The University of Southampton
University of Southampton Institutional Repository

Self-valuation and societal valuations of health state differ with disease severity in chronic and disabling conditions

Self-valuation and societal valuations of health state differ with disease severity in chronic and disabling conditions
Self-valuation and societal valuations of health state differ with disease severity in chronic and disabling conditions
Objectives: We sought to determine the relationship between self-reported ratings of health-related quality of life (HRQoL) by people with 3 chronic and disabling conditions and population estimates of those health states and to model factors that might explain the disagreement between these 2 ratings.
Research Design: A cross-sectional postal survey was sent in which each participant completed a set of questionnaires addressing HRQoL. Data from self-valuation on a visual analog scale (VAS) was compared with a population-based VAS-equivalent valuation, using the EQ-5D instrument. Different ways of scaling the 2 VAS scores were also explored. Data were analyzed using descriptive statistics and analysis of covariance. Subjects: A community sample of 1036 people took part in the study (rheumatoid arthritis n = 142, stroke n = 585, multiple sclerosis n = 309). Measurement instrument: The EQ-5D health state profile and accompanying visual analog scale were used.
Results: Self-ratings were significantly different than the population-based ratings, and agreement was poor, both on the original scale of the data and by analyses of rescaled data. On the original scales the mean difference was 0.13 (95% confidence interval 0.117-0.143). Diagnosis, health state severity, and its square explained 35.3% of the variation in the differences between self and population ratings with a curvilinear relationship suggesting that the differences increased as the health state worsened, but at a decreasing rate as health state severity increased.
Conclusions: This study provides evidence that EQ-5D population valuation estimates of treatment benefit for people with disabling and chronic conditions may well be inaccurate representations of the degree of change actually experienced by the individual with the condition. The varying magnitude of difference between the 2 forms of valuation has important implications for interpreting shifts in health status valuation following interventions for these populations.
chronic, disease, health, quality, quality of life, research, questionnaires, community, rheumatoid, rheumatoid arthritis, arthritis, stroke
0025-7079
1143-1151
McPherson, Kathryn
dc901431-2119-42df-9400-852e4cb46d75
Myers, Julie
f2dec495-1ee6-495a-a38a-afe273278de4
Taylor, William J.
c266dec7-c5c5-4122-9562-56dc353e56b2
McNaughton, Harry K.
bc7770ae-1ba1-463d-8076-b0ee9d208236
Weatherall, Mark
2d0d0abb-6a13-48fc-9e59-34b801b55ce1
McPherson, Kathryn
dc901431-2119-42df-9400-852e4cb46d75
Myers, Julie
f2dec495-1ee6-495a-a38a-afe273278de4
Taylor, William J.
c266dec7-c5c5-4122-9562-56dc353e56b2
McNaughton, Harry K.
bc7770ae-1ba1-463d-8076-b0ee9d208236
Weatherall, Mark
2d0d0abb-6a13-48fc-9e59-34b801b55ce1

McPherson, Kathryn, Myers, Julie, Taylor, William J., McNaughton, Harry K. and Weatherall, Mark (2004) Self-valuation and societal valuations of health state differ with disease severity in chronic and disabling conditions. Medical Care, 42 (11), 1143-1151. (doi:10.1097/00005650-200411000-00014).

Record type: Article

Abstract

Objectives: We sought to determine the relationship between self-reported ratings of health-related quality of life (HRQoL) by people with 3 chronic and disabling conditions and population estimates of those health states and to model factors that might explain the disagreement between these 2 ratings.
Research Design: A cross-sectional postal survey was sent in which each participant completed a set of questionnaires addressing HRQoL. Data from self-valuation on a visual analog scale (VAS) was compared with a population-based VAS-equivalent valuation, using the EQ-5D instrument. Different ways of scaling the 2 VAS scores were also explored. Data were analyzed using descriptive statistics and analysis of covariance. Subjects: A community sample of 1036 people took part in the study (rheumatoid arthritis n = 142, stroke n = 585, multiple sclerosis n = 309). Measurement instrument: The EQ-5D health state profile and accompanying visual analog scale were used.
Results: Self-ratings were significantly different than the population-based ratings, and agreement was poor, both on the original scale of the data and by analyses of rescaled data. On the original scales the mean difference was 0.13 (95% confidence interval 0.117-0.143). Diagnosis, health state severity, and its square explained 35.3% of the variation in the differences between self and population ratings with a curvilinear relationship suggesting that the differences increased as the health state worsened, but at a decreasing rate as health state severity increased.
Conclusions: This study provides evidence that EQ-5D population valuation estimates of treatment benefit for people with disabling and chronic conditions may well be inaccurate representations of the degree of change actually experienced by the individual with the condition. The varying magnitude of difference between the 2 forms of valuation has important implications for interpreting shifts in health status valuation following interventions for these populations.

Text
00005650-200411000-00014.pdf - Version of Record
Restricted to Repository staff only

More information

Published date: 1 November 2004
Keywords: chronic, disease, health, quality, quality of life, research, questionnaires, community, rheumatoid, rheumatoid arthritis, arthritis, stroke

Identifiers

Local EPrints ID: 17979
URI: http://eprints.soton.ac.uk/id/eprint/17979
ISSN: 0025-7079
PURE UUID: 9b69e673-fd91-4eec-83bf-540a6d10635c

Catalogue record

Date deposited: 24 Nov 2005
Last modified: 15 Mar 2024 06:02

Export record

Altmetrics

Contributors

Author: Kathryn McPherson
Author: Julie Myers
Author: William J. Taylor
Author: Harry K. McNaughton
Author: Mark Weatherall

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×