Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter?

Torrance, Nicola, Lawson, Kenny, Afolabi, Ebenezer, Bennett, Michael I., Serpell, Michael G., Dunn, Kate M., and Smith, Blair H. (2014) Estimating the burden of disease in chronic pain with and without neuropathic characteristics: does the choice between the EQ-5D and SF-6D matter? Pain, 155 (10). pp. 1996-2004.

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Abstract

The EQ-5D and Short Form (SF)12 are widely used generic health-related quality of life (HRQoL) questionnaires. They can be used to derive health utility index scores, on a scale where 0 is equivalent to death and 1 represents full health, with scores less than zero representing states "worse than death." We compared EQ-5D or SF-6D health utility index scores in patients with no chronic pain, and chronic pain with and without neuropathic characteristics (NC), and to explore their discriminant ability for pain severity. Self-reported health and chronic pain status was collected as part of a UK general population survey (n = 4451). We found moderate agreement between individual dimensions of EQ-5D and SF-6D, with most highly correlated dimensions found for mental health and anxiety/depression, role limitations and usual activities, and pain and pain/discomfort. Overall 43% reported full health on the EQ-5D, compared with only 4.2% on the SF-6D. There were significant differences in mean utilities for chronic pain with NC (EQ-5D 0.47 vs SF-6D 0.62) and especially for severe pain (EQ-5D 0.33 vs SF-6D 0.58). On the EQ-5D, 17% of those with chronic pain with NC and 3% without NC scored "worse than death," a state which is not possible using the SF-6D. Health utilities derived from EQ-5D and SF-12/36 can discriminate between group differences for chronic pain with and without NC and greater pain severity. However, the instruments generate widely differing HRQoL scores for the same patient groups. The choice between using the EQ-5D or SF-6D matters greatly when estimating the burden of disease.

Item ID: 36690
Item Type: Article (Research - C1)
ISSN: 1872-6623
Keywords: chronic pain, EQ-5D, health-related quality of life, health utilities, neuropathic pain, SF-6D, S-LANSS
Additional Information:

©2014 The Authors. Published by Elsevier B.V. on behalf of International Association for the Study of Pain. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/). Open Access funded by Wellcome Trust.

Funders: Wellcome Trust (WT), Pfizer UK
Projects and Grants: WT 083572
Date Deposited: 03 Dec 2014 07:40
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1109 Neurosciences > 110904 Neurology and Neuromuscular Diseases @ 50%
14 ECONOMICS > 1402 Applied Economics > 140208 Health Economics @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920207 Health Policy Evaluation @ 50%
92 HEALTH > 9202 Health and Support Services > 920208 Health Inequalities @ 50%
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