Mapping between 6 Multiattribute Utility Instruments

Med Decis Making. 2016 Feb;36(2):160-75. doi: 10.1177/0272989X15578127. Epub 2015 Apr 3.


Background: Cost-utility analyses commonly employ a multiattribute utility (MAU) instrument to estimate the health state utilities, which are needed to calculate quality-adjusted life years. Different MAU instruments predict significantly different utilities, which makes comparison of results from different evaluation studies problematical.

Aim: This article presents mapping functions ("crosswalks") from 6 MAU instruments (EQ-5D-5L, SF-6D, Health Utilities Index 3 [HUI 3], 15D, Quality of Well-Being [QWB], and Assessment of Quality of Life 8D [AQoL-8D]) to each of the other 5 instruments in the study: a total of 30 mapping functions.

Methods: Data were obtained from a multi-instrument comparison survey of the public and patients in 7 disease areas conducted in 6 countries (Australia, Canada, Germany, Norway, United Kingdom, and United States). The 8022 respondents were administered each of the 6 study instruments. Mapping equations between each instrument pair were estimated using 4 econometric techniques: ordinary least squares, generalized linear model, censored least absolute deviations, and, for the first time, a robust MM-estimator.

Results: Goodness-of-fit indicators for each of the results are within the range of published studies. Transformations reduced discrepancies between predicted utilities. Incremental utilities, which determine the value of quality-related health benefits, are almost perfectly aligned at the sample means.

Conclusion: Transformations presented here align the measurement scales of MAU instruments. Their use will increase confidence in the comparability of evaluation studies, which have employed different MAU instruments.

Keywords: cost-effectiveness analysis; cost-utility analysis; health-related quality of life; mapping; utility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis / methods*
  • Cost-Benefit Analysis / standards*
  • Health Status*
  • Humans
  • Mental Health*
  • Models, Econometric
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Reproducibility of Results
  • Surveys and Questionnaires