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      Predicting EQ-5D-5L Utility Scores from the Oswestry Disability Index and Roland-Morris Disability Questionnaire for Low Back Pain

      1 , 2 , 3 , 3

      Journal of Pain Research

      Dove

      low back pain, EQ-5D-5L, utility score, QALY, health-related quality of life

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          Abstract

          Background

          Cost utility analysis is important for measuring the impact of chronic disease and helps clinicians and policymakers in patient management and policy decisions, but generic preference-based measures are not always considered in clinical studies.

          Objective

          To evaluate if health-related quality-of-life (HRQoL)-specific questionnaires used in chronic low back pain (CLBP) can predict EQ-5D-5L utility scores.

          Methods

          The data come from an online survey on low back pain conducted between October 2018 and January 2019. Health utility scores for EuroQol Five Dimensions Five Levels (EQ-5D-5L) were calculated with the recommended model of Xie et al. The EQ-5D-5L health states ranged from −0.148 for the worst (55555) to 0.949 for the best (11111). Univariate and multivariate linear regression were performed to predict EQ-5D-5L with Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ) and clinical variables.

          Results

          Analyses were performed in 408 subjects who completed the questionnaires EQ-5D-5L, ODI or RMDQ. Median (range) of EQ-5D-5L was 0.622 (−0.072 to 0.905). There was high correlation between EQ-5D-5L and ODI (r=−0.78, p<0.001), while it was moderate with RMDQ (r=−0.62, p<0.001). The multivariate model to predict EQ-5D-5L with ODI explained 67.6% of variability, and the correlation between actual and predicted EQ-5D-5L was 0.82. Principal predictors were ODI, duration of LBP, invalidity, health satisfaction (0–10 cm), life satisfaction (0–10 cm), and intensity of pain today (0–10 cm).

          Conclusion

          Data from this study demonstrated that individual correlation between ODI and EQ-5D-5L was high, but moderate with RMDQ. Correlations between actual and predicted EQ-5D-5L from multivariate models were higher and very high. Considering these results, the multivariate model can be used in similar studies for patient with CLBP to estimate the utility scores from the ODI when the EQ-5D-5L was not measured.

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          Most cited references 19

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          Non-specific low back pain.

          Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.
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            Chronic pain epidemiology and its clinical relevance.

            Chronic pain affects ∼20% of the European population and is commoner in women, older people, and with relative deprivation. Its management in the community remains generally unsatisfactory, partly because of lack of evidence for effective interventions. Epidemiological study of chronic pain, through an understanding of its distribution and determinants, can inform the development, targeting, and evaluation of interventions in the general population. This paper reviews current knowledge of risk markers associated with chronic pain and considers how these might inform management and prevention. Risk factors include socio-demographic, clinical, psychological, and biological factors. These are relevant to our understanding of chronic pain mechanisms and the nature of, and responses to, current and future treatments.
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              A Time Trade-off-derived Value Set of the EQ-5D-5L for Canada

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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                JPR
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                26 March 2020
                2020
                : 13
                : 623-631
                Affiliations
                [1 ]School of Public Health, Department of Management, Evaluation and Health Policy, University of Montreal , Montreal, QC, Canada
                [2 ]Centre de recherche de l’Institut universitaire en santé mentale de Montréal, CIUSSS de l’Est-de-l’Île-de-Montréal , Montreal, QC, Canada
                [3 ]Centre de recherche du CHUS, CIUSSS de l’Estrie-CHUS , Sherbrooke, QC, Canada
                Author notes
                Correspondence: Thomas G Poder School of Public Health, Department of Management, Evaluation and Health Policy, University of Montreal , Montreal, QC, Canada Email thomas.poder@umontreal.ca
                Article
                236957
                10.2147/JPR.S236957
                7125414
                © 2020 Poder and Carrier.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 3, Tables: 3, References: 28, Pages: 9
                Funding
                This work was supported by the HB-HTA unit of the CIUSSS de l’Estrie – CHUS.
                Categories
                Original Research

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