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Comparative Study
. 2019 Apr;37(4):609-620.
doi: 10.1007/s40273-019-00789-2.

Measuring Health Spillover Effects in Caregivers of Children with Autism Spectrum Disorder: A Comparison of the EQ-5D-3L and SF-6D

Clare C Brown  1 , J Mick Tilford  2 , Nalin Payakachat  3 , D Keith Williams  4 , Karen A Kuhlthau  5   6 , Jeffrey M Pyne  7 , Renske J Hoefman  8 , Werner B F Brouwer  8
Affiliations
Comparative Study

Measuring Health Spillover Effects in Caregivers of Children with Autism Spectrum Disorder: A Comparison of the EQ-5D-3L and SF-6D

Clare C Brown et al. Pharmacoeconomics. 2019 Apr.

Abstract

Background and objective: Healthcare interventions that improve the health of children with autism spectrum disorder (ASD) have the potential to affect the health of caregivers. This study compares the three-level EuroQoL-5 Dimension (EQ-5D-3L) and the Short Form-6 Dimension (SF-6D) in their ability to value such spillover effects in caregivers.

Methods: Clinical data collected from two Autism Treatment Network (ATN) sites was combined with survey data of caregivers of children diagnosed with ASD. Caregivers completed instruments by proxy describing child health and completed the EQ-5D-3L and SF-6D preference-weighted instruments to describe their own health.

Results: There was a strong correlation between the health utility scores of the two preference-weighted instruments (ρ = 0.6172, p < 0.001) measuring caregiver health-related quality of life. There was a similar correlation between both the SF-6D and EQ-5D-3L scores with a previously validated care-related quality of life measure (Care-related Quality of Life instrument [CarerQol-7D]) (ρ = 0.569, p < 0.001 and ρ = 0.541, p < 0.001, respectively). The mean SF-6D scores for caregivers differed significantly in relation to four of the five child health or behavior measures whereas the EQ-5D-3L differed for only two of them.

Conclusions: Health utility values of caregivers for children with ASD vary by the health characteristics of the child, suggesting significant potential for spillover effects. The comparison of the EQ-5D-3L and SF-6D demonstrated that both instruments can be used to estimate spillover effects of interventions to improve child health, but the SF-6D exhibited greater sensitivity to child health among children with ASD.

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Conflict of interest statement

Conflict of interest

Clare C. Brown, J. Mick Tilford, Nalin Payakachat, D. Keith Williams, Karen A. Kuhlthau, Jeffrey M. Pyne, Renske J. Hoefman, and Werner B.F. Brouwer have no conflicts of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Data availability

The datasets utilized and/or analyzed during the current study are available from the corresponding author on reasonable request.

Figures

Fig. 1
Fig. 1
Bland Altman plot demonstrating the relationship between the different between each health utility score with the average between the two scores for each parent (Combination Art, created in STATA® and edited in Adobe Photoshop). EQ-5D EuroQoL-5 Dimension, SF-6D Short Form-6 Dimension
See this image and copyright information in PMC

References

    1. Neumann PJ, Goldie SJ, Weinstein MC. Preference-based measures in economic evaluation in health care. Annu Rev Public Health. 2000;21:587–611. - PubMed
    1. Lipscomb J, Drummond M, Fryback D, Gold M, Revicki D. Retaining, and enhancing, the QALY. Value Health. 2009;12(Suppl 1):S18–S26. - PubMed
    1. Krol M, Papenburg J, van Exel J. Does including informal care in economic evaluations matter? A systematic review of inclusion and impact of informal care in cost-effectiveness studies. Pharmacoeconomics. 2015;32(2):123–135. - PubMed
    1. Basu A, Meltzer D. Implications of spillover effects within the family for medical cost-effectiveness analysis. J Health Econ. 2005;24(4):751–773. - PubMed
    1. Al-Janabi H, Flynn TN, Coast J. QALYs and carers. Pharmacoeconomics. 2011;29(12):1015–1023. - PubMed

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