Tails from the peak district: adjusted limited dependent variable mixture models of EQ-5D questionnaire health state utility values

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Mónica Hernández AlavaRoberta Ara

Abstract

Health utility data generated by using the EuroQol five-dimensional (EQ-5D) questionnaire are right bounded at 1 with a substantial gap to the next set of observations, left bounded, and multimodal. These features present challenges to the estimation of the effect of clinical and socioeconomic characteristics on health utilities. Our objective was to develop and demonstrate an appropriate method for dealing with these features. We developed a statistical model that incorporates an adjusted limited dependent variable approach to reflect the upper bound and the large gap in feasible EQ-5D questionnaire values. Further flexibility was then gained by adopting a mixture modeling framework to address the multimodality of the EQ-5D questionnaire distribution. We compared the performance of these approaches with that of those frequently adopted in the literature (linear and Tobit models) by using data from a clinical trial of patients with rheumatoid arthritis. We found that three latent classes are appropriate in estimating EQ-5D questionnaire values from function, pain, and sociodemographic factors. Superior performance of the adjusted limited dependent variable mixture model was achieved in terms of Akaike and Bayesian information c...Continue Reading

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Citations

Jun 30, 2012·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Ralph CrottCarin Uyl-de-Groot
Jan 23, 2013·Rheumatology·Mónica Hernández AlavaKaleb Michaud
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Sep 23, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Kamran A KhanSarah E Lamb
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Sep 2, 2015·Applied Health Economics and Health Policy·John Brazier, Aki Tsuchiya
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