329–335. [see comment]. - PubMed
    1. Dickson M, Hurst J, Jacobzone S. Survey of pharmacoeconomic assessment activity in eleven countries: OECD. 2003
    1. Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press; 1996.
    1. Kaplan RM, Anderson JP. A general health policy model: update and applications. Health Services Research. 1988 Jun;23(2):203–235. - PMC - PubMed
    1. Brooks R. EuroQol: the current state of play. Health Policy. 1996;37(1):53–72. - PubMed

Publication types