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Methods for addressing uncertainty around EQ-5D values

Why is this important?

  • A key feature of cost effectiveness analysis (CEA) in health care is the treatment of uncertainty, particularly in the context of probabilistic and stochastic sensitivity analysis.
  • The focus of health state valuation research has largely been on producing robust point estimates of the public’s average preferences.
  • There has been little development of methods for identifying and quantifying uncertainty around these health state values and for reporting uncertainty so that it can be routinely incorporated into sensitivity analysis in CEA. This is an important gap, because CEA is the principal use of HRQoL values.

Objectives

  • To provide a comprehensive account of the various sources of uncertainty affecting  'value sets’ for health-related quality of life (HRQoL)
  • To identify what methods have been explored to account for these sources of uncertainty
  • To highlight gaps in methods and reporting, and implications for their use in generating evidence to inform decision making in health care

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Funding

This project was funded by the EuroQol Research Foundation, grant 399-RA.

Acknowledgements

This project on uncertainty around HRQoL values received detailed input from an advisory group: Nigel Rice, Ben van Hout, Bas Janssen, Eleanor Pullenayegum, Bram Roudijk and Mark Sculpher. MVH health state valuation data, obtained from University of Essex UK Data Archive (Williams et al. 1995) was used as an illustration. We are grateful to Oliver Rivero-Arias for sharing information about an unpublished paper (Gray et al. 2012).