title: Psychometric evaluation of the National Eye Institute Visual Function Questionnaire and Visual Function Questionnaire Utility Index in patients with non-infectious intermediate and posterior uveitis Comparison of methods to estimate health state utilities for ovarian cancer using quality of life data: a Gynecologic Oncology Group study. Development of an EORTC-8D Utility Algorithm for Sri Lanka Estimating a preference-based index for a menopause specific health quality of life questionnaire Integrating preferences into health status assessment for amyotrophic lateral sclerosis: The ALS Utility Index Integrating patient preferences into health outcomes assessment: the multiattribute Asthma Symptom Utility Index. Economic evaluation in short bowel syndrome (SBS): an algorithm to estimate utility scores for a patient-reported SBS-specific quality of life scale (SBS-QoL™) Estimating a Preference-Based Index for an Eight-Dimensional Health State Classification System for Multiple Sclerosis. Estimating a Preference-Based Index from the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) Estimating EQ-5D and OAB-5D health state utilities for patients with overactive bladder Developing a utility index for the Aberrant Behavior Checklist (ABC-C) for fragile X syndrome Modeling a preference-based index for two condition-specific measures (asthma and overactive bladder) using a nonparametric Bayesian method. Estimation of patient preference-based utility weights from the functional assessment of cancer therapy - general. Development of the EXACT-U: a preference-based measure to report COPD exacerbation utilities. Asthma symptom utility index: reliability, validity, responsiveness, and the minimal important difference in adult asthmatic patients. Eliciting health state utilities for Dupuytren’s contracture using a discrete choice experiment Estimation of a Preference-Based Index from a Condition-Specific Measure: The King's Health Questionnaire Evaluation of a vision-related utility instrument: the German vision and quality of life index. Estimating a preference-based single index from the Overactive Bladder Questionnaire.
abstract: Objective To evaluate the psychometric properties of the National Eye Institute Visual Function Question naire-25 ( NEI VFQ-25 ) and Visual Function Question naire Utility Index ( VFQ-UI ) in patients with non-infectious intermediate and posterior uveitis . Methods Secondary analysis of pooled data from a 26-week , multicenter , masked , r and omized , sham-controlled Phase 3 clinical trial . Health-related quality of life was assessed using the NEI VFQ-25 , the EQ-5D , and SF-36 . Internal consistency reliability , reproducibility , convergent validity , and known groups of BCVA and vitreous haze severity were assessed . Clinical ly significant difference was assessed using anchor-based and distribution-based methods . Results The study included 224 subjects with non-infectious intermediate ( 80.4 % ) or posterior uveitis ( 19.6 % ) . The NEI VFQ-25 and the VFQ-UI demonstrated good internal consistency ( Cronbach ’s alpha 0.87–0.94 ) and test – retest reliability ( ICCs 0.58–0.88 ) . Spearman ’s product – moment rank correlations between the NEI VFQ-25  and VFQ-UI scores and the SF-6D , EQ-5D , and BCVA ranged from small to moderate . There was a significant association between visual functioning and known groups of visual acuity ( p < 0.05 ) . Clinical significance , using the anchor-based method ( difference between visual acuity groups ≥10–<15 letter better and no change ) , was 10.2 for change from baseline to week 26 for the NEI VFQ-25 composite score and 0.05 for the VFQ-UI . Using the distribution-based method , the clinical significance was 3.86 for the composite score and 0.04 for the VFQ-UI . Conclusion The NEI VFQ-25 and the VFQ-UI are reliable and valid measures of vision-related functioning and preference-based status in patients with non-infectious intermediate and posterior uveitis BACKGROUND Cost-effectiveness/cost-utility analyses are increasingly needed to inform decisions about care . Algorithms have been developed using the Functional Assessment of Cancer Therapy ( FACT ) quality of life instrument to estimate utility weights for cost analyses . This study was design ed to compare these algorithms in the setting of ovarian cancer . METHODS GOG-0152 was a 550-patient r and omized phase III trial of interval cytoreduction , and GOG-0172 was a 415-patient r and omized phase III trial comparing intravenous versus intraperitoneal therapy among women with advanced ovarian cancer .  QOL data were collected via the FACT at four time points in each study . Two published mapping algorithms ( Cheung and Dobrez ) and a linear transformation method were applied to these data . The agreement between measures was assessed by the concordance correlation coefficient ( r(CCC ) ) , and paired t-tests were used to compare means . RESULTS While agreement between the estimation algorithms was good ( ranged from 0.72 to 0.81 ) , there were statistically significant ( p<0.001 ) and clinical ly meaningful differences between the scores : mean scores were higher with Dobrez than with Cheung or the linear transformation method . Scores were also statistically significantly different ( p<0.001 ) between studies . CONCLUSIONS In the absence of prospect ively collected utility data , the use of mapping algorithms is feasible , however , the optimal algorithm is not clear . There were significant differences between studies , which highlight the need for validation of these algorithms in specific setting s. If cost analyses incorporate mapping algorithms to obtain utility estimates , investigators should take the variability into account Background . Currently there are no reported cancer-specific health state valuations in low- and middle-income countries using a vali date d preference-based measure . The EORTC-8D , a cancer-specific preference-based measure , has 81,920 health states and is useful for economic evaluations in cancer care . The aim of this study was to develop a utility algorithm to value EORTC-8D health states using preferences derived from a representative population sample in Sri Lanka . Methods . The time-tradeoff method was used to elicit preferences from a general population sample of 780 in Sri Lanka . A block design of 85 health states , with a time horizon of 10 years , was used for the direct valuation . Data were analyzed using generalized least squares with r and om effects . All respondents with at least one logical inconsistency were excluded from the analysis . Results . After logical inconsistencies were excluded , 4520 observations were available from 717 respondents for the analysis . The preferred model specified main effects with an interaction term for any level 4 or worse descriptor within a health state . Worsening of physical functioning had a substantially greater utility decrement than any other dimension in this population . Limitations are that the data collection could not include the whole country and that females formed a large part of the sample . Conclusions . Preference weights for EORTC-8D health states for Sri Lanka have been derived : These will be very useful in economic evaluations of cancer-related interventions in a range of low- and middle-income countries Background The aim of the study was to develop a menopause-specific , preference-based health-related quality -of-life ( HRQoL ) index reflecting both menopausal symptoms and potential side-effects of Hormone Replacement Therapy ( HRT ) . Methods The study had three phases : the development of a health state classification , a prospect i ve valuation survey and the estimation of a model to interpolate HRQoL indices for all remaining health states as defined by the classification . A menopausal health state classification was developed with seven dimensions : hot flushes , aching joints/muscles , anxious/frightened feelings , breast tenderness , bleeding , vaginal dryness and undesirable and rogenic signs . Each dimension contains between three and five levels and defines a total of 6,075 health states . A sample of 96 health states was selected for the valuation survey . These states were valued by a sample of 229 women aged 45 to 60 , r and omly selected from 6 general practice lists in Sheffield , UK . Respondents were asked to complete a time trade-off ( TTO ) task for nine health states , result ing in an average of 16.5 values for each health state . Results Mean health states valued range from 0.48 to 0.98 ( where 1.0 is full health and zero is for states regarded as equivalent to death ) . Symptoms , as described by the classification system , can be rank-ordered in terms of their impact ( from high to low ) on menopausal HRQoL as follows : aching joints and muscles , bleeding , breast tenderness , anxious or frightened feelings , vaginal dryness , and rogenic signs . Hot flushes did not significantly contribute to model fit . The preferred model produced a mean absolute error of 0.053 , but suffered from bias at both ends of the scale . Conclusion This article presents an attempt to directly value a condition specific health state classification . The overall fit was disappointing , but the results demonstrate that menopausal symptoms are perceived by patients to have a significant impact on utility . The overall effect is modest compared to the more generic health state descriptions such as the EQ-5D . The result ant algorithm generates a preference-based index that can be used economic evaluation and that reflects the impact of this condition We developed a preference‐based measure , the Amyotrophic Lateral Sclerosis Utility Index ( ALSUI ) , allowing computation of US population ‐based utility weights for the wide range of health states observed among ALS patients . A multi‐attribute utility approach was used . An ALS Health State Classification System was developed comprising the following attributes with different severity levels : Speech and Swallowing ( A1 ) ; Eating , Dressing , and Bathing ( A2 ) ; Leg Function ( A3 ) ; and Respiratory Function ( A4 ) . An internet‐based survey was administered to a r and om sample of the US population to assess preferences for ALS health states based on this system using  visual analog scale ( VAS ) and st and ard gamble ( SG ) questions . Using the VAS and SG data from 1374 individuals in the general population , utility functions were computed that corresponded to each severity level within A1 , A2 , A3 , and A4 . ALSUI scores for a given patient are computed by inputting his corresponding utility functions into the following multiplicative formula : ALSUI score = 1.06 × (A1 × A2 × A3 × A4)−0.06 on a scale where 0.0 reflects death and 1.0 reflects healthy . This study provides a useful tool for classifying ALS patients and determining a general public‐based utility score for ALS health states STUDY OBJECTIVE To develop and evaluate a brief , easy-to-administer symptom assessment scale for use as a preference-based outcome measure in clinical trials and cost-effectiveness studies in asthma . DESIGN Cross-sectional survey with 2-week reproducibility assessment . SETTING Ambulatory care : university asthma and allergy center . PARTICIPANTS One hundred sixty-one adults with asthma , 59 % female , mean age 35+/-11 years . Mean FEV1 percent predicted was 86+/-17 % . INTERVENTIONS The  11-item Asthma Symptom Utility Index ( ASUI ) .  MEASUREMENTS AND RESULTS Mean ASUI score for this sample was 0.71+/-0.23 , with a range from 0.02 to 1.0 . The ASUI was reproducible ( intraclass correlation coefficient = 0.74 ) and able to distinguish patients known to differ on disease severity according to clinician ratings ( p < 0.001 ) and by an asthma disease severity scale score ( p < 0.001 ) . The instrument was also significantly correlated with FEV1 percent predicted ( r = 0.27 , p < 0.001 ) , the Asthma Quality of Life Question naire ( r = 0.77 , p < 0.001 ) , and the Health Utilities Index Mark 2 ( r = 0.36 , p < 0.001 ) . CONCLUSION The results of this study support the reliability and validity of the ASUI , suggesting it will be a useful , complementary patient outcome measure for clinical trials and cost-effectiveness studies comparing treatment alternatives for persons with asthma Purpose Condition-specific preference-based measures can offer utility data where they would not otherwise be available or where generic measures may lack sensitivity , although they lack comparability across conditions . This study aim ed to develop an algorithm for estimating utilities from the short bowel syndrome health-related quality of life scale ( SBS-QoL ™ ) . Methods SBS-QoL ™ items were selected based on factor and item performance analysis of a European SBS-QoL ™ data set and consultation with 3 SBS clinical experts . Six-dimension health states were developed using 8 SBS-QoL ™ items ( 2 dimensions combined 2 SBS-QoL ™ items ) . SBS health states were valued by a UK general population sample ( N = 250 ) using the lead-time time trade-off method . Preference weights or ‘ utility decrements ’ for each severity level of each dimension were estimated by regression models and used to develop the scoring algorithm . Results Mean utilities for the SBS health states ranged from −0.46 ( worst health state , very much affected on all dimensions ) to 0.92 ( best health state , not at all affected on all dimensions ) . The r and om effects model with maximum likelihood estimation regression had the best predictive ability and lowest root mean squared error and mean absolute error , and was used to develop the scoring algorithm . Conclusions The preference-weighted scoring algorithm for the SBS-QoL ™ developed is able to estimate a wide range of utility values from patient-level SBS-QoL ™ data . This allows estimation of SBS HRQL impact for the purpose of economic evaluation of SBS treatment benefits BACKGROUND Condition-specific measures are frequently used to assess the health-related quality of life of people with multiple sclerosis ( MS ) . Such measures are unsuitable for use in economic evaluations that require estimates of cost per quality -adjusted life-year because they are not based on preferences . OBJECTIVES To report the estimation of a preference-based single index for an eight-dimensional instrument for MS , the Multiple Sclerosis Impact Scale - Eight Dimensions ( MSIS-8D ) , derived from an MS-specific measure of health-related quality of life , the 29-item Multiple Sclerosis Impact Scale ( MSIS-29 ) . METHODS We elicited preferences for a sample of MSIS-8D states ( n = 169 ) from a sample ( n = 1702 ) of the UK general population . Preferences were elicited using the time trade-off technique via an Internet-based survey . We fitted regression models to these data to estimate values for all health states described by the MSIS-8D . Estimated values were assessed against MSIS-29 scores and values derived from generic preference-based measures in a large , representative sample of people with MS . RESULTS Participants reported that the time trade-off questions were easy to underst and . Observed health state values ranged from 0.08 to 0.89 . The best-performing model was a main effects , r and om effects model ( mean absolute error = 0.04 ) . Validation analyses support the performance of the MSIS-8D index : it correlated more strongly than did generic measures with MSIS-29 scores , and it discriminated effectively between subgroups of people with MS . CONCLUSIONS The MSIS-8D enables health state values to be estimated from the MSIS-29 , adding to the methods available to assess health outcomes and to estimate quality -adjusted life-years for MS for use in health technology assessment and decision-making context Background . The Clinical Outcomes in Routine Evaluation– Outcome Measure ( CORE-OM ) is used to evaluate the effectiveness of psychological therapies in people with common mental disorders . The objective of this study was to estimate a preference-based index for this population using CORE-6D , a health state classification system derived from the CORE-OM consisting of a 5-item emotional component and a physical item , and to demonstrate a novel method for generating states that are not orthogonal . Methods . Rasch analysis was used to identify 11 emotional health states from CORE-6D that were frequently observed in the study population and are , thus , plausible ( in contrast , conventional statistical design might generate implausible states ) . Combined with the 3 response levels of the physical item of CORE-6D , they generate 33 plausible health states , 18 of which were selected for valuation . A valuation survey of 220 members of the public in South Yorkshire , United Kingdom , was undertaken using the time tradeoff ( TTO ) method . Regression analysis was subsequently used to predict values for all possible states described by CORE-6D . Results . A number of multivariate regression models were built to predict values for the 33 health states of CORE-6D , using the Rasch logit value of the emotional state and the response level of the physical item as independent variables . A cubic model with high predictive value ( adjusted R2 = 0.990 ) was selected to predict TTO values for all 729 CORE-6D health states . Conclusion . The CORE-6D preference-based index will enable the assessment of cost-effectiveness of interventions for people with common mental disorders using existing and prospect i ve CORE-OM data sets . The new method for generating states may be useful for other instruments with highly correlated dimensions Background Limited utility data on patients suffering from overactive bladder ( OAB ) are available in the literature . The objectives of this study were to estimate utility values in patients with OAB using the generic EQ-5D question naire and the OAB-5D disease specific question naire , to investigate the relationship between utilities and symptoms , and to evaluate the sensitivity of the two instruments to changes in symptom severity . Methods Analyses were based on pooled data from three large multicenter r and omized 12-week placebo-controlled trials ( SCORPIO , ARIES , CAPRICORN ) . Patients completed a micturition diary , EQ-5D and OAB-q ( a quality of life question naire from which OAB-5D is derived ) at baseline and at weeks 4 , 8 and 12 . Time trade-off tariffs elicited from UK population were applied to obtain utilities from both instruments . Repeated measures regressions were used to estimate EQ-5D and OAB-5D utilities by micturition frequency and incontinence severity level . As a test of sensitivity of the instruments , utility changes from baseline to week 12 were estimated by symptomatic response ( improvement , stable or worsening ) . Results The sample included 4427 patients . Mean utilities ( ± st and ard deviation ) across all visits were 0.82 ( ±0.21 ) for EQ-5D and 0.86 ( ±0.09 ) for OAB-5D . Correlation between EQ-5D and OAB-5D was 0.34 ( p < 0.0001 ) . Both OAB-5D and EQ-5D utilities increased as OAB symptoms improved . Utility values were similar for severe levels of symptoms , but higher with OAB-5D than with EQ-5D for mild cases . Micturitions and incontinence had similar impact on EQ-5D utilities , but micturitions had greater impact on OAB-5D utilities than incontinence . Changes from baseline in OAB-5D utilities differed significantly according to symptomatic response . Changes in EQ-5D utilities were not significantly associated with changes in micturition frequency and weakly associated with changes in incontinence severity among patients with mild symptoms at baseline . Conclusions This study showed that both EQ-5D and OAB-5D can detect changes in severity of OAB , especially in severe cases . However , OAB-5D is more sensitive than EQ-5D in measuring differences between treatments in milder cases . Both OAB-5D and EQ-5D – although leading to different results –may be useful to derive utilities from clinical trial data and perform cost-effectiveness analyses . Trial registration Clinical Trials NCT00689104 , NCT00662909 , NCT00912964 Purpose This study aim ed to develop a utility index ( the ABC-UI ) from the Aberrant Behavior Checklist-Community ( ABC-C ) , for use in quantifying the benefit of emerging treatments for fragile X syndrome ( FXS ) . Methods The ABC-C is a proxy-completed assessment of behaviour and is a widely used measure in FXS . A subset of ABC-C items across seven dimensions was identified to include in health state descriptions . This item reduction process was based on item performance , factor analysis and Rasch analysis performed on an observational study data set , and consultation with five clinical experts and a method ological expert . Dimensions were combined into health states using an orthogonal design and valued using time trade-off ( TTO ) , with lead-time TTO methods used where TTO indicated a state valued as worse than dead . Preference weights were estimated using mean , individual level , ordinary least squares and r and om-effects maximum likelihood estimation [ RE ( MLE ) ] regression models . Results A representative sample of the UK general public ( n = 349 ; mean age 35.8 years , 58.2 % female ) each valued 12 health states . Mean observed values ranged from 0.92 to 0.16 for best to worst health states . The RE ( MLE ) model performed best based on number of significant coefficients and mean absolute error of 0.018 . Mean utilities predicted by the model covered a similar range to that observed . Conclusions The ABC-UI estimates a wide range of utilities from patient-level FXS ABC-C data , allowing estimation of FXS health-related quality of life impact for economic evaluation from an established FXS clinical trial instrument BACKGROUND Conventionally , parametric models were used for health state valuation data . Recently , research ers started to explore the use of nonparametric Bayesian methods in this area . OBJECTIVES We present a nonparametric Bayesian model to estimate a preference-based index for two condition-specific five-dimensional health state classifications , one for asthma ( five-dimensional Asthma Quality of Life Utility Index ) and the other for overactive bladder ( five-dimensional Overactive Bladder Quality of Life-Utility Index ) . METHODS Sample s of 307 and 311 members of the UK general population valued 99 health states selected from a total of 3125 health states defined by each of the measures using the time trade-off technique . The article presents the results of the nonparametric model and compares it with the original model estimated using a conventional parametric r and om-effects model . The different methods are compared theoretically and in terms of empirical performance across the two data sets . It also reports the effect of respondent characteristics on health state valuations . RESULTS The nonparametric models were found to be better at predicting health state values within the estimation sample than without in terms of root mean square error and the patterns of st and ardized residuals . Some respondent characteristics were found to explain variation in health state values , but these did not have a significant effect on the health states values when estimates were adjusted for sample differences with the general population . CONCLUSIONS The nonparametric Bayesian models are theoretically more appropriate than previously used parametric models and provide better utility estimates from the two condition-specific measures . Furthermore , the model is more flexible in estimating the effect of covariates OBJECTIVE The goal of this study was to estimate an algorithm to convert responses to the Functional Assessment of Cancer Therapy - General ( FACT-G ) to time trade-off ( TTO ) utilities based on utilities for current health elicited from cancer patients . METHODS Data for 1433 cancer patients were r and omly separated into construction and validation sample s. Four FACT-G questions were selected for inclusion based on correlation with Eastern Clinical Oncology Group - Performance Status ( ECOG-PS ) scores and TTO utilities . Item response theory was used to collapse response categories . Ordinary least squares regression with the constant constrained to one was used to estimate the algorithm . RESULTS The algorithm estimated mean utility for the full validation sample within three points of observed mean utility ( 0.805 vs. 0.832 , P < 0.01 ) . Mean utilities were well predicted ( mean absolute difference < 0.03 , P > 0.05 ) for most subgroups defined by ECOG-PS and Short Form-36 physical functioning scores , and responses to the FACT-G overall quality of life item . Nevertheless , the algorithm systematic ally overpredicted utilities for poorer health states . CONCLUSIONS A FACT-G-based algorithm of cancer patient utilities was developed that estimates group mean utility scores with accuracy comparable to other indirect preference-based measures of health-related quality of life . Patient-based preferences for health outcomes of cancer treatment may be useful in multiple situations , such as managing re sources within cancer centers and in underst and ing health states preferences among cancer experienced patients before and after treatment BACKGROUND The exacerbations of chronic obstructive pulmonary disease tool ( EXACT ) is a condition-specific daily diary recently developed to evaluate the frequency , severity , and duration of chronic obstructive pulmonary disease ( COPD ) exacerbations . A preference-based algorithm for the EXACT would allow utilities to be reported from patients during an exacerbation when EQ-5D data are not available . OBJECTIVE To develop the exacerbations of chronic obstructive pulmonary disease tool-utility ( EXACT-U ) , a condition-specific preference-based measure to report utilities from the EXACT for use in cost-effectiveness studies . METHODS Five items with three to five levels comprise the EXACT-U. Two groups of health states and respondents were constructed to allow for model development ( Development group ) and predictive validity testing ( Validation group ) using independent sample s. Members of the UK general public each valued 11 r and omized health states using time trade-offs ( TTOs ) scaled from full health/dead with 10-year duration s. Regression models estimated from the Development group using individual data , mean data , and panel design s. Models assessed by number of inconsistent coefficients estimated and R(2 ) and tested against observed utilities from the Validation group using mean absolute error ( MAE ) and root mean squared error ( RMSE ) . RESULTS A total of 55 health states , including the best and worst states , were valued in TTO interviews conducted with 400 respondents . Ten models were developed . The final preferred model contained no logical inconsistencies and found MAE = 0.04 and RMSE = 0.05 with a predicted utility range from 0.09 to 0.95 . CONCLUSIONS The EXACT-U is a condition-specific preference-based measure with strong predictive validity to report daily utilities during an exacerbation BACKGROUND The evaluation of asthma symptoms is a core outcome measure in asthma clinical research . The Asthma Symptom Utility Index ( ASUI ) was developed to assess the frequency and severity of asthma symptoms . The psychometric properties of the ASUI are not well characterized , and a minimal important difference ( MID ) is not established . OBJECTIVES We assessed the reliability , validity , and responsiveness to change of the ASUI in a population of adult asthmatic patients . We also sought to determine the MID for the ASUI . METHODS Adult asthmatic patients ( n = 1648 ) from 2 previously completed multicenter r and omized trials were included .  Demographic information , spirometric results , ASUI scores , and other asthma question naire scores  were obtained at baseline and during follow-up visits . Participants also kept a daily asthma diary . RESULTS The internal consistency reliability of the ASUI was 0.74 ( Cronbach α ) . Test-retest reliability was 0.76 ( intraclass correlation ) . Construct validity was demonstrated by significant correlations between ASUI scores and Asthma Control Question naire scores ( Spearman correlation r = -0.79 ; 95 % CI , -0.85 to -0.75 ; P < .001 ) and Mini Asthma Quality of Life Question naire scores ( r = 0.59 ; 95 % CI , 0.51 - 0.61 ; P < .001 ) . Responsiveness to change was demonstrated , with significant differences between mean changes in ASUI scores across groups of participants differing by 10 % in percent predicted FEV(1 ) ( P < .001 ) and by 0.5 points in Asthma Control Question naire scores ( P < .001 ) . Anchor-based and statistical methods support an MID for the ASUI of 0.09 points . CONCLUSIONS The ASUI is reliable , valid , and responsive to changes in asthma control over time . The MID of the ASUI ( range of scores , 0 - 1 ) is 0.09 Background and purpose An internet-based discrete choice experiment ( DCE ) was conducted to elicit preferences for a wide range of Dupuytren ’s contracture (DC)-related health states . An algorithm was subsequently developed to convert these preferences into health state utilities that can be used to assess DC ’s impact on quality of life and the value of its treatments . Methods Health state preferences for varying levels of DC h and severity were elicited via an internet survey from a sample of the UK adult population . Severity levels were defined using a combination of contractures ( 0 , 45 , or 90 degrees ) in 8 proximal interphalangeal and metacarpophalangeal joints of the index , middle , ring , and little fingers . Right-h and ed , left-h and ed , and ambidextrous respondents indicated which h and was preferable in each of the 10 r and omly-selected h and -pairings comparing different DC severity levels . For consistency across comparisons , anatomically precise digital h and drawings were used . To anchor preferences onto the traditional 0–1 utility scale used in health economic evaluations , unaffected h and s were assigned a utility of 1.0 whereas the utility for a maximally affected h and ( i.e. , all 8 joints set at 90 degrees of contracture ) was derived by asking respondents to indicate what combination of attributes and levels of the EQ-5D-5L profile most accurately reflects the impact of living with such h and . Conditional logistic models were used to estimate indirect utilities , then rescaled to the anchor points on the EQ-5D-5L . Results Estimated utilities based on the responses of 1,745 qualified respondents were 0.49 , 0.57 , and 0.63 for completely affected dominant h and s , non-dominant h and s , or ambidextrous h and s , respectively . Utility for a dominant h and with 90-degree contracture in t h e metacarpophalangeal joints of the ring and little fingers was estimated to be 0.89 . Separately , reducing the contracture of metacarpophalangeal joint for a little finger from 50 to 12 degrees would improve utility by 0.02 . Interpretation DC is associated with substantial utility decre- ments . The algorithms presented herein provide a robust and flexible framework to assess utility for varying degrees of DC severity Background . Generic preference-based measures of health may not adequately cover the impact of some conditions . There is therefore increasing interest in developing condition-specific preference-based measures . Objectives . The purpose of this study was to estimate a preference-based measure from a condition-specific measure of health for urinary incontinence , the 21-item King 's Health Question naire , for use in economic evaluation . Methods . The King 's Health Question naire ( KHQ ) was revised into a 5-dimensional health state classification amenable to valuation using items selected using psychometric evidence . Forty-nine states were valued using st and ard gamble by a representative sample of patients with urinary incontinence attending UK hospital outpatient clinics . Each respondent was asked to value 9 health states . Models have been estimated for predicting health state valuations for all 1024 states defined by the KHQ classification . The modeling had to cope with the clustering of data by respondent and its skewed distribution . Results . In total , 110 usable interviews were obtained from 169 patients approached to participate in the study . These responders generated 959 health state valuations . Mean health state values ranged from 0.77 to 0.98 . Models were estimated using mean health state values and r and om effects models of individual-level health state values . These models generated robust estimates of the ` main effects , ` and in general , the results support the ordinality of the KHQ health state classification . There were problems modeling interaction effects , and a number of alternatives were explored . Conclusion . The recommended model for estimating a preference-based measure from the condition-specific KHQ is presented PURPOSE Multi-attribute utility instruments ( MAUIs ) , which contain a descriptive system , including several health dimensions with associated levels of increasing severity , are used commonly to measure utilities . However , the validity of the descriptive systems rarely is examined using modern psychometric theory . Therefore , we evaluated the psychometric properties of the German version of the  Vision and Quality of Life Index ( VisQol ) , a six-item vision-related MAUI . METHODS The German VisQol was self-administered to 340 patients and 280 controls . All subjects underwent a full ophthalmologic examination , including best-corrected visual acuity ( VA ) testing . The psychometric properties of the VisQoL were assessed using Rasch analysis . RESULTS The VisQoL 's descriptive system did not function in controls . In patients , after collapsing response categories to resolve disordered thresholds and omitting misfitting persons , the measurement properties ( i.e. , precision , unidimensionality , and targeting ) of the German VisQoL were satisfactory . Most person misfit related to unexpected responses to item 4 ( " organizing assistance " ) . Rasch-generated person estimates were not different between age categories , sex , or underlying ocular condition , but decreased significantly with presence of visual impairment in the better eye ( LogMAR ≥ 0.5 , 1.20 ± 4.62 compared to 3.46 ± 3.52 , P < 0.001 ) . CONCLUSIONS The German VisQoL 's descriptive system displayed adequate fit to the Rasch model after removal of a large proportion of patients with poor fit statistics . However , the wording of item four should be revised to reduce respondent confusion and measurement " noise . " The scale 's descriptive system does not function in a sample of visually unimpaired persons , most likely due to a lack of variance in the measured trait OBJECTIVES The aim of the study is to estimate a preference-based single index for calculating quality -adjusted life years for patients with overactive bladder ( OAB ) , based on a survey of the UK general population using the 5-dimensional health classification system OAB-5D , derived from the vali date d Overactive Bladder Question naire ( OAB-q ) . METHODS An interview valuation survey of members of public in the South Yorkshire , UK was undertaken using the time-trade-off method . Each respondent was r and omly allocated to one of 14 blocks , and valued seven states each plus the " pits " state , so that a total of 99 states were valued . A number of multivariate regression models were estimated for predicting a total of 3125 health state values defined by the classification . Models were compared and selected using a set of criteria , including overall diagnosis by adjusted R-squared , the sign and significance of individual parameter estimates , the relative size of coefficients within a given dimension and predictive ability . RESULTS The mean model was recommended for use in economic evaluation . CONCLUSION This will permit the cost-effectiveness of new interventions to be assessed in patients with OAB using existing and future OAB-q data sets
target: Conclusion Various methods have been used at all stages of CSPBM development .
  The choice between developing a classification system de novo or from an existing instrument may depend on the availability of a suitable existing measure , while the choice between a decomposed or composite approach appears to be determined primarily by the purpose for which the instrument is design ed .
background: Background Health state utility values ( HSUVs ) are required to calculate quality -adjusted life-years ( QALYs ) .
  They are frequently derived from generic preference-based measures of health .
  However , such generic measures may not capture health attributes of relevance to specific conditions .
  In such cases , a condition-specific preference-based measure ( CSPBM ) may be more appropriate .
  Objective This systematic review aim ed to identify all published accounts of developing CSPBMs to describe and appraise the methods used .