<abstract xmlns="http://www.w3.org/1999/xhtml"><sec><h3>Introduction</h3><p>The two primary objectives of this paper were (a) to develop first logically consistent TTO based EQ-5D-3L value sets for Slovenia and (b) to revisit earlier developed VAS based EQ-5D-3L value sets.</p></sec><sec><h3>Methods</h3><p>Between September 2005 and April 2006, face-to-face interviews with 225 individuals in Slovenia were conducted. Protocols from the Measurement and Value of Health study were followed closely. Each respondent valued 15 health states out of a total of 23. Model selection was informed by the criteria monotonicity/logical consistency. Predictive accuracy was assessed in terms of mean square difference between out-of-sample predictions and corresponding observed means, as well as Lin’s Concordance Correlation Coefficient.</p></sec><sec><h3>Results</h3><p>Modelling was based on 2,717 VAS and 2,831 TTO values elicited from 225 respondents. A 6-parameter constrained regression model with a supplementary power term was selected for VAS and TTO value sets, as it produces monotonic values, and proved superior in terms of out-of-sample predictive accuracy over the tested alternatives.</p></sec><sec><h3>Conclusion</h3><p>This is the first EQ-5D-3L TTO based value set in Slovenia and the second in Central and Eastern Europe (besides Poland). It is also the first monotonic and logically consistent VAS value set in Central and Eastern Europe. Comparisons with Polish and UK TTO values show considerable differences, mostly due to mobility with having a substantially greater weight in Slovenia. The UK value set generally produces lower values and the Polish value set higher values for mild states.</p></sec></abstract>

IntroductionThe two primary objectives of this paper were (a) to develop first logically consistent TTO based EQ-5D-3L value sets for Slovenia and (b) to revisit earlier developed VAS based EQ-5D-3L value sets.MethodsBetween September 2005 and April 2006, face-to-face interviews with 225 individuals in Slovenia were conducted. Protocols from the Measurement and Value of Health study were followed closely. Each respondent valued 15 health states out of a total of 23. Model selection was informed by the criteria monotonicity/logical consistency. Predictive accuracy was assessed in terms of mean square difference between out-of-sample predictions and corresponding observed means, as well as Lin’s Concordance Correlation Coefficient.ResultsModelling was based on 2,717 VAS and 2,831 TTO values elicited from 225 respondents. A 6-parameter constrained regression model with a supplementary power term was selected for VAS and TTO value sets, as it produces monotonic values, and proved superior in terms of out-of-sample predictive accuracy over the tested alternatives.ConclusionThis is the first EQ-5D-3L TTO based value set in Slovenia and the second in Central and Eastern Europe (besides Poland). It is also the first monotonic and logically consistent VAS value set in Central and Eastern Europe. Comparisons with Polish and UK TTO values show considerable differences, mostly due to mobility with having a substantially greater weight in Slovenia. The UK value set generally produces lower values and the Polish value set higher values for mild states.

Valuation of EQ-5D-3l Health States in Slovenia: VAS based and TTO based Value Sets

Slovenian Journal of Public Health

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Vrednotenje Zdravstvenih stanj EQ-5D-3l V Sloveniji: Vrednosti Zdravstvenih stanj, Pridobljene Z Metodama VAS in TTO

IntroductionThe two primary objectives of this paper were (a) to develop first logically consistent TTO based EQ-5D-3L value sets for Slovenia and (b) to...

	TTO		VAS

	Coefficient	SE	Coefficient	SE
MO	0.943	0.126	0.424	0.070
SC	0.243	0.052	0.105	0.029
UA	0.202	0.039	0.103	0.028
PD	0.448	0.049	0.180	0.012
AD	0.239	0.037	0.137	0.021
L2	0.125	0.043	0.176	0.025
P	0.551	0.044	0.423	0.020

Group	Mean pre-test scores (SD)	Mean post-test scores (SD)
Age
18–24	27 (12%)	190,239 (11.5%)
25–34	48 (21.3%)	300,793 (18.2%)
35–44	43 (19.1%)	304,490 (18.5%)
45–54	39 (17.3%)	310,757 (18.9%)
55–64	28 (12.5%)	229,580 (13.9%)
65+	40 (17.8%)	312,874 (19%)
Mean age (SD)	45.3 (17.4)	n/a

Gender
Male	99 (44%)	981,465 (49%)
Female	126 (56%)	1,021,893 (51%)

Educational level
Primary	53 (23.6%)	494 (28.8%)
Secondary	147 (65.3%)	952 (55.5%)
High	25 (11.1%)	267 (15.6%)

Work
Employed	111 (49.3%)	813,100 (47.3%)
Retired	62 (27.5%)	529,622 (30.8%)
Housewife	8 (3.6%)	n/a
Student	20 (8.9%)	112,228 (6.5%)
Unemployed	18 (8%)	92,575 (5.4%)
Other	6 (2.7%)	n/a

EQ-5D dimension problems (%)		n/a
Mobility	68 (30.2%)
Self-care	21 (9.3%)
Usual activities	69 (30.7%)
Pain/discomfort	101 (44.9%)
Anxiety/Depression	64 (28.4%)

EQ VAS own health (SD)	72.15 (20.2)	n/a

TTO	ADD10	ADD10i	MULT6	MULT6i	MULT6P	MULT6iP

Monotonicity	-	-	✓	✓	✓	✓
R	0.920	0.941	0.934	0.930	0.966	0.966
CCC	0.894	0.938	0.893	0.929	0.966	0.966
MSE	0.046	0.022	0.048	0.024	0.012	0.012
MAE	0.181	0.114	0.182	0.126	0.087	0.087

VAS	ADD10	ADD10i	MULT6	MULT6i	MULT6P	MULT6iP

Monotonicity	-	-	✓	✓	✓	-
R	0.926	0.919	0.891	0.923	0.971	-
CCC	0.879	0.897	0.886	0.883	0.941	-
MSE	0.02	0.015	0.015	0.021	0.01	-
MAE	0.123	0.094	0.096	0.102	0.082	-

Valuation of EQ-5D-3l Health States in Slovenia: VAS based and TTO based Value Sets

Article Category: Original scientific article

Published Online: Dec 13, 2019

Page range: 8 - 17

Received: May 21, 2019

Accepted: Sep 26, 2019

DOI: https://doi.org/10.2478/sjph-2020-0002

Keywords
EQ-5D-3L, Slovenia, quality-adjusted life-years, social value set, utility

© 2020 Valentina Prevolnik Rupel et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Coefficients and bootstrap-based SE estimates.

Study sample characteristics compared with the Slovenian general population data 2005.

Cross-Validation fit statistics.

Valuation of EQ-5D-3l Health States in Slovenia: VAS based and TTO based Value Sets

Article Category: Original scientific article

Published Online: Dec 13, 2019

Page range: 8 - 17

Received: May 21, 2019

Accepted: Sep 26, 2019

DOI: https://doi.org/10.2478/sjph-2020-0002

KeywordsEQ-5D-3L, Slovenia, quality-adjusted life-years, social value set, utility

© 2020 Valentina Prevolnik Rupel et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Coefficients and bootstrap-based SE estimates.

Study sample characteristics compared with the Slovenian general population data 2005.

Cross-Validation fit statistics.

Keywords
EQ-5D-3L, Slovenia, quality-adjusted life-years, social value set, utility