Delivering an Outcomes-based NHS: Creating the Right Conditions
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OHE is set to work on seven new projects funded by the EuroQol Research Foundation. The work will cover a range of topics from understanding the aspects of health that are important to people, to analysing the distribution of EQ-5D observations, to exploring the appropriateness of the EQ‐5D questionnaire in Asian populations.
Members of the OHE team have been awarded funding by the EuroQol Research Foundation to work on seven new research projects. Topics range from understanding the aspects of health that are important to people, to analysing the distribution of EQ-5D observations, to exploring the appropriateness of the EQ‐5D questionnaire in Asian populations.
Further details on each project are given below.
1. A qualitative approach to understanding what aspects of health are important to people
The aims are to develop and pilot an approach to identifying what aspects of health are important to people, and to use that approach to obtain views from a sample of patients and members of the general public. The study will be led by OHE’s Koonal Shah, with collaborators from University of Technology Sydney, University of Sheffield, PHMR, and the EuroQol Group Executive Office. Related work has been featured in a previous OHE blog and on SlideShare.
2. Understanding the relationship between clinical quality of primary care and patient self-reported health on the EQ-5D in England
The primary aim of this study is to explore what policy-relevant general practice factors, in particular the clinical quality of primary care, might affect patients’ self-reported health outcomes in England, as measured by the EQ-5D instrument. The study will be led by OHE’s Yan Feng in collaboration with University of York.
3. New methods for analysing the distribution of EQ-5D observations in data sets
The aims are to develop, test and report the application of three new methods, developed by the research team, to analyse and describe distributions of EQ-5D data: (a) The Health State Density Curve (HSDC), (b) the Health State Density Index (HSDI) and (c) Power Law Analysis (PLA).
The methods will be tested on a variety of patient and general public data sets, including data from the NHS Cambridgeshire Community Services and the Health Survey for England. The study is led by OHE’s Professor Nancy Devlin and David Parkin (King’s College London), working with Bernarda Zamora, Yan Feng, Mike Herdman and Andrew Bateman (NHS Cambridgeshire Community Services).
4. Investigating the descriptive basis of EQ-5D: a cold-case review
Despite widespread use of EQ-5D, the evidence base for the selection of its five dimensions is not well documented. A Lay Concepts study conducted by the York Measurement and Valuation of Health (MVH) team that provided empirical evidence yielded a single publication, and the data from it have been unexploited over the intervening 25 years.
The aim of this study is to conduct a forensic review of the final report of the Lay Concepts study and to re-analyse the qualitative and quantitative data which were generated from a representative sample of the general public, using alternative analytic methods such as non-metric multidimensional scaling and Q-sort.
Results will be used to demonstrate potential gaps in the current EQ-5D descriptive system. OHE’s Professor Nancy Devlin will be working on this study with Professor Paul Kind, who will be leading the study from Leeds University, along with Associate Professor Hilary Bekker.
5. Analysis of EQ-5D profile data and EQ-VAS scores across patient groups is the Swedish National Quality Registers and use in developing alternative ways of summarising EQ-5D data.
Swedish HTA decision makers, TLV, prefer quality adjusted life years (QALYs) to be based on the quality of life weights of the persons experiencing health problems. This raises the question of which patients’ preferences are relevant: patients overall? Groups of patients experiencing specific health problems?
Little is known about how these experience based values differ. This study aims to answer the following questions:
(a) How do EQ-5D profile data differ across patient groups?
(b) How do the EQ-VAS scores for EQ-5D profiles differ across patient groups?
(c) To what extent does the importance of the dimensions, in explaining the EQ-VAS scores, vary depending on the patients’ condition and experience of health?
(d) How does the Swedish experience-based EQ-VAS value set, estimated from models using self-reported EQ-5D profile data and EQ-VAS scores, differ between patient groups?
OHE’s Professor Nancy Devlin will be working on this study, which is led by Associate Professor Kristina Burstrom at the Karolinska Institutet, working together with David Parkin, Emelie Heintz and Evalill Nilsson.
6. A qualitative study to explore the interpretation and relevance of the EQ‐5D questionnaire in 4 Asian countries
The aim is to explore the appropriateness of the EQ‐5D questionnaire in a number of Asian populations including Chinese, Japanese, Koreans, Malays, and Indians. We’ll be investigating both the content validity of the EQ‐5D descriptive system as well as the thought processes used by members of those Asian populations when rating their own health on the EQ‐VAS.
Data will be collected by personal and/or focus group interviews. Researchers from the Singapore Clinical Research Institute, Busan University in South Korea, and Tianjin University in China will also participate.
This study will be led by Mike Herdman from OHE and Associate Professor Nan Luo from the National University of Singapore.
7. Differences in the TTO valuation of experienced and non-experienced health profiles: a country comparison
The aim of this study is to explore the relationship between respondents’ own health and their valuation of EQ-5D-3L health states. For this purpose, we will exploit the standardised protocol recommended by the EuroQol Group for EQ-5D valuation studies across different countries. We will identify respondents in existing TTO datasets whose own self-reported health state was included in the set of profiles that was valued in the TTO exercises (and who therefore valued their own health state). Their values will be compared with those of respondents who were not experiencing the health state under evaluation.
The study will be led by OHE’s Patricia Cubi-Molla, working with OHE’s Professor Nancy Devlin, Koonal Shah and Mike Herdman, and Kristina Burström of the Karolinska Institutet, Sweden.