Qual Life Res. 2021 May;30(5):1445-1455., 14-01-2021

Valuing health-related quality of life using a hybrid approach: Tunisian value set for the EQ-5D-3L

Chemli J, Drira C, Felfel H, Roudijk B, Al Sayah F, Kouki M, Kooli A, Razgallah Khrouf M


Objective: To develop a value set for EQ-5D-3L based on the societal preferences of the Tunisian population. Methods: A representative sample of the Tunisian general population was obtained through multistage quota sampling involving age, gender and region. Participants (n = 327), aged above 20 years, were interviewed using the EuroQol Portable Valuation Technology in face-to-face computer-assisted interviews. Participants completed 10 composite time trade-off (cTTO) and 10 discrete choice experiments (DCE) tasks. Utility values for the EQ-5D-3L health states were estimated using regression modeling. The cTTO and DCE data were analyzed using linear and conditional logistic regression modeling, respectively. Multiple hybrid models were computed to analyze the combined data and were compared on goodness of fit measured by the Akaike information criterion (AIC). Results: A total of 300 participants with complete data that met quality criteria were included. All regression models showed both logical consistency and significance with respect to the parameter estimates. A hybrid model accounting for heteroscedasticity presented the lowest value for the AIC among the hybrid models. Hence, it was used to construct the Tunisian EQ-5D-3L valuation set with a range of predicted values from − 0.796 to 1.0. Conclusion: This study provides utility values for EQ-5D-3L health states for the Tunisian population. This value set will be used in economic evaluations of health technologies and for Tunisian health policy decision-making.

Composite time trade-off; Discrete choice experiment; EQ-5D-3L; Health measurement; Health-related quality of life; Tunisian value set.