Dependency and health utilities in stroke: data to inform cost-effectiveness analyses
Introduction: Health utilities (HU) assign preference weights to specific health states and are required for costeffectiveness analyses. Existing HU for stroke inadequately reflect the spectrum of post-stroke disability. Using international stroke trial data, we calculated HU stratified by disabilit...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
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SAGE Publications
2017
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| Online Access: | https://eprints.nottingham.ac.uk/44946/ |
| _version_ | 1848797034891444224 |
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| author | Ali, Myzoon MacIsaac, Rachael Quinn, Terence J. Bath, Philip M.W. Veenstra, David L. Xu, Yaping Brady, Marian C. Patel, Anita Lees, Kennedy R. |
| author_facet | Ali, Myzoon MacIsaac, Rachael Quinn, Terence J. Bath, Philip M.W. Veenstra, David L. Xu, Yaping Brady, Marian C. Patel, Anita Lees, Kennedy R. |
| author_sort | Ali, Myzoon |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Introduction: Health utilities (HU) assign preference weights to specific health states and are required for costeffectiveness analyses. Existing HU for stroke inadequately reflect the spectrum of post-stroke disability. Using international stroke trial data, we calculated HU stratified by disability to improve precision in future cost-effectiveness analyses.
Materials and methods: We used European Quality of Life Score (EQ-5D-3L) data from the Virtual International Stroke Trials Archive (VISTA) to calculate HU, stratified by modified Rankin Scale scores (mRS) at 3 months. We applied published value sets to generate HU, and validated these using ordinary least squares regression, adjusting for age and baseline National Institutes of Health Stroke Scale (NIHSS) scores.
Results: We included 3858 patients with acute ischemic stroke in our analysis (mean age: 67.5+-12.5, baseline NIHSS: 12+-5). We derived HU using value sets from 13 countries and observed significant international variation in HU distributions (Wilcoxon signed-rank test p<0.0001, compared with UK values). For mRS=0, mean HU ranged from 0.88 to 0.95; for mRS=5, mean HU ranged from -0.48 to 0.22. OLS regression generated comparable HU (for mRS=0, HU ranged from 0.9 to 0.95; for mRS=5, HU ranged from -0.33 to 0.15). Patients’ mRS scores at 3 months accounted for 65–71% of variation in the generated HU.
Conclusion: We have generated HU stratified by dependency level, using a common trial endpoint, and describing expected variability when applying diverse value sets to an international population. These will improve future cost-effectiveness analyses. However, care should be taken to select appropriate value sets. |
| first_indexed | 2025-11-14T19:57:28Z |
| format | Article |
| id | nottingham-44946 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:57:28Z |
| publishDate | 2017 |
| publisher | SAGE Publications |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-449462024-08-15T15:21:38Z https://eprints.nottingham.ac.uk/44946/ Dependency and health utilities in stroke: data to inform cost-effectiveness analyses Ali, Myzoon MacIsaac, Rachael Quinn, Terence J. Bath, Philip M.W. Veenstra, David L. Xu, Yaping Brady, Marian C. Patel, Anita Lees, Kennedy R. Introduction: Health utilities (HU) assign preference weights to specific health states and are required for costeffectiveness analyses. Existing HU for stroke inadequately reflect the spectrum of post-stroke disability. Using international stroke trial data, we calculated HU stratified by disability to improve precision in future cost-effectiveness analyses. Materials and methods: We used European Quality of Life Score (EQ-5D-3L) data from the Virtual International Stroke Trials Archive (VISTA) to calculate HU, stratified by modified Rankin Scale scores (mRS) at 3 months. We applied published value sets to generate HU, and validated these using ordinary least squares regression, adjusting for age and baseline National Institutes of Health Stroke Scale (NIHSS) scores. Results: We included 3858 patients with acute ischemic stroke in our analysis (mean age: 67.5+-12.5, baseline NIHSS: 12+-5). We derived HU using value sets from 13 countries and observed significant international variation in HU distributions (Wilcoxon signed-rank test p<0.0001, compared with UK values). For mRS=0, mean HU ranged from 0.88 to 0.95; for mRS=5, mean HU ranged from -0.48 to 0.22. OLS regression generated comparable HU (for mRS=0, HU ranged from 0.9 to 0.95; for mRS=5, HU ranged from -0.33 to 0.15). Patients’ mRS scores at 3 months accounted for 65–71% of variation in the generated HU. Conclusion: We have generated HU stratified by dependency level, using a common trial endpoint, and describing expected variability when applying diverse value sets to an international population. These will improve future cost-effectiveness analyses. However, care should be taken to select appropriate value sets. SAGE Publications 2017-03-01 Article PeerReviewed Ali, Myzoon, MacIsaac, Rachael, Quinn, Terence J., Bath, Philip M.W., Veenstra, David L., Xu, Yaping, Brady, Marian C., Patel, Anita and Lees, Kennedy R. (2017) Dependency and health utilities in stroke: data to inform cost-effectiveness analyses. European Stroke Journal, 2 (1). pp. 70-76. ISSN 2396-9873 Stroke trial health utility EQ-5D cost effectiveness modified Rankin Scale quality of life http://journals.sagepub.com/doi/10.1177/2396987316683780 doi:10.1177/2396987316683780 doi:10.1177/2396987316683780 |
| spellingShingle | Stroke trial health utility EQ-5D cost effectiveness modified Rankin Scale quality of life Ali, Myzoon MacIsaac, Rachael Quinn, Terence J. Bath, Philip M.W. Veenstra, David L. Xu, Yaping Brady, Marian C. Patel, Anita Lees, Kennedy R. Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title | Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title_full | Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title_fullStr | Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title_full_unstemmed | Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title_short | Dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| title_sort | dependency and health utilities in stroke: data to inform cost-effectiveness analyses |
| topic | Stroke trial health utility EQ-5D cost effectiveness modified Rankin Scale quality of life |
| url | https://eprints.nottingham.ac.uk/44946/ https://eprints.nottingham.ac.uk/44946/ https://eprints.nottingham.ac.uk/44946/ |