The PRET project: Preparation for the re-evaluation of the EQ-5D tariff

Project overview

Resources are limited and need to be allocated efficiently. The National Institute for Health and Clinical Excellence (NICE) was set up to help make better health care resource allocation decisions. NICE bases its recommendations on cost effectiveness, and the EQ-5D is the preferred instrument to use when quantifying the health related quality of life impact of medical interventions. EQ-5D is a tool that classifies 243 different health states with 5 different dimensions of health (mobility, self care, usual activities, pain/discomfort, anxiety/depression), each with an identified level of severity.

NICE uses an EQ-5D "tariff". This is a set of numbers that indicate the level of health related quality of life of each EQ-5D health state, on a scale with 1 for full health and 0 for dead (range -0.594 to 1, where negative values are valued as worse than dead). By comparing the different EQ-5D health states patients are in before and after treatment, analysts can calculate how effective the treatment is.

The current EQ-5D tariff is based on a survey in 1994. The study asked members of the general public to "value" a selection of hypothetical EQ-5D states using a specifically designed questionnaire. However, in the past 15 years, there have been various developments that have lead to the need for a "re-evaluation" of the EQ-5D. In order for NICE to make the most appropriate decisions, the EQ-5D population value set needs to be one that is up to date, based on the latest understanding of how to value health states.

The PRET project is a methodological piece of work that will contribute to the re-evaluation of the EQ-5D tariff. The aim is to produce a protocol for an actual re-evaluation study to use. The project will look into different ways of survey members of the public including online surveys and face to face interviews. The project will look at different ways of designing and wording the questionnaire to value hypothetical EQ-5D health states, or which EQ-5D health states to use. The first stage is a large scale online survey to gauge the relevant concerns, where a long list of issues can be explored by surveying a large number of people, but not in much detail. The second stage is a smaller scale interview study, where researchers can ask participants more detailed questions. The final stage of the project is to test out a recommended study protocol for the actual re-evaluation study to use, and make any further fine tuning adjustments.

Further information

For further information about this project please contact Brendan Mulhern or Aki Tsuchiya.