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      German Value Set for the EQ-5D-5L

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          Abstract

          Objectives

          The objective of this study was to develop a value set for EQ-5D-5L based on the societal preferences of the German population. As the first country to do so, the study design used the improved EQ-5D-5L valuation protocol 2.0 developed by the EuroQol Group, including a feedback module as internal validation and a quality control process that was missing in the first wave of EQ-5D-5L valuation studies.

          Methods

          A representative sample of the general German population ( n = 1158) was interviewed using a composite time trade-off and a discrete choice experiment under close quality control. Econometric modeling was used to estimate values for all 3125 possible health states described by EQ-5D-5L. The value set was based on a hybrid model including all available information from the composite time trade-off and discrete choice experiment valuations without any exclusions due to data issues.

          Results

          The final German value set was constructed from a combination of a conditional logit model for the discrete choice experiment data and a censored at −1 Tobit model for the composite time trade-off data, correcting for heteroskedasticity. The value set had logically consistent parameter estimates ( p < 0.001 for all coefficients). The predicted EQ-5D-5L index values ranged from −0.661 to 1.

          Conclusions

          This study provided values for the health states of the German version of EQ-5D-5L representing the preferences of the German population. The study successfully employed for the first time worldwide the improved protocol 2.0. The value set enables the use of the EQ-5D-5L instrument in economic evaluations and in clinical studies.

          Electronic supplementary material

          The online version of this article (10.1007/s40273-018-0615-8) contains supplementary material, which is available to authorized users.

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          Most cited references10

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          A program of methodological research to arrive at the new international EQ-5D-5L valuation protocol.

          To describe the research that has been undertaken by the EuroQol Group to improve current methods for health state valuation, to summarize the results of an extensive international pilot program, and to outline the key elements of the five-level EuroQol five-dimensional (EQ-5D-5L) questionnaire valuation protocol, which is the culmination of that work.
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            Validating the EQ-5D with time trade off for the German population.

            The aim of this survey study was to derive the societal values of the general public for the EuroQol EQ-5D. Using the same protocol as previously used in the United Kingdom, we compared the German values with the British. In face-to-face interviews a sample of 339 individuals in northern Germany valued 15 different health states from a sample of 36 states. Values were derived using the York MVH protocol for time trade-off (TTO) and a visual analogue scale (VAS). Values for all 243 health states of the EQ-5D were estimated by a regression model. The VAS values revealed close a resemblance to the British VAS results. German TTO values were higher than the British. This was especially the case for the worse health states. The results suggest that the TTO values are more related to national variables than values derived by VAS. The use of the TTO values of this investigation makes it possible to anticipate these cultural differences in studies carried out in Germany.
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              Deleting 'irrational' responses from discrete choice experiments: a case of investigating or imposing preferences?

              Investigation of the 'rationality' of responses to discrete choice experiments (DCEs) has been a theme of research in health economics. Responses have been deleted from DCEs where they have been deemed by researchers to (a) be 'irrational', defined by such studies as failing tests for non-satiation, or (b) represent lexicographic preferences. This paper outlines a number of reasons why deleting responses from DCEs may be inappropriate after first reviewing the theory underpinning rationality, highlighting that the importance placed on rationality depends on the approach to consumer theory to which one ascribes. The aim of this paper is not to suggest that all preferences elicited via DCEs are rational. Instead, it is to suggest a number of reasons why it may not be the case that all preferences labelled as 'irrational' are indeed so. Hence, deleting responses may result in the removal of valid preferences; induce sample selection bias; and reduce the statistical efficiency and power of the estimated choice models. Further, evidence suggests random utility theory may be able to cope with such preferences. Finally, we discuss a number of implications for the design, implementation and interpretation of DCEs and recommend caution regarding the deletion of preferences from stated preference experiments. Copyright 2006 John Wiley & Sons, Ltd.
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                Author and article information

                Contributors
                +49 (0)521 106-4259 , kristina.ludwig@uni-bielefeld.de
                +49 (0)511 762-5083 , jms@ivbl.uni-hannover.de
                +49 (0)521 106-6989 , wolfgang.greiner@uni-bielefeld.de
                Journal
                Pharmacoeconomics
                Pharmacoeconomics
                Pharmacoeconomics
                Springer International Publishing (Cham )
                1170-7690
                1179-2027
                19 February 2018
                19 February 2018
                2018
                : 36
                : 6
                : 663-674
                Affiliations
                [1 ]ISNI 0000 0001 0944 9128, GRID grid.7491.b, Health Economics and Health Care Management, Bielefeld University, ; P.O. Box 10 01 31, 33501 Bielefeld, Germany
                [2 ]ISNI 0000 0001 2163 2777, GRID grid.9122.8, Center for Health Economics Research Hannover (CHERH), , Leibniz Universität Hannover, ; Otto-Brenner-Straße 1, 30159 Hannover, Germany
                Article
                615
                10.1007/s40273-018-0615-8
                5954069
                29460066
                e4246456-77be-4728-b07f-b9e92326adc6
                © The Author(s) 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100006419, EuroQol Research Foundation;
                Award ID: 2012020
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;
                Award ID: 01EH1201A
                Award Recipient :
                Categories
                Original Research Article
                Custom metadata
                © Springer International Publishing AG, part of Springer Nature 2018

                Economics of health & social care
                Economics of health & social care

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