Reliability and validity of using EQ-5D-5L among healthy and adolescents with major mental health disorders in Ethiopia.

BACKGROUND: The EQ-5D is a validated and widely used generic measure of health-related quality of life (HRQoL) in both healthy individuals and those with various medical conditions. The objective of this study was to test whether EQ-5D-5L is reliable and valid for use among school sample adolescents and those with major mental health disorders in Ethiopia. METHODS: Participants were recruited from ten sub-districts comprising the Butajira Rural Health Programme (BRHP) and Butajira major mental health disorders center. Data were collected using an Amharic (Ethiopia) EQ-5D-5L self-complete-paper and the questionnaire was administered 10 days after the first completion for test-retest procedures. Two-way mixed-effects models absolute intraclass correlation coefficient (ICC) was used to test reliability of the instrument while Kruskal-Wallis rank test with pairwise comparison was used to assess the known group validity of the instrument. RESULTS: There were 501 (201 school sample and 300 adolescents with major mental health disorders) participants recruited and 497 were included in the sample for analysis. The ICC was high (ICC > 0.7, p < 0.001) for all EQ-5D-5L dimensions, EQ-5D-5L utility index and EQ-VAS scores. The findings revealed that the Amharic EQ-5D-5L has significant known group validity as shown by the difference in scores among various disease group (depression, schizophrenia, and bipolar) and experience of chronic illness. CONCLUSIONS: The results shows that the Amharic EQ-5D-5L is reliable and valid instrument for the measurement of HRQoL among adolescent populations in Ethiopia.

Valuing Health State: An EQ-5D-5L Value Set for Ethiopians.

OBJECTIVES: There is a growing interest in health technology assessment and economic evaluations in developing countries such as Ethiopia. The objective of this study was to derive an EQ-5D-5L value set from the Ethiopian general population to facilitate cost utility analysis. METHODS: A nationally representative sample (N = 1050) was recruited using a stratified multistage quota sampling technique. Face-to-face, computer-assisted interviews using the EuroQol Portable Valuation Technology (EQ-PVT) protocol of composite time trade-off (c-TTO) and discrete choice experiments (DCEs) were undertaken to elicit preference scores. The feasibility of the EQ-PVT protocol was pilot tested in a sample of the population (n = 110). A hybrid regression model combining c-TTO and DCE data was used to estimate the final value set. RESULTS: In the pilot study, the acceptability of the tasks was good, and there were no special concerns with undertaking the c-TTO and DCE tasks. The coefficients generated from a hybrid model were logically consistent. The predicted values for the EQ-5D-5L ranged from -0.718 to 1. Level 5 anxiety/depression had the largest impact on utility decrement (-0.458), whereas level 5 self-care had the least impact (-0.222). The maximum predicted value beyond full health was 0.974 for the 11112 health state. CONCLUSIONS: This is the first EQ-5D-5L valuation study in Africa using international valuation methods (c-TTO and DCE) and also the first using the EQ-PVT protocol to derive a value set. We expect that the availability of this value set will facilitate health technology assessment and health-related quality-of-life research and inform policy decision making in Ethiopia.