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Evaluation of EuroQol Valuation Technology (EQ-VT) Designs to Generate National Value Sets: Learnings from the Development of an EQ-5D Value Set for India Using an Extended Design (DEVINE) Study

Author

Listed:
  • Gaurav Jyani

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

  • Zhihao Yang

    (Guizhou Medical University, Guiyang, People’s Republic of China)

  • Atul Sharma

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

  • Aarti Goyal

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

  • Elly Stolk

    (EuroQol Research Foundation, Rotterdam, South Holland, the Netherlands)

  • Fredrick Dermawan Purba

    (Department of Developmental Psychology, Faculty of Psychology, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia)

  • Sandeep Grover

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

  • Manmeet Kaur

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

  • Shankar Prinja

    (Postgraduate Institute of Medical Education and Research, Chandigarh, India)

Abstract

Introduction Countries develop their EQ-5D-5L value sets using the EuroQol Valuation Technology (EQ-VT) protocol. This study aims to assess if extension in the conventional EQ-VT design can lead to development of value sets with improved precision. Methods A cross-sectional survey was undertaken in a representative sample of 3,548 adult respondents, selected from 5 different states of India using a multistage stratified random sampling technique. A novel extended EQ-VT design was created that included 18 blocks of 10 health states, comprising 150 unique health states and 135 observations per health state. In addition to the standard EQ-VT design, which is based on 86 health states and 100 observations per health state, 3 extended designs were assessed for their predictive performance. The extended designs were created by 1) increasing the number of observations per health state in the design, 2) increasing the number of health states in the design, and 3) implementing both 1) and 2) at the same time. Subsamples of the data set were created for separate designs. The root mean squared error (RMSE) and mean absolute error (MAE) were used to measure the predictive accuracy of the conventional and extended designs. Results The average RMSE and MAE for the standard EQ-VT design were 0.055 and 0.041, respectively, for the 150 health states. All 3 types of design extensions showed lower RMSE and MAE values as compared with the standard design and hence yielded better predictive performance. RMSE and MAE were lowest (0.051 and 0.039, respectively) for the designs that use a greater number of health states. Extending the design with inclusion of more health states was shown to improve the predictive performance even when the sample size was fixed at 1,000. Conclusion Although the standard EQ-VT design performs well, its prediction accuracy can be further improved by extending its design. The addition of more health states in EQ-VT is more beneficial than increasing the number of observations per health state. Highlights The EQ-5D-5L value sets are developed using the standardized EuroQol Valuation Technology (EQ-VT) protocol. This is the first study to empirically assess how much can be gained from extending the standard EQ-VT design in terms of sample size and/or health states. It not only presents useful insights into the performance of the standard design of the EQ-VT but also tests the potential extensions in the standard EQ-VT design in terms of increasing the health states to be directly valued as well as the number of observations recorded to predict the utility value of each of these health states. The study demonstrates that the standard EQ-VT design performs good, and an extension in the design of the standard EQ-VT can lead to further improvement in its performance. The addition of more health states in EQ-VT is more beneficial than increasing the number of observations per health state. Extending the design with inclusion of more health states marginally improves the predictive performance even when the sample size was fixed at 1,000. The findings of the study will streamline the systematic process for generating precise EQ-5D-5L value sets, thus facilitating the conduct of credible, transparent, and robust outcome valuation in health technology assessments.

Suggested Citation

  • Gaurav Jyani & Zhihao Yang & Atul Sharma & Aarti Goyal & Elly Stolk & Fredrick Dermawan Purba & Sandeep Grover & Manmeet Kaur & Shankar Prinja, 2023. "Evaluation of EuroQol Valuation Technology (EQ-VT) Designs to Generate National Value Sets: Learnings from the Development of an EQ-5D Value Set for India Using an Extended Design (DEVINE) Study," Medical Decision Making, , vol. 43(6), pages 692-703, August.
  • Handle: RePEc:sae:medema:v:43:y:2023:i:6:p:692-703
    DOI: 10.1177/0272989X231180134
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    References listed on IDEAS

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