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Questions

Q: Are there Dutch guidelines for health economic evaluations? (answer)
Q: Where can I find quickly some QALY weights for a specific disease and cost per QALY-league tables? (answer)
Q: I have used the EQ-5D-5L. How can I get utilities (Dutch)? (answer)
Q: I have used the EQ-5D-3L. How can I get utilities (UK or Dutch)? (answer)
Q: I looking for EQ-5D norms categorized by sex and age groups... (answer)
Q: I looking for HUI norms categorized by sex and age groups... (answer)
Q: I used the EQ-5D and got negative utilities, what does that mean? (answer)
Q: I used the youth version of the EQ-5D-Y. How do I get utilities? (answere)
Q: I have used the EQ-5D+. How can I get utilities? (answer)
Q: I am making a presentation about quality of life measurement and/or QALYs. Do you have some slides? See: Presentations

Answers

Q: Are there Dutch guidelines for health economic evaluations?
A: There are official guidelines, but they are not (yet) compulsorily for reimbursement. (Guidelines in Dutch)

Q: Where can I find quickly some QALY weights and cost per QALY-league tables?
A: CM Bell et al made an extensive literature search to build a large QALY-league table. They also presents also QALY-weights. Because the list is based on a different investigations, differences in QALY (weights) might also reflect differents between methods. See the article of Bell et al. in Medical Decision Making or the full report.
A: The Burden of Disease and Injury in Australia Project provide a list of estimates for QALY weights based on Dutch PTO values. Because the list is based on a single investigation, differences due to different methods does not occure in this investigation.

Q: I have used the EQ-5D-5L. How can I get utilities (UK or Dutch)? This is the Dutch publication about the tariff.

Q: I have used the EQ-5D-3L. How can I get utilities (UK or Dutch)?
A: The most often used algorithm is the "MVH_A1 tariff" published by Dolan in Medical Care (1997). The values are based on the largest population study of its kind: 3000 respondents valued the health states with the use of TTO. The values represent the societal viewpoint and are particular suitable for the calculations of QALYs. The SPSS commands are printed below.

* SPSS syntax for the MVH_A1 tariff (TTO, York)
* mo = mobility, sc= self care, ua = usual activities, pd = pain & discomfort , ad = anxiety and depression.
COMPUTE MVH_A1 = 1.
VARIABLE LABELS MVH_A1 'York A1 tariff'.
DO IF (NVALID(mo, sc, ua, pd, ad) < 5 ).
RECODE
  MVH_A1 (1 = SYSMIS).
END IF.
IF (MAX(mo, sc, ua, pd, ad) > 1) MVH_A1 = MVH_A1 -.081.
IF (mo = 2) MVH_A1 = MVH_A1 - .069.
IF (mo = 3) MVH_A1 = MVH_A1 - .314.
IF (sc = 2) MVH_A1 = MVH_A1 - .104.
IF (sc = 3) MVH_A1 = MVH_A1 - .214.
IF (ua = 2) MVH_A1 = MVH_A1 - .036.
IF (ua = 3) MVH_A1 = MVH_A1 - .094.
IF (pd = 2) MVH_A1 = MVH_A1 - .123.
IF (pd = 3) MVH_A1 = MVH_A1 - .386.
IF (ad = 2) MVH_A1 = MVH_A1 - .071.
IF (ad = 3) MVH_A1 = MVH_A1 - .236.
IF (MAX(mo, sc, ua, pd, ad) > 2) MVH_A1 = MVH_A1 - .269.

Dutch values also exits. A Dutch reference is Lamers et al. in Nederlands Tijdschrift voor Geneeskunde (2005;149(28):1574-8). The tariff works just like the UK as presented above. The parameters of the model are presented in table 2 of the article. The SPSS commands are printed below.

* SPSS syntax for the Dutch TTO Tariff
* mo = mobility, sc=self care, ua = usual activities, pd = pain & discomfort, ad = anxiety and depression.
* Nederlands Tijdschrift voor Geneeskunde 2005;149(28):1574-8.
COMPUTE EQ5DNL = 1.
VARIABLE LABELS EQ5DNL 'Dutch EQ-5D tariff'.
DO IF (NVALID(mo, sc, ua, pd, ad) < 5 ).
RECODE
  EQ5DNL (1 = SYSMIS).
END IF.
IF (MAX(mo, sc, ua, pd, ad) > 1) EQ5DNL = EQ5DNL -.071.
IF (mo = 2) EQ5DNL = EQ5DNL - .036.
IF (mo = 3) EQ5DNL = EQ5DNL - .161.
IF (sc = 2) EQ5DNL = EQ5DNL - .082.
IF (sc = 3) EQ5DNL = EQ5DNL - .152.
IF (ua = 2) EQ5DNL = EQ5DNL - .032.
IF (ua = 3) EQ5DNL = EQ5DNL - .057.
IF (pd = 2) EQ5DNL = EQ5DNL - .086.
IF (pd = 3) EQ5DNL = EQ5DNL - .329.
IF (ad = 2) EQ5DNL = EQ5DNL - .124.
IF (ad = 3) EQ5DNL = EQ5DNL - .325.
IF (MAX(mo, sc, ua, pd, ad) > 2) EQ5DNL = EQ5DNL - .234.

Q: I looking for EQ-5D norms categorized by sex and age groups.
A:  EQ_norms.sav is a SPSS-file based on the MVH-study of more than 3000 households in the UK. For a more details see: Kind P, Hardman G, Macran S. UK population norms for the EQ-5D. University of York, Centre for Health Economics, Discussion paper 172, November 1999.
A Dutch values is publist in a proceding of the EuroQol group: Stolk EA, Krabbe P, Busschbach J. Using the internet to collect EQ-5D norm scores: a valid alternative? In:  Proceedings of the 24th Scientific Plenary Meeting of the EuroQol Group. Kijkduin The Hague, The Netherlands, September 13-15, 2007. Busschbach J, Rabin R, De Charro, F (Ed). EuroQol Executive Office, Rotterdam. ISBN/EAN: 978-90-814425-1-0. [PDF].

Q: I looking for HUI norms categorized by sex and age groups.
A: See article of Mittmann 1999 [pdf]

Q: I used the youth version of the EQ-5D-Y. How do I get utilities?
A: There is no 'tariff' for the EQ-5D-Y yet. I know that some teams used the adult tariff. A different way would be to analyse the data as we did before the tariffs were available: descriptive statistics on the number of level 2 or 3 answers).

Q: I used the EQ-5D and got negative utilities, what does that mean?
Utilities weights are said to run from 0 to 1, but in theory it should be minus infinity to plus 1: you can always think of a health states worse than the one you imagine right now.... Because large negative values will ruin your data structure, and because most people find negative values difficult to understand, values are truncate at zero or minus 1 as done in the EQ-5D. Because not al of us consider the worse EQ-5D health state as the worst thing in life, the lowest value is higher than minus 1, for instance -.5 in the UK utilities.

Q: I have used the EQ-5D+. (EQ-6D) How can I get utilities?
A: The EQ-5D+, sometime referred to as EQ-6D is not an 'official' version of the EQ-5D. As fare as I know, there is no utility scorings system for the EQ-5D+, like the published and tested tariffs for the official EQ-5D. However, you can try to use the algorithm for The Burden of Disease and Injury in Australia Project. This algorithm is based on Dutch PTO values from doctor- and lay panels. The SPSS commands are printed below. Norm scores for the (Dutch) population are also available (Hoeymans et al, 2005).

Title 'Calculate Dutch PTO Weight for the EQ-5D+'.
* Derive from The Burden of Disease and Injury in Australia
* The Australian Institute of Health and Welfare
* Mathers C, Vos T, Stevenson C.
* http://www.aihw.gov.au/publications/health/bdia/index.html#s02
* prog = Prognosis: 1 if poor or uncertain, 0 otherwise.
* manifest = Health state is 111111, but nevertheless disease still manifest.
* Short = a short duration acute illness, 1 = yes, 0 = no.

* Calcuted weight.
Compute weight = 0.
VARIABLE LABELS weight 'Dutch PTO Weight'.
DO IF (NVALID(mo,sc,ua,pd,ad,cog) < 6).
RECODE
  weight (0 = SYSMIS).
END IF.
IF (mo = 2)  weight = weight - 0.247.
IF (mo = 3)  weight = weight - 0.5419.
IF (sc = 2)  weight = weight - 0.12455.
IF (sc = 3)  weight = weight - 0.5718.
IF (ua = 2)  weight = weight - 0.
IF (ua = 3)  weight = weight - 0.2051.
IF (pd = 2)  weight = weight - 0.0576.
IF (pd = 3)  weight = weight - 0.5039.
IF (ad = 2)  weight = weight - 0.2284.
IF (ad = 3)  weight = weight - 0.742.
IF (cog = 2) weight = weight - 0.1915.
IF (cog = 3) weight = weight - 0.5635.
IF (manifest = 1) weight = weight - 0.008801.
IF (prog  = 1) weight = weight - 0.1228.
IF (short  = 1) weight = weight - 0.20369.
COMPUTE weight = EXP(weight).