A comparison of the EQ-5D and the SF-6D across seven patient groups

As the number of preference-based instruments grows, it becomes increasingly important to compare different preference-based measures of health in order to inform an important debate on the choice of instrument. This paper presents a comparison of two of them, the EQ-5D and the SF-6D (recently developed from the SF-36) across seven patient/population groups (chronic obstructive airways disease, osteoarthritis, irritable bowel syndrome, lower back pain, leg ulcers, post menopausal women and elderly). The mean SF-6D index value was found to exceed the EQ-5D by 0.045 and the intraclass correlation coefficient between them was 0.51. Whilst this convergence lends some support for the validity of these measures, the modest difference at the aggregate level masks more significant differences in agreement across the patient groups and over severity of illness, with the SF-6D having a smaller range and lower variance in values. There is evidence for floor effects in the SF-6D and ceiling effects in the EQ-5D. These discrepancies arise from differences in their health state classifications and the methods used to value them. Further research is required to fully understand the respective roles of the descriptive systems and the valuation methods and to examine the implications for estimates of the impact of health care interventions

The estimation of a preference-based measure of health from the SF-36

This paper reports on the findings of a study to derive a preference-based measure of health from the SF-36 for use in economic evaluation. The SF-36 was revised into a six-dimensional health state classification called the SF-6D. A sample of 249 states defined by the SF-6D have been valued by a representative sample of 611 members of the UK general population, using standard gamble. Models are estimated for predicting health state valuations for all 18,000 states defined by the SF-6D. The econometric modelling had to cope with the hierarchical nature of the data and its skewed distribution. The recommended models have produced significant coefficients for levels of the SF-6D, which are robust across model specification. However, there are concerns with some inconsistent estimates and over prediction of the value of the poorest health states. These problems must be weighed against the rich descriptive ability of the SF-6D, and the potential application of these models to existing and future SF-36 data set

A formal translation of the Assimilation-Accommodation Coping Scale from German to Dutch

The Assimilation-Accommodation Coping Scale was developed in Germany by Brandtstädter and Renner and applied in the UK and the Netherlands. A formal translation was never reported. Such formal translation was warranted as we found ambivalent language and atypical sentences in the Dutch translation. We therefore organised a formal forwards and backwards translation from German to Dutch. This report gives the details of that process and pr

Keep it simple: ranking health states yields values similar to cardinal measurement approaches

Abstract OBJECTIVES: To examine the relationship between ordinal and cardinal valuation of health states. STUDY DESIGN AND SETTING: We analyzed rank, visual analog scale (VAS), and time trade-off (TTO) responses for 52 health states defined using the EQ-5D classification system developed by the EuroQol Group. We analyzed 179,431 responses from 11,483 subjects in eight countries: Slovenia, Argentina, Denmark, Japan, Netherlands, Spain, United Kingdom, and United States. We first compared responses across methods by frequency of ties and values below dead. Ordinal associations between methods were evaluated using Spearman's correlation and Kendall's tau. Next, we estimated numerical values from rank responses using country-specific conditional logit models. After anchoring predicted values on a common scale, we further investigated the cardinal relationships between rank, VAS, and TTO-based values using Pearson's rho and quadratic regression. RESULTS: For each country, rank responses are less likely than TTO responses to be tied and to indicate that states are worse than dead. In all countries, rank responses show a strong linear correlation with both TTO (Pearson's rho=0.88-0.99) and VAS (rho=0.91-0.98) responses. However, rank-ba

Psychomotor therapy and aggression regulation in eating disorders

Eating disorder behaviours can be seen as self-destructive behaviours to a greatextent related to inhibited anger expression. However, a treatment protocoltargeted at anger and aggression in these disorders is lacking. This paperdescribes a psychomotor therapy (PMT) model as a body-oriented method tohelp patients with eating disorders to cope with anger and aggression. They learnto see aggression as a positive, relational, body-felt experience, and to controlanger expression at the right time with appropriate intensity. Our clinicalexperience indicates that PMT can accelerate the overall treatment process bytriggering hidden feelings and thoughts and by developing expression skills.This article discusses PMT principles of aggression regulation and themethodological procedures of the intervention. Randomised controlled researchis needed to validate clinical experiences