Spotlight on OHE: Measurement and Valuation of Health Using PROMs

The OHE continues to play a central role in the development and use of patient-reported outcomes measures (PROMs). The last quarter of 2012 was characteristically busy.

The OHE continues to play a central role in the development and use of patient-reported outcomes measures (PROMs). The last quarter of 2012 was characteristically busy.

In September, OHE’s Prof Nancy Devlin, chair of the EuroQol Group’s Executive Committee, gave a presentation at the Group’s Scientific Plenary meeting in Rotterdam, setting out the scientific direction for the Group for the coming years. Her presentation, summarised recent developments in EQ-5D instruments for measuring health and methods for valuing health states. She noted that much of the research agenda for the Group in recent years has been dominated by the requirements of economic evaluation and cost effectiveness analysis. Nancy outlined plans for six new workings groups that will pursue specific research agendas—on value sets, valuation methodology, establishing of a EuroQol data archive, EQ-5D in children, EQ-5D in large scale health applications, and use of EQ-5D outside the health care sector.  Nancy was also co-author of a paper presented at the plenary: Gutacker, N., Bojke, C., Daidone, S., Devlin, N. and Street, A. (forthcoming) Hospital variation in patient-reported outcomes at the level of EQ-5D dimensions: Evidence from England. Medical Decision Making.

At ISPOR in November, Nancy chaired a symposium where she presented the EuroQol Group’s scientific agenda and introduced plans for new areas of methodological research. This includes in particular experimental work on the potential use of “bolt on” dimensions for the EQ-5D.  The symposium discussed the conceptual and empirical challenges involved in developing and valuing these bolt ons.

In October, Nancy was the keynote speaker at a Canadian conference on PROMs organised by the Health Quality Council of Alberta, the Institute of Health Economics and Alberta Health Services. Her presentation, NHS Experience of the EQ-5D as an Outcomes Measure, discussed the rationale for the PROMs programme and provided an overview of the various uses of the EQ-5D in England—for example by NICE in health technology assessment, in population surveys and in the English NHS PROMS program. The presentation also reviewed how EQ-5D data are collected, analysed and used in the UK to inform decisions by health care providers, payers and patients.

In November, the UK King’s Fund held a conference on PROMs. Nancy’s presentation, Analysis of EQ-VAS and EQ-5D Profile Data from PROMs, explained that while the analysis of index-weighted EQ-5D profiles is useful, use of EQ-5D data should not be restricted to analysis of index-weighted profiles. The reasons include: (a) index weighting obscures relevant information on the underlying health problems  that drive index-weighted scores, (b) hospital performance varies across dimensions, which has implications for understanding where improvements in performance are possible, (c) patients’ “raw” EQ-5D profile data can reveal important information about relevant patient subgroups and (d) The EQ-VAS provides the patients’ own perspective on overall health whereas index weighting reflects the preferences of the general public. The presentation drew, in part, on new results from a paper to be presented at the Health Economics Study Group in January 2013 by David Parking, Nancy Devlin and Feng, What determines the shape of an EQ-5D Index distribution?

In October and November, OHE’s Prof Nancy Devlin and Koonal Shah, Brendan Mulhern from Sheffield University, and staff from Ipsos Mori ran a series of all-day workshops in London and Leeds that marked the start of the data collection phase of the EQ-5D-5L Value Set for England study. (See our earlier blog post for additional information.) Ipsos Mori interviewers were trained in the use of the computer-aided personal interview techniques developed by the EuroQol Group for use in this and similar studies currently underway around the world. In 2013, this study will produce a value set that will facilitate use of the five-level version of the EQ-5D in a wide range of applications, including clinical trials, observational studies, population health surveys and the PROMs programme. Funded by NIHR Policy Research Programme grant, the study is led by Prof Nancy Devlin and Prof Ben van Hout and involves OHE’s Dr Yan Feng.

OHE and Sheffield University also have been awarded grants from the EuroQol Foundation and the Chief Scientist Office of the Scottish Government to undertake data collection in Wales, Northern Ireland and Scotland to produce an EQ-5D-5L value set for all of the UK.

In November, the EuroQol Group and NICE International collaborated in presenting an EQ-5D workshop at the China National Health Development Research Center (CNHDRC) in Beijing. The workshop was chaired by Francis Ruiz of NICE International and Prof Zhao Kun from the CNHDRC. Prof Nancy Devlin and Prof Jan van Busschbach of Erasmus University presented the programme on behalf of the EuroQol Group. Nancy’s presentations focused three topics: the development of the EQ-5D-5L, the use of EQ-5D in decision making and the use of EQ-5D in health service performance management in the NHS PROMs programme.

For more information on OHE’s PROMs-related activities, please contact Prof Nancy Devlin.