Identification, development and valuation of bolt-on dimensions for the EQ-5D-5L for use in health care decision-making.

Aureliano Paolo Finch is a first year PhD student in Health Economics and Decision Science at the School of Health and Related Research. Prior to moving to Sheffield, Aureliano graduated from the London School of Economics and the London School of Hygiene and Tropical Medicine joint programme "Health Policy, Planning and Financing". Aureliano has worked for one year as a White Helmet for the Caritas Brasileira Regional do Piaui, Parnaiba, Brazil, and for two years as a research fellow at Cergas - Bocconi University, Milan, Italy. Aureliano is a regular reviewer for Value in Health and Health Policy, and from the latter he was awarded the Outstanding Contribution in Reviewing, a prize given to the top 10th percentile of reviewers in terms of number of reviews completed for the journal. Aureliano is also a member of ISPOR and has published three peer-reviewed papers.

The title of Aureliano's PhD project, supervised by John E Brazier and Clara Mukuria, is: Identification, development and valuation of bolt-on dimensions for the EQ-5D-5L for use in health care decision-making.

The project aims to explore and develop methods for bolt on research of generic preference based measures of health as a means of improving the instruments validity and responsiveness.  This will involve several stages beginning with a comparison of different methods for identifying potentially relevant dimensions or potentially relevant areas of the EQ-5D-5L descriptive system where the addition of dimensions might be of interest. The project will go on to develop a group of bolt-ons, testing their impact on preferences for health states taken from the EQ-5D-5L and evaluating their effect on patients’ health states utility values.

Click this link to view a poster about Aureliano's research to date.

In this poster Aureliano presents the results of his critical overview of systematic reviews on the validity and responsiveness of preference based measures. The overview shows that the reviews found few studies with complete psychometric results and/or comparative evidence between generic preference based measures. Most of the known groups and responsiveness tests were considered weak (e.g. patients vs. general population) and there was poor reporting of psychometric criteria (e.g. validity cut-offs) and results. However, on the basis of what was found there is some evidence to support EQ-5D validity and responsiveness in some conditions within respiratory, endocrine and skin diseases, but not in hearing and vision, with mixed results in mental health and in diseases of the nervous system. Limited evidence on SF-6D supported validity in visual disorders but found problems in cardiovascular diseases. HUI3 was valid in some conditions of nervous system and mental health, but not in some neoplasms. There was support for 15D in some genitourinary and metabolic diseases, while the AQoL had good psychometric characteristics in nervous system diseases. However, there were many condition/instrument pairs where there was scarce or no evidence.  This highlights that the large amount of evidence produced to date provides only limited answers about generic preference based measures performance in different conditions. Consequently, this evidence give health technology assessment bodies little basis for selecting instruments and more comparative research is required using stronger tests of validity and responsiveness.