US valuation of health outcomes measured using the PROMIS-29

Abstract

Objectives: Health valuation studies enhance economic evaluations of treatments by estimating the value of health-related quality of life (HRQOL). The Patient-Reported Outcomes Measurement Information System (PROMIS) includes a 29-item short-form HRQOL measure, the PROMIS-29.

Methods: To value PROMIS-29 responses on a quality-adjusted life-year scale, we conducted a national survey (N = 7557) using quota sampling based on the US 2010 Census. Based on 541 paired comparisons with over 350 responses each, pair-specific probabilities were incorporated into a weighted least-squared estimator.

Results: All losses in HRQOL influenced choice; however, respondents valued losses in physical function, anxiety, depression, sleep, and pain more than those in fatigue and social functioning.

Conclusions: This article introduces a novel approach to valuing HRQOL for economic evaluations using paired comparisons and provides a tool to translate PROMIS-29 responses into quality-adjusted life-years.

Keywords: discrete choice experiments; patient-reported outcomes; quality-adjusted life-years.

Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Example of Paired Comparison

Figure 2

Proportion who prefer a loss in lifespan over pain or depression for 10 years.* * Pain Intensity was measured on an 11-point scale from no pain (0) to worst imaginable pain (10). Each point represents a pair-specific sample and sample sizes range from 711 to 772, except the first and last pairs on Pain Intensity 3 (571 and 282, respectively) due to a coding error.

Figure 3

Losses in QALYs associated with health problems for 10 years described by PROMIS-29* QALY=quality-adjusted life year *Cut points in the bars represent the losses in QALYs associated with an increase in severity of a health problem (i.e., Level 1 to 2…Level 10 to 11). The full bar represents the loss in QALYs associated with 10 years with the health problem at its worst level of severity.

Figure 4

Histogram of 1-year values on a quality-adjusted life year scale by self-reported general health