caa a22 4500 445332417 CHVBK 20180317142741.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10198-010-0252-4 doi (NATIONALLICENCE)springer-10.1007/s10198-010-0252-4 The impact of disease severity on EQ-5D and SF-6D utility discrepancies in chronic heart failure [Elektronische Daten] [Nick Kontodimopoulos, Michalis Argiriou, Nikolaos Theakos, Dimitris Niakas] Objectives: To compare EQ-5D and SF-6D utilities across groups of chronic heart failure (CHF) patients with varying levels of disease severity. Methods: A consecutive sample (N=251) of CHF patients undergoing elective cardiac surgery were surveyed. Disease severity was proxied via a self-assessment scale, the EQ-VAS and the Duke Activity Status Index (DASI); however, validity was demonstrated only by the latter. Association and level of agreement between instruments in DASI-based severity groups were estimated with Pearson's r and the intraclass correlation coefficient (ICC), respectively. Paired-samples t test was used to identify significant differences. In a linear regression model, the DASI was used as an anchor of disease severity to identify a potential "crossover” point between EQ-5D and SF-6D utilities. Results: EQ-5D and SF-6D strongly correlated over the entire sample (r=0.647, P<0.001); however, their agreement was moderate (ICC=0.484, P<0.001). In the less severe DASI groups (i.e. higher functional capacity) EQ-5D was significantly higher than SF-6D (P<0.001) and differences constituted minimally important differences (MIDs). Contrarily, in the more severe groups SF-6D was predominantly higher than EQ-5D. The regression model indicated a utility crossover point at 0.722 and predicted that individuals with a utility score less than this would score higher on the SF-6D than on the EQ-5D, and vice versa. The DASI score at crossover was calculated at 31.94. Conclusions: In subgroups of patients differing in CHF severity according to the DASI, mean EQ-5D and SF-6D indices differed significantly. Contrarily, in socio-demographic and clinical groups, these utility differences were not directly evident. According to the evidence, comparisons based on severity classification via a valid disease-specific external instrument may provide insight on instrument choice in cost-utility analyses. Springer-Verlag, 2010 Chronic heart failure nationallicence Cost-utility analysis nationallicence Duke activity status index nationallicence EQ-5D nationallicence Health-related quality of life nationallicence SF-6D nationallicence Kontodimopoulos Nick Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut Argiriou Michalis Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut Theakos Nikolaos 2nd Department of Cardiac Surgery, Evangelismos Hospital, Athens, Greece aut Niakas Dimitris Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut The European Journal of Health Economics Springer-Verlag 12/4(2011-08-01), 383-391 1618-7598 12:4<383 2011 12 10198 https://doi.org/10.1007/s10198-010-0252-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10198-010-0252-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kontodimopoulos Nick Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut NATIONALLICENCE 700 1- Argiriou Michalis Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut NATIONALLICENCE 700 1- Theakos Nikolaos 2nd Department of Cardiac Surgery, Evangelismos Hospital, Athens, Greece aut NATIONALLICENCE 700 1- Niakas Dimitris Faculty of Social Sciences, Hellenic Open University, Bouboulinas 57, 26222, Patras, Greece aut NATIONALLICENCE 773 0- The European Journal of Health Economics Springer-Verlag 12/4(2011-08-01), 383-391 1618-7598 12:4<383 2011 12 10198 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer