Abstract
Background: Responses to single-item categorical self-rated health (SRH) measures predict mortality, but performance of quality-adjusted life year (QALY) compatible health measures in this regard has not been much investigated. Objectives: To examine mortality prediction and discrimination by 4 QALY compatible health measures, a reference single-item categorical SRH measure, and 1-year declines in those measures. Research Design: Cox survival and area under the curve (AUC) (discrimination) analyses of the 2000 to 2002 Medical Expenditures Panel Survey respondent data linked to the National Death Index through 2006, with and without adjustment for sociodemographic characteristics (age, sex, race/ethnicity, education, and income). Subjects: A total of 22,259 respondents aged 18 to 90. Measures: EQ-5D summary index (EQ-5D); predicted EQ-5D (pEQ-5D) derived from the SF-12; SF-6D; EQ visual analog scale (EQ VAS); and a single-item categorical SRH measure. Results: Adjusted mortality hazard ratios for 0.1 point decrements in QALY compatible health measure scores were: EQ-5D, 1.24 [95% confidence interval (CI): 1.20, 1.29); pEQ-5D, 1.40 (95% CI: 1.34, 1.47); EQ VAS, 1.30 (95% CI: 1.26, 1.35); SF-6D, 1.37 (95% CI: 1.30, 1.43)]. In adjusted AUC analyses, baseline scores on all study health measures discriminated mortality risk, but the pEQ-5D, EQ VAS, and single-item categorical SRH measures were statistically superior in this regard. One-year declines also predicted mortality for all study health measures, but only pEQ-5D decline discriminated mortality risk in adjusted AUC analyses. Conclusions: For all of the study health measures, baseline scores and 1-year declines in scores predicted mortality. The pEQ-5D also consistently discriminated mortality risk in adjusted AUC analyses.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 443-450 |
| Number of pages | 8 |
| Journal | Medical Care |
| Volume | 49 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 2011 |
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Keywords
- cost-effectiveness analysis
- health-related quality of life
- mortality
- quality-adjusted life years
- self-rated health
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Cite this
Mortality prediction by quality-adjusted life year compatible health measures : Findings in a nationally representative US sample. / Jerant, Anthony F; Tancredi, Daniel J; Franks, Peter.
In: Medical Care, Vol. 49, No. 5, 05.2011, p. 443-450.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Mortality prediction by quality-adjusted life year compatible health measures
T2 - Findings in a nationally representative US sample
AU - Jerant, Anthony F
AU - Tancredi, Daniel J
AU - Franks, Peter
PY - 2011/5
Y1 - 2011/5
N2 - Background: Responses to single-item categorical self-rated health (SRH) measures predict mortality, but performance of quality-adjusted life year (QALY) compatible health measures in this regard has not been much investigated. Objectives: To examine mortality prediction and discrimination by 4 QALY compatible health measures, a reference single-item categorical SRH measure, and 1-year declines in those measures. Research Design: Cox survival and area under the curve (AUC) (discrimination) analyses of the 2000 to 2002 Medical Expenditures Panel Survey respondent data linked to the National Death Index through 2006, with and without adjustment for sociodemographic characteristics (age, sex, race/ethnicity, education, and income). Subjects: A total of 22,259 respondents aged 18 to 90. Measures: EQ-5D summary index (EQ-5D); predicted EQ-5D (pEQ-5D) derived from the SF-12; SF-6D; EQ visual analog scale (EQ VAS); and a single-item categorical SRH measure. Results: Adjusted mortality hazard ratios for 0.1 point decrements in QALY compatible health measure scores were: EQ-5D, 1.24 [95% confidence interval (CI): 1.20, 1.29); pEQ-5D, 1.40 (95% CI: 1.34, 1.47); EQ VAS, 1.30 (95% CI: 1.26, 1.35); SF-6D, 1.37 (95% CI: 1.30, 1.43)]. In adjusted AUC analyses, baseline scores on all study health measures discriminated mortality risk, but the pEQ-5D, EQ VAS, and single-item categorical SRH measures were statistically superior in this regard. One-year declines also predicted mortality for all study health measures, but only pEQ-5D decline discriminated mortality risk in adjusted AUC analyses. Conclusions: For all of the study health measures, baseline scores and 1-year declines in scores predicted mortality. The pEQ-5D also consistently discriminated mortality risk in adjusted AUC analyses.
AB - Background: Responses to single-item categorical self-rated health (SRH) measures predict mortality, but performance of quality-adjusted life year (QALY) compatible health measures in this regard has not been much investigated. Objectives: To examine mortality prediction and discrimination by 4 QALY compatible health measures, a reference single-item categorical SRH measure, and 1-year declines in those measures. Research Design: Cox survival and area under the curve (AUC) (discrimination) analyses of the 2000 to 2002 Medical Expenditures Panel Survey respondent data linked to the National Death Index through 2006, with and without adjustment for sociodemographic characteristics (age, sex, race/ethnicity, education, and income). Subjects: A total of 22,259 respondents aged 18 to 90. Measures: EQ-5D summary index (EQ-5D); predicted EQ-5D (pEQ-5D) derived from the SF-12; SF-6D; EQ visual analog scale (EQ VAS); and a single-item categorical SRH measure. Results: Adjusted mortality hazard ratios for 0.1 point decrements in QALY compatible health measure scores were: EQ-5D, 1.24 [95% confidence interval (CI): 1.20, 1.29); pEQ-5D, 1.40 (95% CI: 1.34, 1.47); EQ VAS, 1.30 (95% CI: 1.26, 1.35); SF-6D, 1.37 (95% CI: 1.30, 1.43)]. In adjusted AUC analyses, baseline scores on all study health measures discriminated mortality risk, but the pEQ-5D, EQ VAS, and single-item categorical SRH measures were statistically superior in this regard. One-year declines also predicted mortality for all study health measures, but only pEQ-5D decline discriminated mortality risk in adjusted AUC analyses. Conclusions: For all of the study health measures, baseline scores and 1-year declines in scores predicted mortality. The pEQ-5D also consistently discriminated mortality risk in adjusted AUC analyses.
KW - cost-effectiveness analysis
KW - health-related quality of life
KW - mortality
KW - quality-adjusted life years
KW - self-rated health
UR - http://www.scopus.com/inward/record.url?scp=79954705579&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79954705579&partnerID=8YFLogxK
U2 - 10.1097/MLR.0b013e318206c231
DO - 10.1097/MLR.0b013e318206c231
M3 - Article
C2 - 21368679
AN - SCOPUS:79954705579
VL - 49
SP - 443
EP - 450
JO - Medical Care
JF - Medical Care
SN - 0025-7079
IS - 5
ER -