EQ-5D-5L Valuation for the Malaysian Population
The aim of this study was to develop an EQ-5D-5L value set reflecting the health preferences of the Malaysian adult population.
Respondents were sampled with quotas for urbanicity, gender, age, and ethnicity to ensure representativeness of the Malaysian population. The study was conducted using a standardized protocol involving the EuroQol Valuation Technology (EQ-VT) computer-assisted interview system. Respondents were administered ten composite time trade-off (C-TTO) tasks and seven discrete choice experiment (DCE) tasks. Both linear main effects and constrained non-linear regression models of C-TTO-only data and hybrid models combining C-TTO and DCE data were explored to determine an efficient and informative model for value set prediction.
Data from 1125 respondents representative of the Malaysian population were included in the analysis. Logical consistency was present in all models tested. Using cross-validation, eight-parameter models for C-TTO only and C-TTO + DCE hybrid data displayed greater out-of-sample predictive accuracy than their 20-parameter, main-effect counterparts. The hybrid eight-parameter model was chosen to represent the Malaysian value set, as it displayed greater out-of-sample predictive accuracy over C-TTO data than the C-TTO-only model, and produced more precise estimates. The estimated value set ranged from − 0.442 to 1.
The constrained eight-parameter hybrid model demonstrated the best potential in representing the Malaysian value set. The presence of the Malaysian EQ-5D-5L value set will facilitate its application in research and health technology assessment activities.
The authors thank the interviewers of the study for their dedication to the project. The authors would also like to express gratitude to Rhu Yann Ho, Elly Stolk, Kristina Ludwig, Jan J.V. Busschbach, Arnd Prause, and Juan Manuel Ramos Goñi, for their support during the study. The authors also thank Hospital Universiti Sains Malaysia, Hospital Sungai Buloh, and Segi College Subang Jaya for providing the facilities for this study. Lastly, we would like to thank the Director General of Health Malaysia for his permission to publish this article.
AAS designed the study and acquired the necessary funding. AAS, AVT, and CJL coordinated the data collection process, assisted by NL and FAMY. KR, NL, AAS, and AVT conceived the analysis. AAS, AVT, and CJL came up with the first draft of the manuscript. Every author contributed in reviewing the analysis, results, and recommended revisions to the final manuscript to ensure accuracy and fair balance.
This study was co-funded by EuroQol Research Foundation and Universiti Sains Malaysia’s Research University Grant (1001/PFARMASI/811287).
Compliance with Ethical Standards
Conflict of interest
Nan Luo and Kim Rand-Hendriksen are members of the EuroQol Research Foundation. Asrul Akmal Shafie, Nan Luo, and Kim Rand-Hendriksen have received grants from EuroQol Research Foundation. There is no other conflict of interest.
The study received ethical approval from the Malaysia Medical Research & Ethics Committee (ID NMRR-13-1377-18574) and was conducted in accordance with the Declaration of Helsinki.
Informed consent was obtained from all individual participants included in the study.
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