rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2010-829rsp-962Research ArticleСтатьиArticlesСравнение метода «временных уступок» и индекса EQ-5D для определения полезностиу больных ревматоидным артритомThe time to trade-off method versus the EQ-5D index to determine health utility in patients with rheumatoid arthritisGoryachevDmitriy VladimirovichGoryachevDmitriy Vladimirovichgorachev@regmed.ru <mailto:gorachev@regmed.ru>ЭрдесШ. Ф.ErdesSh F-GoryachevDmitry VladimirovichGoryachevDmitry Vladimirovichgorachev@regmed.ru <mailto:gorachev@regmed.ru>ЭрдесШ. Ф.ErdesSh F-201015122010486№6 (2010)8689Copyright © Goryachev D.V., Эрдес Ш.Ф., Goryachev D.V., Эрдес Ш.Ф., 20102010Goryachev D.V., Эрдес Ш.Ф., Goryachev D.V., Эрдес Ш.Ф.Goryachev D.V., Erdes S.F., Goryachev D.V., Erdes S.F.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/962

Проведение клинико-экономических исследований требует использования коэффициента полезности для подсчета качественно прожитых лет жизни (QALY). Выбор адекватного метода определения полезности для больных РА делает необходимым сравнение разных подходов к такой оценке. Цель. Сравнение значений полезности, полученных с использованием метода «временных уступок» («Time to trade-of», ТТО) и опросника EQ-5D. Материал и методы. Проведен однократный опрос 45 больных РА (средняя продолжительность РА 11,7±6,6 года) со средним значением HAQ 1,22±0,52. Полезность определялась с помощью прямого метода «временных уступок» (ТТО), индекса EQ-5D и визуальной аналоговой шкалы общего состояния здоровья (ВАШ ОСЗ), учитывался индекс функциональной активности HAQ. Результаты. 5 (11,2%) больных РА не смогли ответить на вопрос для подсчета ТТО. Средние значения индексов ТТО, EQ-5D, ВАШ-«термометр» ОСЗ составили 0,55±0,36; 0,30±0,32 и 0,47±0,23 соответственно. При пересчете EQ-5D в индекс полезности получены значения, сходные со средним значением ТТО (0,54±0,29). Значения индекса полезности, рассчитанного по ТТО, не коррелировали со значениями HAQ и EQ-5D. Длительность заболевания не была связана со значениями индекса полезности, рассчитанного по любому из использованных методов. Взаимосвязь индекса ТТО обнаружена только для значений ВАШ-«термометр» ОСЗ. Заключение. При определении полезности для проведения клинико-экономического анализа у больных РА предпочтительным является использование индекса EQ-5D и ВАШ ОСЗ.

Clinicoeconomic studies require that the health utility index be used to calculate quality-adjusted life years (QALY). Choice of an adequate method for determining health utility for patients with rheumatoid arthritis (RA) makes it necessary to compare various approaches to this assessment. Objective. To compare health utility values obtained with a time to trade-off (TTO) method and those with the EQ-5D questionnaire. Subjects and methods. A single interview was made in 45 patients with RA (mean RA duration 11.7±6.6 years) with a mean HAQ of 1.22±0.52. Utility was assessed using the direct TTO method, EQ-5D index, and visual analogue scale of general health (VAS-GH); functional disease activity index was assessed according to the Health Assessment Questionnaire (HAQ). Results. Five (11.2%) patients with RA could not answer a question to calculate TTO. The mean TTO, EQ-5D, and VAS-GH "thermometer" indices were 0.55±0.36, 0.30±0.32, and 0.47±0.23, respectively. Conversion from EQ-5D to utility index yielded the values similar to those with a mean TTO of 0.54±0.29. The values of the utility index calculated by TTO failed to correlate with those of HAQ and EQ-5D. The disease duration was unrelated to the values of the utility index calculated by any of the methods used. The association of TTO index was found only for VAS-GH "thermometer". Conclusion. EQ-5D index and VAS-GH are the methods of choice in determining health utility for a clinicoeconomic analysis in patients with RA.

ревматоидный артритиндекс полезностиметод «временных уступок» (ТТО)EQ-5Drheumatoid arthritisutility indexEQ-5Dtime to trade-off method (TTO)References<div><p>Torrance G. Measurement of health state utilities for economic appraisal. J Health Econ 1986; 5: 1-30.</p><p>Mark D.B., Simons Т.А. Fundamentals of economic analysis. Am Heart J 1999; 137: 38-40.</p><p>Investigating Health and Health Services - Research Methods in Health. Buckingham - Philadelphia: Open University Press, 1997; 79-98.</p><p>Marra C.A., Marion S.A., Guh D.P. et al. Not all «quality-adjusted life years» are equal. J Clin Epidemiol 2007; 60: 616-24.</p><p>Barton G.R., Sach T.H., Jenkinson C. et al. Do estimates of cost-utility based on the EQ-5D differ from those based on the mapping of utility scores? Health Qual Life Outcomes 2008; 6: 51-62.</p><p>Ariza-Ariza R., Hernandez-Cruz B., Carmona L. et al. Assessing utility values in rheumatoid arthritis: a comparison between time trade-off and the EuroQol. Arthr Rheum 2006; 55: 751-6.</p><p>Tijhuis G., Jansen S., Stiggelbout A. et al. Value of the time trade off method for measuring utilities in patients with rheumatoid arthritis. Ann Rheum Dis 2000; 59: 892-7.</p><p>Stiggelbout A.M., Kiebert G.M., Kievit J. et al. The «utility» of the Time Trade-Off method in cancer patients: feasibility and proportional Trade-Off. Clin Epidemiol 1995; 48: 1207-14.</p><p>Scott D., Koshaba B., Choy E. Limited correlation between the RAQ and EuroQol in rheumatoid arthritis: questionalble validity of deriving quality adjusted life years from HAQ. Ann Rheum Dis 2007; 66: 1534-7.</p><p>Witney A.G., Treharne G., Tavakoli M. et al. The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis. Rheumatology 2006; 45: 975-81.</p><p>Revicki D., Kaplan R. Relationship between psychometric and utility-based approaches to the measurement of health related quality of life. Qual Life Res 1993; 2: 477-87.</p></div><br /><div><p>Torrance G. Measurement of health state utilities for economic appraisal. J Health Econ 1986; 5: 1-30.</p><p>Mark D.B., Simons Т.А. Fundamentals of economic analysis. Am Heart J 1999; 137: 38-40.</p><p>Investigating Health and Health Services - Research Methods in Health. Buckingham - Philadelphia: Open University Press, 1997; 79-98.</p><p>Marra C.A., Marion S.A., Guh D.P. et al. Not all «quality-adjusted life years» are equal. J Clin Epidemiol 2007; 60: 616-24.</p><p>Barton G.R., Sach T.H., Jenkinson C. et al. Do estimates of cost-utility based on the EQ-5D differ from those based on the mapping of utility scores? Health Qual Life Outcomes 2008; 6: 51-62.</p><p>Ariza-Ariza R., Hernandez-Cruz B., Carmona L. et al. Assessing utility values in rheumatoid arthritis: a comparison between time trade-off and the EuroQol. Arthr Rheum 2006; 55: 751-6.</p><p>Tijhuis G., Jansen S., Stiggelbout A. et al. Value of the time trade off method for measuring utilities in patients with rheumatoid arthritis. Ann Rheum Dis 2000; 59: 892-7.</p><p>Stiggelbout A.M., Kiebert G.M., Kievit J. et al. The «utility» of the Time Trade-Off method in cancer patients: feasibility and proportional Trade-Off. Clin Epidemiol 1995; 48: 1207-14.</p><p>Scott D., Koshaba B., Choy E. Limited correlation between the RAQ and EuroQol in rheumatoid arthritis: questionalble validity of deriving quality adjusted life years from HAQ. Ann Rheum Dis 2007; 66: 1534-7.</p><p>Witney A.G., Treharne G., Tavakoli M. et al. The relationship of medical, demographic and psychosocial factors to direct and indirect health utility instruments in rheumatoid arthritis. Rheumatology 2006; 45: 975-81.</p><p>Revicki D., Kaplan R. Relationship between psychometric and utility-based approaches to the measurement of health related quality of life. Qual Life Res 1993; 2: 477-87.</p></div><br />

The authors declare that there are no conflicts of interest present.