Putting the ‘Q’ in depression QALYs: a comparison of utility measurement using EQ-5D and SF-6D health related quality of life measures Comparison of EQ-5D and SF-6D utilities in mental health patients. An empirical evaluation of the SF-12, SF-6D, EQ-5D and Michigan Hand Outcome Questionnaire in patients with rheumatoid arthritis of the hand Quality of Life and General Health After Elective Surgery for Cervical Spine Pathologies: Determining a Valid and Responsive Metric of Health State Utility. Mapping SF-36 onto the EQ-5D index: how reliable is the relationship? Using the SF-36 and Euroqol on an elderly population Assessing the empirical validity of alternative multi-attribute utility measures in the maternity context EQ-5D in a general population survey – A description of the most commonly reported EQ-5D health states using the SF-36 Cost-utility estimates in depression: does the valuation method matter? Mapping between the Roland Morris Questionnaire and generic preference-based measures. Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Comparison of the SF-6D and the EQ-5D in patients with coronary heart disease An empirical comparison of EQ-5D and SF-6D in liver transplant patients. Mapping the FACT-G cancer-specific quality of life instrument to the EQ-5D and SF-6D A Portuguese value set for the SF-6D. Estimating a preference-based index from the Japanese SF-36. Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease
Background Generic health preference measures that capture quality of life improvements in depression are important for economic analysis of new technologies . Aim To compare two widely used preference measures , the EQ-5D and SF-6D , in terms of their dimensions and health utility values . Method EQ-5D and SF-6D data collected from 114 patients with depression , who participated in a cluster , r and omised controlled trial to evaluate a collaborative care intervention in UK , primary care practice s.  Utilities were examined across the whole sample and by level of depression severity using the PHQ-9 . Results Depression was associated with disutility at baseline . At 3 month follow-up mean utility increased 0.147 for EQ-5D and 0.082 for SF-6D . Health gains were observed in patients in remission from depression and those with the mildest level of depression severity . Conclusions Both generic preference measures were sensitive to health gains in depression within a relatively short follow-up period ; larger health gain was observed for the EQ-5D Various  preference-based measures of health are available for use as an outcome measure in cost-utility analysis . The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients . Baseline data from a Dutch multi-centre r and omised trial of 616 patients with mood and /or anxiety disorders were used . Mean and median  EQ-5D  and  SF-6D utilities were compared , both in the total sample and between severity subgroups based on quartiles of SCL-90 scores . Utilities were expected to decline with increased severity . Both EQ-5D and SF-6D utilities differed significantly between patients of adjacent severity groups . Mean utilities increased from 0.51 at baseline to 0.68 at 1.5 years follow-up for EQ-5D and from 0.58 to 0.70 for SF-6D . For all severity subgroups , the mean change in EQ-5D utilities as well as in SF-6D utilities was statistically significant . St and ardised response means were higher for SF-6D utilities . We concluded that both EQ-5D and SF-6D discriminated between severity subgroups and captured improvements in health over time . However , the use of EQ-5D result ed in larger health gains and consequent lower cost-utility ratios , especially for the subgroup with the highest severity of mental health problems Background The aim of this study was to assess the psychometric properties , namely acceptability , validity , reliability , interpretability and responsiveness of the EuroQol EQ-5D ( EQ-5D visual analogue ( VAS ) and EQ-5D ( utility ) ) , Short Form 12 Dimensions ( SF-12 ) , SF-6D and Michigan H and Outcome Question naire ( MHQ ) in patients with rheumatoid arthritis ( RA ) of the h and . Methods The empirical investigation was based upon data from a r and omised controlled trial of 488 adults with rheumatoid arthritis who had pain and dysfunction of the h and s and /or wrists . Participants completed the EQ-5D , SF-12 and MHQ at baseline and at 4 and 12 months follow up . Acceptability was measured using completion rates over time ; construct validity using the “ known groups ” approach , based on pain troublesomeness ; convergent validity using spearman ’s rho correlation ( ρ ) ; reliability using internal consistency ( Cronbach ’s alpha ) ; interpretability using minimal important differences ( MID ) ; and responsiveness using effect sizes and st and ardised response means ( SRM ) stratified by level of self-rated improvement in h and and wrist function or level of self-rated benefit and satisfaction from trial treatments . Results At baseline , the study population had a mean age of 62.4 years , a mean MHQ score of 52.1 and included 76 % women . The EQ-5D ( utility ) had the highest completion rates across time points . All instruments discriminated between pre-specified groups based on pain troublesomeness . Convergent validity analysis indicated that the MHQ score correlated strongly with the EQ-5D ( ρ = 0.65 ) and SF-6D ( ρ = 0.63 ) utility scores . The MHQ was most responsive at detecting change in indicators of RA pain severity between baseline and 4 months , whilst minimal important differences varied considerably across PROMs . Conclusions The instruments evaluated in this study displayed varying psychometric properties in the context of RA of the h and . The selection of a preferred instrument in evaluative studies should ultimately depend on the relative importance placed on individual psychometric properties and the importance placed on generation of health utilities for economic evaluation purpose BACKGROUND As part of the Affordable Care Act , health utility metrics are being investigated to define a cost-effective , value-based health care model . EuroQOL-5D ( EQ-5D ) and Short Form-6D ( SF-6D ) are commonly used quality -of-life instruments . Domains in the EQ-5D question naire are thought to be less responsive in measuring quality of life after cervical surgery . OBJECTIVE To evaluate the validity and responsiveness of SF-6D and EQ-5D in determining health and quality of life after elective cervical spine surgery . METHODS A total of 420 patients undergoing elective cervical spine surgery over a period of 2 years were enrolled in a prospect i ve longitudinal registry . Patient-reported outcomes Neck Disability Index ( NDI ) , EQ-5D , and SF-12 were recorded . Based on previously published equations , SF-6D was calculated using NDI and SF-12 scores . Patients were asked whether " surgery met their expectations " ( meaningful improvement ) . The validity and relative responsiveness of SF-6D ( NDI ) , SF-6D ( SF-12 ) , and EQ-5D to discriminate between meaningful and nonmeaningful improvement were calculated . RESULTS Sixty-six percent of patients ( 277 ) reported a level of improvement after surgery that met their expectations ( meaningful improvement ) . SF-6D ( NDI ) ( area under the curve [ AUC ] = 0.69 ) was a more valid discriminator of meaningful improvement compared with the SF-6D ( SF-12 ) ( AUC = 0.65 ) and EQ-5D ( AUC = 0.62 ) . SF-6D ( NDI ) was also a more responsive measure compared with SF-6D ( SF-12 ) and EQ-5D ( st and ardized response mean difference : 0.66 , 0.48 , and 0.44 , respectively ) . CONCLUSION SF-6D is a more valid and responsive measure of general health and quality of life compared with EQ-5D . SF-6D derived from disease-specific disability scores was more valid and responsive than that derived from the generic preference-based SF-12 . Cost-effective studies should use SF-6D as a measure of QALY after cervical spine surgery Background Mapping from health status measures onto generic preference-based measures is becoming a common solution when health state utility values are not directly available for economic evaluation . However the accuracy and reliability of the models employed is largely untested , and there is little evidence of their suitability in patient data sets . This paper examines whether mapping approaches are reliable and accurate in terms of their predictions for a large and varied UK patient data set . Methods SF-36 dimension scores are mapped onto the EQ-5D index using a number of different model specifications . The predicted EQ-5D scores for subsets of the sample are compared across inpatient and outpatient setting s and medical conditions . This paper compares the results to those obtained from existing mapping functions . Results The model including SF-36 dimensions , squared and interaction terms estimated using r and om effects GLS has the most accurate predictions of all models estimated here and existing mapping functions as indicated by MAE ( 0.127 ) and MSE ( 0.030 ) . Mean absolute error in predictions by EQ-5D utility range increases with severity for our models ( 0.085 to 0.34 ) and for existing mapping functions ( 0.123 to 0.272 ) . Conclusion Our results suggest that models mapping the SF-36 onto the EQ-5D have similar predictions across inpatient and outpatient setting and medical conditions . However , the models overpredict for more severe EQ-5D states ; this problem is also present in the existing mapping functions An important method ological issue in measuring health-related quality of life is whether instruments such as SF-36 and EQ can be used on an elderly population . This paper aims to test the completion , reliability and validity of the SF-36 and Euroqol on an elderly female population , and to compare them with the OPCS Disability Survey .  Three hundred and eighty women aged 75 and over participated in a r and omized controlled trial of the use of clodronate provided the sample . As part of the trial , patients were asked to complete the  UK SF-36 and Euroqol  , and the OPCS disability survey instrument  administered by interview in a hospital clinic at baseline . A r and om sub sample of respondents were retested six months later . The SF-36 achieved poorer levels of completion by dimension ( 68.1%–88.9 % ) than the OPCS ( 99.2 % ) and Euroqol ( 84%–93.5 % ) instruments . There were no major floor effects in the distribution of scores , except for the role dimensions of SF-36 . Correlation between test-retest were significant for all instruments , but lower for the role dimensions and social functioning of SF-36 , and these dimensions also had 95 % Cls for the mean differences in excess of 10 points . There was substantial agreement between the three instruments , and evidence for their construct validity against age and recent use of health services . The sensitivities of the instruments were tested through hypothetical changes in health status . There was some evidence of greater sensitivity to lower levels of morbidity in the SF-36 . Where brevity is required and the health changes are expected to be substantial , then EQ may be sufficient . For greater sensitivity SF-36 seems to have an advantage , however lower completion rates and problems with consistency suggest it requires adaptation . One solution would be to use interviewer administration . Another would be to change the SF-36 to make it more suitable for use in elderly people , although this may reduce its usefulness as a generic instrument Background Multi-attribute utility measures are preference-based health-related quality of life measures that have been developed to inform economic evaluations of health care interventions . The objective of this study was to compare the empirical validity of two multi-attribute utility measures ( EQ-5D and SF-6D ) based on hypothetical preferences in a large maternity population in Engl and . Methods Women who participated in a r and omised controlled trial of additional postnatal support provided by trained community support workers represented the study population for this investigation . The women were asked to complete the EQ-5D descriptive system ( which defines health-related quality of life in terms of five dimensions : mobility , self care , usual activities , pain/discomfort and anxiety/depression ) and the SF-36 ( which defines health-related quality of life , using 36 items , across eight dimensions : physical functioning , role limitations ( physical ) , social functioning , bodily pain , general health , mental health , vitality and role limitations ( emotional ) ) at six months postpartum . Their responses were converted into utility scores using the York A1 tariff set and the SF-6D utility algorithm , respectively . One-way analysis of variance was used to test the hypothetically-constructed preference rule that each set of utility scores differs significantly by self-reported health status ( categorised as excellent , very good , good , fair or poor ) . The degree to which EQ-5D and SF-6D utility scores reflected alternative dichotomous configurations of self-reported health status and the Edinburgh Postnatal Depression Scale score was tested using the relative efficiency statistic and receiver operating characteristic ( ROC ) curves . Results The mean utility score for the EQ-5D was 0.861 ( 95 % CI : 0.844 , 0.877 ) , whilst the mean utility score for the SF-6D was 0.809 ( 95 % CI : 0.796 , 0.822 ) , representing a mean difference in utility score of 0.052 ( 95 % CI : 0.040 , 0.064 ; p < 0.001 ) . Both measures demonstrated statistically significant differences between subjects who described their health status as excellent , very good , good , fair or poor ( p < 0.001 ) , as well as monotonically decreasing utility scores ( test for linear trend : p < 0.001 ) . The SF-6D was between 29.1 % and 423.6 % more efficient than the EQ-5D at detecting differences in self-reported health status , and between 129.8 % and 161.7 % more efficient at detecting differences in the Edinburgh Postnatal Depression Scale score . In addition , the SF-6D generated higher area under the curve ( AUC ) scores generated by the ROC curves than the EQ-5D , indicating greater discriminatory power , although in all but one analysis the differences in AUC scores between the measures were not statistically significant . Conclusion This study provides evidence that the SF-6D is an empirically valid and efficient alternative multi-attribute utility measure to the EQ-5D , and is capable of discriminating between external indicators of maternal health The importance of study ing health-related quality of life in the general population has increasingly been emphasized . From a public health perspective , this benefits the identification of population inequalities in health status . One of the currently most popular instruments is the EQ-5D . Evaluations of the EQ-5D generally focus on the overall preference-based index . As this index has a built-in value , exploration of the information from the underlying health states is also important . In this study , the ten most commonly reported EQ-5D health states are described using the SF-36 . Data collected in 1999 by question naires mailed to a r and om sample aged 20–74 in south-eastern Sweden were used ( n = 9489 ) . Almost 43 % reported the best possible EQ-5D health state and 78 % were accounted for by three EQ-5D health states . The EQ-5D health state classification was largely reflected by the SF-36 , with the EQ-5D items mobility , usual activities , pain/discomfort and anxiety/depression tapping most clearly on the SF-36 scales physical functioning , role limitations due to physical health problems , bodily pain , and mental health , respectively . However , within the same level of EQ-5D ( i.e. , moderate problems ) there was a rather large variation of SF-36 scale scores , particularly regarding the EQ-5D item pain/discomfort and the SF-36 scale BP BACKGROUND Depression imposes a substantial burden on society . In view of the economic burden of depression , studies evaluating depression treatment increasingly incorporate a cost-utility analysis . Outcomes of these analyses are used by decision makers to prioritize healthcare . Although generic preference-based instruments have been recommended for measuring utility , depression research often uses a disease-specific method , based on depression-free days ( DFD ) , to measure utilities . AIMS OF THE STUDY The objective of this study was to compare utility measurement techniques in the context of a r and omized controlled trial . In particular , we studied the agreement between QALYs measured with the  EuroQol ( EQ-5D ) , the Short Form 6D ( SF-6D ) , and the DFD method , using the EQ-5D as the reference method . We also studied whether the use of different techniques leads to different conclusions for decision makers . METHODS Data were derived from the Depression in Elderly with Long-Term Afflictions ( DELTA ) study . This r and omized controlled trial was design ed to study the effectiveness and cost-effectiveness of a minimal psychological intervention for chronically ill patients with co-occurring minor or mild to moderate major depression . The  EQ-5D , SF-6D and Beck Depression Inventory  ( to estimate DFDs ) were assessed at baseline , and at three , six and twelve months after baseline . RESULTS Poor agreement was found between the EQ-5D and DFD ( Kendall 's Tau : 0.33 ; ICC : 0.21 ( 95 % CI:-0.07 - 0.45 ) ) and moderate agreement between the EQ-5D and SF-6D ( Kendall 's Tau : 0.60 ; ICC : 0.47 ( 95 % CI : 0.36 - 0.57 ) ) . The incremental cost-utility ratio led to similar conclusions for decision makers across techniques . DISCUSSION In conclusion , utilities from the disease-specific DFD method should not be compared directly with utilities derived from the EQ-5D . Although a disease-specific method might yield similar cost-utility ratios as generic instruments , generic instruments remain the preferred option for prioritizing healthcare . Limitations of this study include the presence of minor depression and chronic illnesses in our study population . IMPLICATION S Generic instruments remain preferred for cost-utility analyses , especially when results are used to prioritize healthcare . If the DFD method is a way forward , further research is required to vali date utility weights assigned to the DFDs OBJECTIVES The Rol and Morris Question naire ( RMQ ) is a widely used health status measure for low back pain ( LBP ) . It is not preference-based , and there are currently no established algorithms for mapping between the RMQ and preference-based health-related quality -of-life measures . Using data from r and omized controlled trials of treatment for LBP , we sought to develop algorithms for mapping between RMQ scores and health utilities derived using either the EuroQol five-dimensional question naire ( EQ-5D ) or the six-dimensional health state short form ( derived from Medical Outcomes Study 36-Item Short-Form Health Survey ) ( SF-6D ) . METHODS This study is based on data from the Back Skills Training Trial in which data were collected from 701 patients at baseline and subsequently at 3 , 6 , and 12 months postr and omization using a range of outcome measures , including the  RMQ , the EQ-5D , and the Short Form 12 item Health Survey ( SF-12 ) ( from which SF-6D utilities can be derived ) . We used baseline trial data to estimate models using both direct and response mapping approaches to predict EQ-5D and SF-6D health utilities and dimension responses . A multistage model selection process was used to assess the predictive accuracy of the models . We then explored different techniques and mapping models that made use of repeated follow-up observations in the data . The estimated mapping algorithms were vali date d using external data from the UK Back Pain Exercise and Manipulation trial . RESULTS A number of models were developed that accurately predict health utilities in this context . The best performing model for RMQ to EQ-5D mapping was a beta regression with Bayesian quasi-likelihood estimation that included 24 dummy variables for RMQ responses , age , and sex as covariates ( mean squared error 0.0380 ) based on repeated data . The model selected for RMQ to SF-6D mapping was a finite mixture model that included the overall RMQ score , age , sex , RMQ score squared , age squared , and an interaction term for age and RMQ score as covariates ( mean squared error 0.0114 ) based on repeated data . CONCLUSIONS It is possible to reasonably predict EQ-5D and SF-6D health utilities from RMQ scores and responses using regression methods . Our regression equations provide an empirical basis for estimating health utilities when EQ-5D or SF-6D data are not available . They can be used to inform future economic evaluations of interventions targeting LBP OBJECTIVES The purpose s of this analysis were to evaluate the construct validity of the EQ-5D and compare responses on the EQ-5D with the Physical Component Summary ( PCS-12 ) and Mental Component Summary ( MCS-12 ) scores of the SF-12 Health Survey . METHODS Data were collected via a survey instrument mailed to 4,200 r and omly selected subjects in the province of Alberta , Canada . The instrument contained the EQ-5D and SF-12 health surveys , with additional questions eliciting clinical and demographic information from the respondents . RESULTS 1,555 respondents returned mailed question naires ; 606 question naires were returned undeliverable . The SF-12 summary scores were calculated for 1,380 respondents . Analysis of the EQ-5D responses by demographic variables found significant differences among categories of age , gender , and self-reported chronic medical conditions . Corresponding dimensions and summary scores were more strongly related ( eg , mobility and PCS-12 ; F ratio = 598.3 , P < 0.001 ) than dissimilar dimensions ( eg , mobility and MCS-12 ; F ratio = 18.8 , P < 0.001 ) . The EQ-5D index scores were moderately correlated with SF-12 summary scores ( r = 0.41 for MCS-12 and r = 0.68 for PCS-12 ) . For subjects reporting no problems on the EQ-5D , PCS-12 and MCS-12 scores were significantly lower for people reporting medical problems or feelings of depression . CONCLUSIONS The results of this investigation generally supported the validity of the EQ-5D . However , an important ceiling effect was observed for the EQ-5D in this sample . The combination of the EQ-5D and SF-12 provides relatively broad coverage of important health domains and scores for various purpose Background The SF-6D was derived from the SF-36 . A single summary score is obtained allegedly preserving the descriptive richness and sensitivity to change of the SF-36 into utility measurement . We compared the SF-6D and EQ-5D on domain content , scoring distribution , pre-treatment and change scores . Methods The SF-6D and the EQ-5D were completed prior to intervention and 1 , 3 , 6 and 12 months post-intervention in a study enrolling 561 patients with symptomatic coronary stenosis . Patients were r and omized to off-pump coronary artery bypass surgery ( CABG ) , st and ard on-pump CABG , or percutaneous transluminal coronary angioplasty ( PTCA ) .  Baseline and change over time scores were compared using parametric and non-parametric tests . Results The relative contribution of similar domains measuring daily functioning to the utility scores differed substantially . SF-6D focused more on social functioning , while EQ-5D gave more weight to physical functioning . Pain and mental health had similar contributions . The scoring range of the EQ-5D was twice the range of the SF-6D . Before treatment , EQ-5D and SF-6D mean scores appeared similar ( 0.64 versus 0.63 , p = 0.09 ) . Median scores , however , differed substantially ( 0.69 versus 0.60 ) , a difference exceeding the minimal important difference of both instruments . Agreement was low , with an intra-class correlation of 0.45.Finally , we found large differences in measuring change over time . The SF-6D recorded greater intra-subject change in the PTCA-group . Only the EQ-5D recorded significant change in the CABG-groups . In the latter groups changes in SF-6D domains cancelled each other out . Conclusion Although both instruments appear to measure similar constructs , the EQ-5D and SF-6D are quite different . The low agreement and the differences in median values , scoring range and sensitivity to change after intervention show that the EQ-5D and SF-6D yield incomparable scores in patients with coronary heart disease There remains disagreement about the preferred utility-based measure of health-related quality of life for use in constructing quality -adjusted life years ( QALYs ) . The recent development of a new measure , the SF-6D , has highlighted this issue . The SF-6D and EuroQol EQ-5D measure health-related utilities on a scale where 0 represents death and 1 represents full health , and both have utility scores generated from r and om sample s of the general UK population . This study explored whether , in a large sample of liver transplant patients , the two instruments provide similar results . The empirical data highlight important variation in the results generated from the use of the two instruments . The data are consistent with a view that the SF-6D does not describe health states at the lower end of the utility scale but is more sensitive than EQ-5D in detecting small changes towards the top of the scale Objective To help facilitate economic evaluations of oncology treatments , we mapped responses on cancer-specific instrument to generic preference-based measures . Methods Cancer patients ( n = 367 ) completed one cancer-specific instrument , the FACT-G , and two preference-based measures , the  EQ-5D and SF-6D . Responses were r and omly divided to form development ( n = 184 ) and cross-validation ( n = 183 ) sample s. Relationships between the instruments were estimated using ordinary least squares ( OLS ) , generalized linear models ( GLM ) , and censored least absolute deviations ( CLAD ) regression approaches . The performance of each model was assessed in terms of how well the responses to the cancer-specific instrument predicted EQ-5D and SF-6D utilities using mean absolute error ( MAE ) and root mean squared error ( RMSE ) . Results Physical , functional , and emotional well-being domain scores of the FACT-G best explained the EQ-5D and SF-6D . In terms of accuracy of prediction as measured in RMSE , the CLAD model performed best for the EQ-5D ( RMSE = 0.095 ) whereas the GLM model performed best for the SF-6D ( RMSE = 0.061 ) . The GLM predicted SF-6D scores matched the observed values more closely than the CLAD and OLS . Conclusion Our results demonstrate that the estimation of both EQ-5D and SF-6D utility indices using the FACT-G responses can be achieved . The CLAD model for the EQ-5D and the GLM model for the SF-6D are recommended . Thus , it is possible to estimate quality -adjusted life years for economic evaluation from studies where only cancer-specific instrument have been administered OBJECTIVES The SF-6D is a preference-based measure of health derived from the SF-36 that can be used for cost-effectiveness analysis using cost-per- quality adjusted life-year analysis . This study seeks to estimate a system weight for the SF-6D for Portugal and to compare the results with the UK system weights . METHODS A sample of 55 health states defined by the SF-6D has been valued by a representative r and om sample of the Portuguese population , stratified by sex and age ( n = 140 ) , using the St and ard Gamble ( SG ) . Several models are estimated at both the individual and aggregate levels for predicting health-state valuations . Models with main effects , with interaction effects and with the constant forced to unity are presented . R and om effects ( RE ) models are estimated using generalized least squares ( GLS ) regressions . Generalized estimation equations ( GEE ) are used to estimate RE models with the constant forced to unity . Estimations at the individual level were performed using 630 health-state valuations . Alternative functional forms are considered to account for the skewed distribution of health-state valuations . RESULTS The models are analyzed in terms of their coefficients , overall fit , and the ability for predicting the SG-values . The RE models estimated using GLS and through GEE produce significant coefficients , which are robust across model specification . However , there are concerns regarding some inconsistent estimates , and so parsimonious consistent models were estimated . There is evidence of under prediction in some states assigned to poor health . The results are consistent with the UK results . CONCLUSION The models estimated provide preference-based quality of life weights for the Portuguese population when health status data have been collected using the SF-36 . Although the sample was r and omly drowned findings should be treated with caution , given the small sample size , even knowing that they have been estimated at the individual level OBJECTIVE The main objective of the study was to estimate a preference-based Short Form (SF)-6D index from the SF-36 for Japan and compare it with the UK results . STUDY DESIGN AND SETTING The SF-6D was translated into Japanese . Two hundred and forty-nine health states defined by this version of the SF-6D were then valued by a representative sample of 600 members of the Japanese general population using st and ard gamble ( SG ) . These health-state values were modeled using classical parametric r and om-effect methods with individual-level data and ordinary least squares ( OLS ) on mean health-state values , together with a new nonparametric approach using Bayesian methods of estimation . RESULTS All parametric models estimated on Japanese data were found to perform less well than their UK counterparts in terms of poorer goodness of fit , more inconsistencies , larger prediction errors and bias , and evidence of systematic bias in the predictions . Nonparametric models produce a substantial improvement in out-of- sample predictions . The physical , role , and social dimensions have relatively larger decrements than pain and mental health compared with those in the United Kingdom . CONCLUSION The differences between Japanese and UK valuations of the SF-6D make it important to use the Japanese valuation data set estimated using the nonparametric Bayesian technique presented in this article Background The need for cost effectiveness analyses in r and omized controlled trials that compare treatment options is increasing . The selection of the optimal utility measure is important , and a central question is whether the two most commonly used indexes - the EuroQuol 5D ( EQ5D ) and the Short Form 6D ( SF6D ) – can be used interchangeably . The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties . The psychometric properties of the two utility indexes were compared to a disease-specific instrument , the Oswestry Disability Index ( ODI ) , in the setting of a r and omized controlled trial for degenerative disc disease . Methods In a r and omized controlled multicentre trial , 172 patients who had experienced low back pain for an average of 6 years were r and omized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses .  Patients filled out the ODI , EQ5D , and SF-36 at baseline and two-year follow up . The utility indexes was compared with respect to measurement error , structural validity , criterion validity , responsiveness , and interpretability according to the COSMIN taxonomy . Results At follow up , 113 patients had change score values  for all three instruments . The SF6D had better similarity with the disease-specific instrument ( ODI ) regarding sensitivity , specificity , and responsiveness . Measurement error was lower for the SF6D ( 0.056 ) compared to the EQ5D ( 0.155 ) . The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D . The minimal detectable change score value at a 95 % confidence level were 0.157 for SF6D and 0.429 for EQ5D , and the difference in mean change score values ( SD ) between them was 0.23 ( 0.29 ) and so exceeded the clinical significant change score value for both instruments . Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately , but that they do not exactly measure the same underlying construct . Conclusions This study indicates that the difference in important measurement properties between EQ5D and SF6D is too large to consider them interchangeable . Since the similarity with the “ gold st and ard ” ( the disease-specific instrument ) was quite different , this could indicate that the choice of index should be determined by the diagnosis
The EQ-5D and SF-36 achieved mixed results in the quantitative testing against psychometric criteria .
The qualitative analysis suggests this is because they provide a very limited coverage of themes identified by people with mental health problems .
BACKGROUND Generic preference-based measures of health like the EQ-5D and SF-6D ( ® ) are increasingly being used in economic evaluation and outcome assessment .
However , there are concerns as to whether or not these generic measures are appropriate for use in people with mental health problems .
OBJECTIVES The EQ-5D and SF-36 ( ® ) ( including its derivatives the SF-12 ( ® ) and SF-6D ) were assessed using the psychometric criteria of validity and responsiveness using quantitative and qualitative methods .
Another aim was to estimate mapping functions between the EQ-5D and SF-6D and condition-specific measures , where appropriate .