USE OF A DISEASE-SPECIFIC INSTRUMENT IN ECONOMIC EVALUATIONS- MAPPING WOMAC ONTO THE EQ-5D UTILITY INDEX

Author(s)

Xie F1, Pullenayegum E2, Li SC31PATH Research Institute, McMaster University, Hamilton, ON, Canada, 2McMaster University, Hamilton, ON, Canada, 3University of Newcastle, School of Biomedical Sciences, Callaghan, NSW, Australia

Objective: To map the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) onto the EQ-5D utility index in patients with knee osteoarthritis (OA). Methods: A consecutive sample of patients (n=258) with diagnosed knee OA completed both the WOMAC and the EQ-5D. Regression models with ordinary least squares (OLS) or the censored least absolute deviations (CLAD) as the estimator were used to establish the mapping function. The WOMAC was represented as explanatory variables in four ways: (a) total score; (b) domain scores (i.e., pain, stiffness, and physical function), (c) domain scores plus pairwise interaction terms to account for possible nonlinearities; and (d) individual item scores. Goodness-of-fit criteria included mean absolute error (MAE, the primary criterion) and root mean squared error (RMSE) obtained using an iterative random sampling procedure. Prediction precision was evaluated at individual patient level and at the group level.  Results: The model using OLS estimator and WOMAC domain scores as explanatory variables had the best fit and was chosen as the preferred mapping model. The prediction error at individual level exceeded the maximal tolerance value (i.e. the minimally important difference of EQ-5D) in about 16% of patients. At group level, the width of 95% CI of prediction errors varied from 0.0176 at a sample size of 400 to 0.0359 at a sample size of 100. Conclusions: EQ-5D scores can be predicted using WOMAC domain scores with an acceptable precision at both the individual and group levels in patients with mild to moderate knee OA.

Conference/Value in Health Info

2010-05, ISPOR 2010, Atlanta, GA, USA

Value in Health, Vol. 13, No. 3 (May 2010)

Code

PMS74

Topic

Clinical Outcomes, Economic Evaluation, Methodological & Statistical Research, Patient-Centered Research

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies, Modeling and simulation, Patient-reported Outcomes & Quality of Life Outcomes, Relating Intermediate to Long-term Outcomes

Disease

Musculoskeletal Disorders

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