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Janesh K Gupta, Jane P Daniels, Lee J Middleton, Helen M Pattison, Gail Prileszky, Tracy E Roberts, Sabina Sanghera, Pelham Barton, Richard Gray, Joe Kai & on behalf of the ECLIPSE Collaborative Group.

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Janesh K Gupta ^1,2, Jane P Daniels ^3,*, Lee J Middleton ³, Helen M Pattison ⁴, Gail Prileszky ⁵, Tracy E Roberts ⁶, Sabina Sanghera ⁶, Pelham Barton ⁶, Richard Gray ⁷, Joe Kai ⁵,

¹ School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
² Birmingham Women’s Hospital NHS Foundation Trust, Edgbaston, Birmingham, UK
³ Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
⁴ School of Health and Life Sciences, Aston University, Birmingham, UK
⁵ Division of Primary Care, University of Nottingham, Nottingham, UK
⁶ Health Economics Unit, University of Birmingham, Birmingham, UK
⁷ Clinical Trials Service Unit, University of Oxford, Oxford, UK
^* Corresponding author Email: j.p.daniels@bham.ac.uk

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https://doi.org/{{metadata.DOI}}

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Response by Paul Kind on 2 February 2017 at 3:19 PM
Unacceptable practice?
An account is given of the methods used to estimate utility weights for QALY computation. As stated the text reads: Utility values for the individual states were calculated by averaging the EQ-5D and SF-6D values obtained by each woman in the given state at any given. This is completely lacking in any sustainable methodology. EQ-5D weights are generated using TIme Trace-Off (TTO) and SF-6D weights are generated using Standard Gamble. TTO utility weights and SG weights are systematically different (even NICE Guidance recognises this widely accepted fact). It is not possible to convert TTO weights into SG weights since the relationship between the two systems is unknown. The arithmetic aggregation of two numeric values from wholly different metrics defies credibility - would anyone take the average of a height expressed in terms of cms and inches? There must have been a reason behind this heroic assumption that the two utility weights should be aggregated in this way. That in turn suggests that the researchers were aware of differences that might emerge if the two systems were applied independently. It is imperative that a proper account is given of the justification for the current practice. Without such an explanation the entire economic evaluation risks being little short of meaningless.

Response by Tracy Roberts on 2 February 2017 at 10:42 AM
Response by author

The sentence quoted is at the start of the second paragraph under the heading “Quality-of-life measures”. We agree that, taken in isolation, the sentence quoted could be interpreted in the way the commenter says. However, it should be clear from the rest of the chapter that what we actually did was carry out completely separate analysis first using EQ-5D values only and secondly using SF-6D values only. For example, at the beginning of the Results section we said “The results of the base-case analysis and sensitivity analyses are presented in two parts. Part 1 depicts the results using the EQ-5D for the outcome at 2 years and 5 years. Part 2 shows the results using the SF-6D for 2 years and 5 years.” In the sentence quoted, we should perhaps have said “averaging the EQ-5D or SF-6D values” as we did in the sentence immediately before the one quoted.