Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease

Abstract Background Health economic evaluation is critical in supporting novel cardiovascular disease therapies. However, most clinical studies do not include preference-based questionnaires to calculate utilities for health economic evaluations. Thus, this study aimed to develop mapping algorithms...

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Main Authors: Chaofan Li, Lei Dou, Qiang Fu, Shunping Li
Format: Article
Language:English
Published: BMC 2023-07-01
Series:Health and Quality of Life Outcomes
Subjects:
Online Access:https://doi.org/10.1186/s12955-023-02151-9
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author Chaofan Li
Lei Dou
Qiang Fu
Shunping Li
author_facet Chaofan Li
Lei Dou
Qiang Fu
Shunping Li
author_sort Chaofan Li
collection DOAJ
description Abstract Background Health economic evaluation is critical in supporting novel cardiovascular disease therapies. However, most clinical studies do not include preference-based questionnaires to calculate utilities for health economic evaluations. Thus, this study aimed to develop mapping algorithms that convert the Seattle Angina Questionnaire (SAQ) to EQ-5D-5L health utility scores for patients with coronary health disease (CHD) in China. Methods Data were obtained from a longitudinal study of patients with CHD conducted at the Tianjin Medical University General Hospital in China. Convenience sampling was used to recruit patients with CHD. The inclusion criteria were having been diagnosed with CHD through a medical examination and being aged 18 years or older. The exclusion criteria were a lack of comprehension ability, serious comorbidities, mental illness, and hearing or vision impairment. All eligible patients were invited to participate, and 305 and 75 patients participated at baseline and in the follow-up, respectively. Seven regression models were developed using a direct approach. Furthermore, we predicted the five EQ-5D items using ordered logit model and derived the utility score from predicted responses using an indirect approach. Model performances were evaluated using mean absolute error (MAE), root mean squared error (RMSE), correlation coefficient (ρ), and Lin’s concordance correlation coefficient (CCC). A five-fold cross-validation method was used to evaluate internal validation. Results The average age was 63.04 years, and 53.72% of the included patients were male. Most (70.05%) patients had unstable angina pectoris, and the mean illness duration was 2.50 years. The EQ-5D scores were highly correlated with five subscales of the SAQ, with Spearman’s rank correlation coefficients ranging from 0.6184 to 0.7093. The mixture beta model outperformed the other regression models in the direct approach, with the lowest MAE and RMSE and highest ρ and CCC. The ordered logit model in the indirect approach performed the same as the mixture beta regression with equal MAE, lower RMSE, and higher ρ and CCC. Conclusion Mapping algorithms developed using mixture beta and ordered logit models accurately converted SAQ scores to EQ-5D-5L health utility values, which could support health economic evaluations related to coronary heart disease.
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spelling doaj.art-3785177af11749f29b08c24d4f7e38f42023-07-09T11:25:43ZengBMCHealth and Quality of Life Outcomes1477-75252023-07-012111910.1186/s12955-023-02151-9Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart diseaseChaofan Li0Lei Dou1Qiang Fu2Shunping Li3Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong UniversityCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong UniversityDepartment of Cardiovascular Surgery, General Hospital of Tianjin Medical UniversityCentre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong UniversityAbstract Background Health economic evaluation is critical in supporting novel cardiovascular disease therapies. However, most clinical studies do not include preference-based questionnaires to calculate utilities for health economic evaluations. Thus, this study aimed to develop mapping algorithms that convert the Seattle Angina Questionnaire (SAQ) to EQ-5D-5L health utility scores for patients with coronary health disease (CHD) in China. Methods Data were obtained from a longitudinal study of patients with CHD conducted at the Tianjin Medical University General Hospital in China. Convenience sampling was used to recruit patients with CHD. The inclusion criteria were having been diagnosed with CHD through a medical examination and being aged 18 years or older. The exclusion criteria were a lack of comprehension ability, serious comorbidities, mental illness, and hearing or vision impairment. All eligible patients were invited to participate, and 305 and 75 patients participated at baseline and in the follow-up, respectively. Seven regression models were developed using a direct approach. Furthermore, we predicted the five EQ-5D items using ordered logit model and derived the utility score from predicted responses using an indirect approach. Model performances were evaluated using mean absolute error (MAE), root mean squared error (RMSE), correlation coefficient (ρ), and Lin’s concordance correlation coefficient (CCC). A five-fold cross-validation method was used to evaluate internal validation. Results The average age was 63.04 years, and 53.72% of the included patients were male. Most (70.05%) patients had unstable angina pectoris, and the mean illness duration was 2.50 years. The EQ-5D scores were highly correlated with five subscales of the SAQ, with Spearman’s rank correlation coefficients ranging from 0.6184 to 0.7093. The mixture beta model outperformed the other regression models in the direct approach, with the lowest MAE and RMSE and highest ρ and CCC. The ordered logit model in the indirect approach performed the same as the mixture beta regression with equal MAE, lower RMSE, and higher ρ and CCC. Conclusion Mapping algorithms developed using mixture beta and ordered logit models accurately converted SAQ scores to EQ-5D-5L health utility values, which could support health economic evaluations related to coronary heart disease.https://doi.org/10.1186/s12955-023-02151-9Coronary heart diseaseHealth-related quality of lifeSeattle angina questionnaireHealth utilityEQ-5D-5L
spellingShingle Chaofan Li
Lei Dou
Qiang Fu
Shunping Li
Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
Health and Quality of Life Outcomes
Coronary heart disease
Health-related quality of life
Seattle angina questionnaire
Health utility
EQ-5D-5L
title Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
title_full Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
title_fullStr Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
title_full_unstemmed Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
title_short Mapping the Seattle Angina Questionnaire to EQ-5D-5L in patients with coronary heart disease
title_sort mapping the seattle angina questionnaire to eq 5d 5l in patients with coronary heart disease
topic Coronary heart disease
Health-related quality of life
Seattle angina questionnaire
Health utility
EQ-5D-5L
url https://doi.org/10.1186/s12955-023-02151-9
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