Censoring Time Trade-off Values at 0 Versus at −1: How Does the Assumption for Worse-Than-Dead Time Trade-off Values Affect the Modeling of EQ-5D-5L Valuation Data?

May 1, 2023, 00:00
10.1016/j.jval.2022.11.001
https://www.valueinhealthjournal.com/article/S1098-3015(22)04731-3/fulltext
Title : Censoring Time Trade-off Values at 0 Versus at −1: How Does the Assumption for Worse-Than-Dead Time Trade-off Values Affect the Modeling of EQ-5D-5L Valuation Data?
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(22)04731-3&doi=10.1016/j.jval.2022.11.001
First page : 685
Section Title : METHODOLOGY
Open access? : No
Section Order : 685

Objectives

A recent study found that negative utility values elicited using composite time trade-off (TTO) were barely associated with the severity of EQ-5D-5L health states, suggesting poor discriminative ability. Assuming negative values provide limited information, this study aimed to explore the usefulness of censoring negative TTO values at 0 in modeling EQ-5D-5L valuation data.

Methods

We analyzed EQ-5D-5L valuation data from China, The Netherlands, Canada, Singapore, and Thailand. For each data set, we estimated value sets using 2 Tobit models, one left-censored at −1 (current practice) and one left-censored at 0 (our proposed method), and compared the model performances. We hypothesized that censoring at 0 and censoring at −1 would produce similar values, though on slightly different scales.

Results

When censoring at 0, logical inconsistencies and statistical significance were improved but the value range was compressed. In the cross-attribute level effects model, the 3-level parameters were similar between the models censored at 0 and −1, but the rank order of some dimension parameters was altered. Health state values predicted by the 2 censoring models approximated a perfect agreement after rescaling.

Conclusions

Censoring TTO values at 0 improved model estimation and fit but produced higher utility values than models censoring at −1. Investigators of future EQ-5D value set studies using the composite TTO method are advised to examine the validity of negative TTO values before choosing modeling strategies.

Categories :
  • Health State Utilities
  • Methodological & Statistical Research
  • Missing Data
  • Patient-Centered Research
  • Patient-reported Outcomes & Quality of Life Outcomes
  • Preference Methods
Tags :
  • composite TTO
  • EQ-5D
  • negative values
  • worse-than-dead
Regions :
  • Asia Pacific (including Oceania)
  • North America
  • Western Europe
ViH Article Tags :