Thakumar, Annushiah Vasan
(2020)
Valuation Of Eq-5d-5l Study For The
Malaysian Population.
PhD thesis, Universiti Sains Malaysia.
Abstract
With the rise of healthcare expenditure, prudent resource allocation decisions
become vital and economic evaluations offer valuable information in guiding these
decisions. Cost-utility analysis is one such alternative with outcomes measured using
quality-adjusted life years (QALYs). QALYs takes into consideration health
preference weights, with generic preference-based measures (PBMs) being most
commonly used to generate these weights. One of the most widely used instrument todate,
EQ-5D-5L has informed economic evaluation decisions throughout the world.
However, Malaysia has yet to validate the measure and apply it to generate a countryspecific
value set. Therefore, the main objective of this thesis is to estimate a valid EQ-
5D-5L value set for Malaysians. Two focus group discussions (FGDs) were held to
explore the EQ-5D-5L dimensions understanding in Malaysians and investigate
potential dimensions (bolt-ons) that may complement the concept of health. Next,
using 100 conveniently sampled respondents, the influence of these identified bolt-ons
on the current EQ-5D-5L dimensions were tested in a pilot setting in Penang.
Subsequently, employing a cross-sectional multi-stage sampling design, an EQ-5D-5L
nationwide valuation study was carried out by 18 trained interviewers on 1137
Malaysian general population. The psychometric properties of EQ-5D-5L were also
assessed in the process. A variety of modelling methods were fitted onto the valuation
data and performance of these models in predicting health state values were assessed
using robust techniques. Another value set was estimated, but applying an earlier
version of the instrument, EQ-5D-3L.
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