A Scoring Algorithm for Deriving Utility Values from the Neuro-QoL for Patients with Multiple Sclerosis

Louis S. Matza; Glenn Phillips; Barry Dewitt; Katie D. Stewart; David Cella; David Feeny; Janel Hanmer; Deborah M. Miller; Dennis A. Revicki

doi:10.1177/0272989X20951782

A Scoring Algorithm for Deriving Utility Values from the Neuro-QoL for Patients with Multiple Sclerosis

Louis S. Matza^*, Glenn Phillips, Barry Dewitt, Katie D. Stewart, David Cella, David Feeny, Janel Hanmer, Deborah M. Miller, Dennis A. Revicki

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Introduction: The Neuro-QoL is a standardized approach to assessing health-related quality of life in people with neurological conditions, including multiple sclerosis (MS). Item banks were developed with item response theory (IRT) methodology so items are calibrated along a continuum of each construct. The purpose of this study was to develop a preference-based scoring algorithm for the Neuro-QoL to derive utilities that could be used in economic modeling. Methods: With input from neurologists, 6 Neuro-QoL domains were selected based on relevance to MS and used to define health states for a utility elicitation study in the United Kingdom. General population participants and individuals with MS valued the health states and completed questionnaires (including Neuro-QoL short forms). The Neuro-QoL Utility Scoring System (NQU) was derived based on multi-attribute utility theory using data from the general population sample. Single-attribute disutility functions for 6 Neuro-QoL domains were estimated using isotonic regression with linear interpolation and then combined with a multiplicative model. NQU validity was assessed using MS participant data. Results: Interviews were completed with 203 general population participants (50.2% female; mean age = 45.0 years) and 62 participants with MS (62.9% female; mean age = 46.1 years). Mean (SD) NQU scores were 0.94 (0.06) and 0.82 (0.13) for the general population and MS samples, respectively. The NQU demonstrated known-groups validity by differentiating among subgroups categorized based on level of disability. The NQU demonstrated convergent validity via correlations with generic measures (0.66 and 0.63 with EQ-5D-5L and Health Utilities Index Mark 3, respectively; both P < 0.001). Discussion: With the NQU, utilities can be derived from any MS treatment group, subgroup, or patient sample who completes items from 6 Neuro-QoL domains. Because the Neuro-QoL is frequently used with MS patients, the NQU greatly expands the options for quantifying outcomes in cost-utility analyses conducted to inform allocation of resources for MS treatment.

Original language	English (US)
Pages (from-to)	897-911
Number of pages	15
Journal	Medical Decision Making
Volume	40
Issue number	7
DOIs	https://doi.org/10.1177/0272989X20951782
State	Published - Oct 1 2020

Funding

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: This study was funded by Biogen. GP was employed by Biogen at the time this study was conducted. LSM, KDS, and DAR are employees of Evidera, a company that received funding from Biogen for time spent on this research. BD, DC, DF, JH, and DMM received funding for time spent on this research. DF has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada. HUInc. distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of the HUI. We thank Freda Norquay and the Orkney MS Therapy Centre for assistance with MS patient recruitment; Ashley Duenas, Gordon Parola, Meredith Hoog, Timothy Howell, Christopher Langelotti, Naomi Knoble, and Ryan Pelkey for assistance with data collection; Christine Thompson for statistical programming; and Amara Tiebout for editorial support. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this study was provided by a contract with Biogen, but the authors had complete independence in designing the study, conducting the study, interpreting the data, and writing the manuscript.

Keywords

NQU
Neuro-QoL
Neuro-QoL utility scoring system
health state utilities
multi-attribute utility theory
multiple sclerosis

ASJC Scopus subject areas

Health Policy

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10.1177/0272989X20951782

Cite this

@article{6f9efeb944544277959e4697c0fa5851,

title = "A Scoring Algorithm for Deriving Utility Values from the Neuro-QoL for Patients with Multiple Sclerosis",

abstract = "Introduction: The Neuro-QoL is a standardized approach to assessing health-related quality of life in people with neurological conditions, including multiple sclerosis (MS). Item banks were developed with item response theory (IRT) methodology so items are calibrated along a continuum of each construct. The purpose of this study was to develop a preference-based scoring algorithm for the Neuro-QoL to derive utilities that could be used in economic modeling. Methods: With input from neurologists, 6 Neuro-QoL domains were selected based on relevance to MS and used to define health states for a utility elicitation study in the United Kingdom. General population participants and individuals with MS valued the health states and completed questionnaires (including Neuro-QoL short forms). The Neuro-QoL Utility Scoring System (NQU) was derived based on multi-attribute utility theory using data from the general population sample. Single-attribute disutility functions for 6 Neuro-QoL domains were estimated using isotonic regression with linear interpolation and then combined with a multiplicative model. NQU validity was assessed using MS participant data. Results: Interviews were completed with 203 general population participants (50.2% female; mean age = 45.0 years) and 62 participants with MS (62.9% female; mean age = 46.1 years). Mean (SD) NQU scores were 0.94 (0.06) and 0.82 (0.13) for the general population and MS samples, respectively. The NQU demonstrated known-groups validity by differentiating among subgroups categorized based on level of disability. The NQU demonstrated convergent validity via correlations with generic measures (0.66 and 0.63 with EQ-5D-5L and Health Utilities Index Mark 3, respectively; both P < 0.001). Discussion: With the NQU, utilities can be derived from any MS treatment group, subgroup, or patient sample who completes items from 6 Neuro-QoL domains. Because the Neuro-QoL is frequently used with MS patients, the NQU greatly expands the options for quantifying outcomes in cost-utility analyses conducted to inform allocation of resources for MS treatment.",

keywords = "NQU, Neuro-QoL, Neuro-QoL utility scoring system, health state utilities, multi-attribute utility theory, multiple sclerosis",

author = "Matza, {Louis S.} and Glenn Phillips and Barry Dewitt and Stewart, {Katie D.} and David Cella and David Feeny and Janel Hanmer and Miller, {Deborah M.} and Revicki, {Dennis A.}",

note = "Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: This study was funded by Biogen. GP was employed by Biogen at the time this study was conducted. LSM, KDS, and DAR are employees of Evidera, a company that received funding from Biogen for time spent on this research. BD, DC, DF, JH, and DMM received funding for time spent on this research. DF has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada. HUInc. distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of the HUI. Funding Information: We thank Freda Norquay and the Orkney MS Therapy Centre for assistance with MS patient recruitment; Ashley Duenas, Gordon Parola, Meredith Hoog, Timothy Howell, Christopher Langelotti, Naomi Knoble, and Ryan Pelkey for assistance with data collection; Christine Thompson for statistical programming; and Amara Tiebout for editorial support. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this study was provided by a contract with Biogen, but the authors had complete independence in designing the study, conducting the study, interpreting the data, and writing the manuscript. Publisher Copyright: {\textcopyright} The Author(s) 2020.",

year = "2020",

month = oct,

day = "1",

doi = "10.1177/0272989X20951782",

language = "English (US)",

volume = "40",

pages = "897--911",

journal = "Medical Decision Making",

issn = "0272-989X",

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T1 - A Scoring Algorithm for Deriving Utility Values from the Neuro-QoL for Patients with Multiple Sclerosis

AU - Matza, Louis S.

AU - Phillips, Glenn

AU - Dewitt, Barry

AU - Stewart, Katie D.

AU - Cella, David

AU - Feeny, David

AU - Hanmer, Janel

AU - Miller, Deborah M.

AU - Revicki, Dennis A.

N1 - Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: This study was funded by Biogen. GP was employed by Biogen at the time this study was conducted. LSM, KDS, and DAR are employees of Evidera, a company that received funding from Biogen for time spent on this research. BD, DC, DF, JH, and DMM received funding for time spent on this research. DF has a proprietary interest in Health Utilities Incorporated, Dundas, Ontario, Canada. HUInc. distributes copyrighted Health Utilities Index (HUI) materials and provides methodological advice on the use of the HUI. Funding Information: We thank Freda Norquay and the Orkney MS Therapy Centre for assistance with MS patient recruitment; Ashley Duenas, Gordon Parola, Meredith Hoog, Timothy Howell, Christopher Langelotti, Naomi Knoble, and Ryan Pelkey for assistance with data collection; Christine Thompson for statistical programming; and Amara Tiebout for editorial support. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Financial support for this study was provided by a contract with Biogen, but the authors had complete independence in designing the study, conducting the study, interpreting the data, and writing the manuscript. Publisher Copyright: © The Author(s) 2020.

PY - 2020/10/1

Y1 - 2020/10/1

N2 - Introduction: The Neuro-QoL is a standardized approach to assessing health-related quality of life in people with neurological conditions, including multiple sclerosis (MS). Item banks were developed with item response theory (IRT) methodology so items are calibrated along a continuum of each construct. The purpose of this study was to develop a preference-based scoring algorithm for the Neuro-QoL to derive utilities that could be used in economic modeling. Methods: With input from neurologists, 6 Neuro-QoL domains were selected based on relevance to MS and used to define health states for a utility elicitation study in the United Kingdom. General population participants and individuals with MS valued the health states and completed questionnaires (including Neuro-QoL short forms). The Neuro-QoL Utility Scoring System (NQU) was derived based on multi-attribute utility theory using data from the general population sample. Single-attribute disutility functions for 6 Neuro-QoL domains were estimated using isotonic regression with linear interpolation and then combined with a multiplicative model. NQU validity was assessed using MS participant data. Results: Interviews were completed with 203 general population participants (50.2% female; mean age = 45.0 years) and 62 participants with MS (62.9% female; mean age = 46.1 years). Mean (SD) NQU scores were 0.94 (0.06) and 0.82 (0.13) for the general population and MS samples, respectively. The NQU demonstrated known-groups validity by differentiating among subgroups categorized based on level of disability. The NQU demonstrated convergent validity via correlations with generic measures (0.66 and 0.63 with EQ-5D-5L and Health Utilities Index Mark 3, respectively; both P < 0.001). Discussion: With the NQU, utilities can be derived from any MS treatment group, subgroup, or patient sample who completes items from 6 Neuro-QoL domains. Because the Neuro-QoL is frequently used with MS patients, the NQU greatly expands the options for quantifying outcomes in cost-utility analyses conducted to inform allocation of resources for MS treatment.

AB - Introduction: The Neuro-QoL is a standardized approach to assessing health-related quality of life in people with neurological conditions, including multiple sclerosis (MS). Item banks were developed with item response theory (IRT) methodology so items are calibrated along a continuum of each construct. The purpose of this study was to develop a preference-based scoring algorithm for the Neuro-QoL to derive utilities that could be used in economic modeling. Methods: With input from neurologists, 6 Neuro-QoL domains were selected based on relevance to MS and used to define health states for a utility elicitation study in the United Kingdom. General population participants and individuals with MS valued the health states and completed questionnaires (including Neuro-QoL short forms). The Neuro-QoL Utility Scoring System (NQU) was derived based on multi-attribute utility theory using data from the general population sample. Single-attribute disutility functions for 6 Neuro-QoL domains were estimated using isotonic regression with linear interpolation and then combined with a multiplicative model. NQU validity was assessed using MS participant data. Results: Interviews were completed with 203 general population participants (50.2% female; mean age = 45.0 years) and 62 participants with MS (62.9% female; mean age = 46.1 years). Mean (SD) NQU scores were 0.94 (0.06) and 0.82 (0.13) for the general population and MS samples, respectively. The NQU demonstrated known-groups validity by differentiating among subgroups categorized based on level of disability. The NQU demonstrated convergent validity via correlations with generic measures (0.66 and 0.63 with EQ-5D-5L and Health Utilities Index Mark 3, respectively; both P < 0.001). Discussion: With the NQU, utilities can be derived from any MS treatment group, subgroup, or patient sample who completes items from 6 Neuro-QoL domains. Because the Neuro-QoL is frequently used with MS patients, the NQU greatly expands the options for quantifying outcomes in cost-utility analyses conducted to inform allocation of resources for MS treatment.

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KW - multi-attribute utility theory

KW - multiple sclerosis

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A Scoring Algorithm for Deriving Utility Values from the Neuro-QoL for Patients with Multiple Sclerosis

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Keywords

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