Abstract
Aim: To estimate the effect of extended hours dialysis on utility‐based quality of life (QOL) using two distinct multi‐attribute utility instruments.
Background: Health economic evaluations often rely on measurements of health utility. Validated health utility assessment tools are available but whether they perform similarly is rarely assessed.
Methods: The ACTIVE Dialysis trial randomised 200 participants to extended hours (≥24 hours/week) or standard hours (≤18 hours/week) haemodialysis for 12 months. Utility‐based QOL was assessed every three months by the EuroQOL‐5 Dimensions (EQ‐5D) and Short Form‐6 Dimensions (SF‐6D). The mean difference in utility weights between groups was obtained by mixed linear regression. Quality adjusted life years (QALYs), a measure that combines survival and quality of life, were calculated.
Results: Extended dialysis hours did not improve utility‐based QOL measured by the EQ‐5D (0.036 [95%CI ‐0.022, 0.093]; p=0.223) but did significantly improve it when measured by the SF‐6D (0.027 [95%CI 0.003, 0.052]; p=0.026). There was no significant difference in mean QALYs gained per patient from extended over standard dialysis as measured by the SF‐6D (0.015 [95%CI ‐0.070, 0.041]) or the EQ‐5D (0.029 [95%CI ‐0.108, 0.049]) – equivalent to a mean per patient gain of 5.5 (95%CI ‐25.6, 15.0) and 10.6 (95%CI ‐39.4, 17.9) days of perfect health, respectively.
Conclusions: The EQ‐5D and SF‐6D resulted in different interpretations of utility‐based QOL effects of extended hours dialysis, although the significant improvement in utility‐based QOL found with the SF‐6D did not translate into a significant gain in QALYs. These results emphasise the need for a better understanding of the impact of different scoring algorithms and instrument properties on the performance of multi‐attribute utility instruments to measure QOL in dialysis patients.
Background: Health economic evaluations often rely on measurements of health utility. Validated health utility assessment tools are available but whether they perform similarly is rarely assessed.
Methods: The ACTIVE Dialysis trial randomised 200 participants to extended hours (≥24 hours/week) or standard hours (≤18 hours/week) haemodialysis for 12 months. Utility‐based QOL was assessed every three months by the EuroQOL‐5 Dimensions (EQ‐5D) and Short Form‐6 Dimensions (SF‐6D). The mean difference in utility weights between groups was obtained by mixed linear regression. Quality adjusted life years (QALYs), a measure that combines survival and quality of life, were calculated.
Results: Extended dialysis hours did not improve utility‐based QOL measured by the EQ‐5D (0.036 [95%CI ‐0.022, 0.093]; p=0.223) but did significantly improve it when measured by the SF‐6D (0.027 [95%CI 0.003, 0.052]; p=0.026). There was no significant difference in mean QALYs gained per patient from extended over standard dialysis as measured by the SF‐6D (0.015 [95%CI ‐0.070, 0.041]) or the EQ‐5D (0.029 [95%CI ‐0.108, 0.049]) – equivalent to a mean per patient gain of 5.5 (95%CI ‐25.6, 15.0) and 10.6 (95%CI ‐39.4, 17.9) days of perfect health, respectively.
Conclusions: The EQ‐5D and SF‐6D resulted in different interpretations of utility‐based QOL effects of extended hours dialysis, although the significant improvement in utility‐based QOL found with the SF‐6D did not translate into a significant gain in QALYs. These results emphasise the need for a better understanding of the impact of different scoring algorithms and instrument properties on the performance of multi‐attribute utility instruments to measure QOL in dialysis patients.
| Original language | English |
|---|---|
| Pages (from-to) | 11-12 |
| Number of pages | 2 |
| Journal | Nephrology |
| Volume | 23 |
| Issue number | S3 |
| Early online date | 30 Aug 2018 |
| DOIs | |
| Publication status | Published - 1 Sept 2018 |