Investigating the Importance of EQ-5D Domains and Two Bolt-on Items: How Do the Preferences of People With Acute Leukemia Differ From the General Population?
Author(s)
David John Mott, BSc, MSc, PhD1, Hannah Hussain, MPharm, MSc, PhD2, Sulayman Zaman Chowdhury, MSc3, Samantha Nier, MSc4, Chris Skedgel, MA, PhD1.
1Office of Health Economics, London, United Kingdom, 2Economist, OHE, London, United Kingdom, 3N/A, London, United Kingdom, 4ALAN (Acute Leukemia Advocate Network), Bern, Switzerland.
1Office of Health Economics, London, United Kingdom, 2Economist, OHE, London, United Kingdom, 3N/A, London, United Kingdom, 4ALAN (Acute Leukemia Advocate Network), Bern, Switzerland.
OBJECTIVES: Acute leukaemia and its treatment substantially affect health-related quality of life, impacting physical functioning and symptoms like fatigue and cognitive difficulties. Understanding how patients prioritise different aspects of health is important for informing patient-centred decision-making. This study explored the relative importance of health dimensions from the perspective of people with acute leukaemia, as well as the general population.
METHODS: In five countries (UK, USA, France, Germany, and Italy), samples of adults with acute leukaemia and the general population were recruited to complete an online survey containing a profile-case best-worst scaling (BWS) exercise. Respondents selected the ‘best’ and ‘worst’ health problems on seven dimensions - those from EQ-5D, as well as tiredness and cognition ‘bolt-on’ items. The BWS data were pooled across countries and analysed using marginal-sequential conditional logit model, with relative attribute importance (RAI) scores computed to enable comparisons.
RESULTS: A total of 511 general population and 212 patient respondents were recruited. In both samples, “pain/discomfort” was the most important (RAI=21.4% for patients; RAI=18.5% for general population). The rank ordering of the other dimensions differed, and the least important dimensions were “self-care” for patients (RAI=8.6%) and “tiredness” for the general population (RAI=7.6%). Differences in RAI scores between the two samples were statistically significant across all dimensions except cognition. Overall, people with acute leukaemia gave less weight to more objective dimensions (e.g., “mobility”, “self-care”) and relatively more weight to more subjective dimensions (e.g., “pain/discomfort”, “anxiety/depression”) compared to the general population.
CONCLUSIONS: Our results suggest that the preferences of people with acute leukaemia differ significantly to the general population. As such, the use of value sets based on general population preferences in economic models may result in decisions that do not fully reflect patient preferences. Furthermore, our results suggest that items beyond the core dimensions of EQ-5D matter to both patients and the general population.
METHODS: In five countries (UK, USA, France, Germany, and Italy), samples of adults with acute leukaemia and the general population were recruited to complete an online survey containing a profile-case best-worst scaling (BWS) exercise. Respondents selected the ‘best’ and ‘worst’ health problems on seven dimensions - those from EQ-5D, as well as tiredness and cognition ‘bolt-on’ items. The BWS data were pooled across countries and analysed using marginal-sequential conditional logit model, with relative attribute importance (RAI) scores computed to enable comparisons.
RESULTS: A total of 511 general population and 212 patient respondents were recruited. In both samples, “pain/discomfort” was the most important (RAI=21.4% for patients; RAI=18.5% for general population). The rank ordering of the other dimensions differed, and the least important dimensions were “self-care” for patients (RAI=8.6%) and “tiredness” for the general population (RAI=7.6%). Differences in RAI scores between the two samples were statistically significant across all dimensions except cognition. Overall, people with acute leukaemia gave less weight to more objective dimensions (e.g., “mobility”, “self-care”) and relatively more weight to more subjective dimensions (e.g., “pain/discomfort”, “anxiety/depression”) compared to the general population.
CONCLUSIONS: Our results suggest that the preferences of people with acute leukaemia differ significantly to the general population. As such, the use of value sets based on general population preferences in economic models may result in decisions that do not fully reflect patient preferences. Furthermore, our results suggest that items beyond the core dimensions of EQ-5D matter to both patients and the general population.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR143
Topic
Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Patient-reported Outcomes & Quality of Life Outcomes
Disease
Oncology