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A vision ‘bolt-on’ increases the responsiveness of EQ-5D: preliminary evidence from a study of cataract surgery

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Abstract

Objectives

(1) To evaluate the effect of adding a vision dimension (‘bolt-on’) to the 5-level EQ-5D (EQ-5D-5L) and 3-level EQ-5D (EQ-5D-3L) on their responsiveness, and (2) to compare the responsiveness of a vision ‘bolt-on’ EQ-5D-3L (EQ-5D-3L + V) with SF-6D and Health Utilities Index Mark 3 (HUI3) to the benefit of cataract surgery.

Methods

Sixty-three patients were assessed before and after their cataract surgery using the EQ-5D-3L, EQ-5D-5L, SF-6D, HUI3, as well as a 3-level and a 5-level vision dimension. Preference-based indices were calculated using available value sets for EQ-5D-3L, EQ-5D-3L + V, EQ-5D-5L, SF-6D, and HUI3, and non-preference-based indices were calculated using the sum-score method for EQ-5D-5L and EQ-5D-5L + V (vision bolt-on EQ-5D-5L). Responsiveness was assessed using the standardized response mean (SRM) and F-statistic.

Results

Among preference-based indices, mean changes from pre to post-surgery in EQ-5D-3L + V and EQ-5D-3L indices were 0.031 and 0.018, respectively. The mean changes for EQ-5D-5L, SF-6D and HUI3 indices were 0.020, 0.012 and 0.105, respectively. The SRM (F-statistic) for EQ-5D-3L + V and EQ-5D-3L indices were 0.458 (13.2) and 0.098 (0.6), respectively. The responsiveness of EQ-5D-3L + V was better than EQ-5D-5L, SF-6D; the responsiveness of HUI3 was better than all other measures. Using non-preference-based indices, mean change for EQ-5D-5L + V and EQ-5D-5L were 0.067 and 0.017, respectively. The corresponding SRM (F-statistic) were 0.709 (31.7) and 0.295 (5.4).

Conclusions

Preliminary evidence from our study suggests that a vision ‘bolt-on’ may increase the responsiveness of EQ-5D-3L and EQ-5D-5L to change in health outcomes experienced by patients undergoing cataract surgery. In absence of the preference-based vision bolt-on EQ-5D-5L index, HUI3 was the most responsive measure.

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Data availability

The data sets during and/or analyzed during the current study available from the corresponding author on reasonable request.

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Acknowledgements

We thank the EuroQol Research Foundation for funding this study and all patients of this study for their participation.

Author information

Authors and Affiliations

  1. Department of Biostatistics, Singapore Clinical Research Institute, #02-01, 31 Biopolis Way, Singapore, Singapore

    Mihir Gandhi

  2. Centre for Quantitative Medicine, Duke-NUS Medical School, 8 College Road, Singapore, Singapore

    Mihir Gandhi

  3. Tampere Center for Child Health Research, Tampere University, Arvo-building, Tampere, Finland

    Mihir Gandhi

  4. Department of Ophthalmology, Singapore National Eye Centre, 11 Third Hospital Ave, Singapore, Singapore

    Marcus Ang, Kelvin Teo, Chee Wai Wong & Yvonne Chung-Hsi Wei

  5. Ophthalmology and Visual Sciences Department, Duke-NUS Medical School, 8 College Road, Singapore, Singapore

    Marcus Ang

  6. Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, Singapore

    Rachel Lee-Yin Tan & Nan Luo

  7. Section Medical Psychology and Psychotherapy, Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands

    Mathieu F. Janssen

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Contributions

MA, MFJ, and NL jointly conceived the study. KT, CWW, and YCHW contributed in the study design and patient recruitment. RLYT contributed in the data collection form design, patient recruitment and data management. MG analyzed the data and drafted the first version of the manuscript. All authors reviewed and approved the manuscript.

Corresponding author

Correspondence to Nan Luo.

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Conflict of interest

The study had financial support from the EuroQol Research Foundation (EQ Project 2016310), The Netherlands; MFJ is a member of the scientific team of the EuroQol Business Office and both MFJ and NL are members of the EuroQol Group. The EuroQol Research Foundation has had no other involvement in the running of the study or the writing of the manuscript. The views expressed by the authors in this paper do not necessarily reflect the views of the EuroQol Group. No other relationship or activities that could appear to have influenced the submitted work. Other authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

The study was approved by the SingHealth Centralized Institutional Review Board (CIRB Ref: 2016/2649). Informed consent was obtained from all individual participants included in the study.

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Gandhi, M., Ang, M., Teo, K. et al. A vision ‘bolt-on’ increases the responsiveness of EQ-5D: preliminary evidence from a study of cataract surgery. Eur J Health Econ 21, 501–511 (2020). https://doi.org/10.1007/s10198-019-01156-w

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