OBJECTIVES:The 29-item Multiple Sclerosis Impact Scale (MSIS-29) is a psychometrically validated patient-reported outcome measure increasingly used in trials of treatments for multiple sclerosis. However, it is non-preference-based and not amenable for use across policy decision-making contexts. Our objective was to statistically map from the MSIS-29, version 2, to the EuroQol five-dimension (EQ-5D) and the six-dimension health state short form (derived from short form 36 health survey) (SF-6D) to estimate algorithms for use in cost-effectiveness analyses. METHODS:The relationships between MSIS-29, version 2, and EQ-5D and SF-6D scores were estimated by using data from a cohort of people with multiple sclerosis in South West England (n=672). Six ordinary least squares (OLS), Tobit, and censored least adjusted deviation (CLAD) regression analyses were conducted on estimation samples, including the use of subscale and item scores, squared and interaction terms, and demographics. Algorithms from models with the smallest estimation errors (mean absolute error [MAE], root mean square error [RMSE], normalized RMSE) were then assessed by using separate validation samples. RESULTS:Tobit and CLAD. For the EQ-5D, the OLS models including subscale squared terms, and item scores and demographics performed comparably (MAE 0.147, RMSE 0.202 and MAE 0.147, RMSE 0.203, respectively), and estimated scores well up to 3 years post-baseline. Estimation errors for the SF-6D were smaller (OLS model including squared terms: MAE 0.058, RMSE 0.073; OLS model using item scores and demographics: MAE 0.059, RMSE 0.08), and the errors for poorer health states found with the EQ-5D were less pronounced. CONCLUSIONS:We have provided algorithms for the estimation of health state utility values, both the EQ-5D and SF-6D, from scores on the MSIS-29, version 2. Further research is now needed to determine how these algorithms perform in practical decision-making contexts, when compared with observed EQ-5D and SF-6D values.

译文

目的:29项多发性硬化症影响量表(MSIS-29)是一种经心理计量学验证的患者报告的结局指标,越来越多地用于治疗多发性硬化症的试验中。但是,它不是基于首选项的,并且不适合在决策决策环境中使用。我们的目标是从MSIS-29(版本2)到EuroQol五维(EQ-5D)和六维健康状态简表(来自于36卫生调查的简表)(SF-6D)进行统计映射,估算用于成本效益分析的算法。
方法:使用来自英格兰西南部多发性硬化症人群的数据(n = 672),估计MSIS-29(版本2)与EQ-5D和SF-6D评分之间的关​​系。对估计样本进行了六个普通最小二乘(OLS),Tobit和删失最小调整偏差(CLAD)回归分析,包括使用小数和项目得分,平方和交互作用项以及人口统计学。然后,通过使用单独的验证样本评估来自估计误差最小(平均绝对误差[MAE],均方根误差[RMSE],归一化RMSE)的模型中的算法。
结果:Tobit和CLAD。对于EQ-5D,OLS模型(包括次级量表平方项)以及项目得分和人口统计数据具有可比性(分别为MAE 0.147,RMSE 0.202和MAE 0.147,RMSE 0.203),并且估计分数在基线后长达3年。 SF-6D的估计误差较小(OLS模型包括平方项:MAE 0.058,RMSE 0.073; OLS模型使用项目评分和人口统计:MAE 0.059,RMSE 0.08),而EQ-5D发现的较差健康状态误差不太明显。
结论:我们提供了根据MSIS-29版本2的得分估算健康状态效用值(EQ-5D和SF-6D)的算法,现在需要进一步研究以确定这些算法在实际决策中的性能与观察到的EQ-5D和SF-6D值进行比较时。

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