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Mapping utility scores from the Barthel index

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Abstract

Purpose

It is not always possible to collect utility-based outcome data, like EQ-5D, needed for conducting economic evaluations in populations of older people. Sometimes, information on other non-utility outcome measures may have been collected. This paper examines the possibility of mapping the EQ-5D from a non-utility-based outcome, the Barthel index.

Methods

Data for 1,189 UK intermediate care patients were used. Ordinary least squares (OLS), censored least absolute deviations (CLAD) estimator and multinomial logistic (ML) models were used. The mean absolute error (MAE) and root-mean-squared error (RMSE) were used to estimate the predictive accuracy of eight regression models. Validation of primary models was carried out on random samples of data collected at admission and discharge.

Results

Models where the EQ-5D was entered as a continuous dependent variable and Barthel dimensions used as explanatory variables performed better. CLAD performed best on MAE and OLS on the RMSE, while the ML performed the worst on both measures. The CLAD predicted EQ-5D scores that matched the observed values more closely than the OLS.

Conclusions

It is possible to reasonably predict that the EQ-5D from the Barthel using regression methods and the CLAD model (4) is recommended.

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Acknowledgments

We are grateful to colleagues from the Universities of Birmingham and Leicester (the ICNET team) who participated in the National Evaluation of Intermediate Care Services from which data used in this study were obtained. We are also thankful to the intermediate care-coordinators and the staff from the case study sites that provided the quantitative data and clarified follow-up questions. Special thanks go to participants at the UK Health Economists Study Group meeting held at the University of York in July 2006 for comments on an earlier iteration of this work. The National Evaluation was funded by the Department of Health (Policy Research Programme) and the Medical Research Council. The funders were not involved in the study design, in the writing of the manuscript or in the decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Health Economics Unit, Public Health Building, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK

    Billingsley Kaambwa

  2. Cancer Research UK Clinical Trials Unit (CRCTU), University of Birmingham, Edbaston, Birmingham, B15 2TT, UK

    Lucinda Billingham

  3. MRC Midland Hub for Trials Methodology Research, University of Birmingham, Edbaston, Birmingham, B15 2TT, UK

    Lucinda Billingham

  4. Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Research Pavilion, 702-828 West 10th Ave, Vancouver, BC, Canada

    Stirling Bryan

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  1. Billingsley Kaambwa
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Correspondence to Billingsley Kaambwa.

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Kaambwa, B., Billingham, L. & Bryan, S. Mapping utility scores from the Barthel index. Eur J Health Econ 14, 231–241 (2013). https://doi.org/10.1007/s10198-011-0364-5

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