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Shedding new light onto the ceiling and floor? A quantile regression approach to compare EQ‐5D and SF‐6D responses

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  • Janelle Seymour
  • Paul McNamee
  • Anthony Scott
  • Michela Tinelli

Abstract

An important issue in the measurement of health status concerns the extent to which an instrument displays lack of sensitivity to changes in health status at the extremes of the distribution, known as floor and ceiling effects. Previous studies use relatively simple methods that focus on the mean of the distribution to examine these effects. The aim of this paper is to determine whether quantile regression using longitudinal data improves our understanding of the relationship between quality of life instruments. The study uses EQ‐5D and SF‐36 (converted to SF‐6D values) instruments with both baseline and follow‐up data. Relative to ordinary least least‐squares (OLS), a first difference model shows much lower association between the measures, suggesting that OLS methods may lead to biased estimates of the association, due to unobservable patient characteristics. The novel finding, revealed by quantile regression, is that the strength of association between the instruments is different across different parts of the health distribution, and is dependent on whether health improves or deteriorates. The results suggest that choosing one instrument at the expense of another is difficult without good prior information surrounding the expected magnitude and direction of health improvement related to a health‐care intervention. Copyright © 2009 John Wiley & Sons, Ltd.

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  • Janelle Seymour & Paul McNamee & Anthony Scott & Michela Tinelli, 2010. "Shedding new light onto the ceiling and floor? A quantile regression approach to compare EQ‐5D and SF‐6D responses," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 683-696, June.
    • Handle: RePEc:wly:hlthec:v:19:y:2010:i:6:p:683-696
    DOI: 10.1002/hec.1505
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    References listed on IDEAS

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    Cited by:

    1. Gang Chen & Munir A. Khan & Angelo Iezzi & Julie Ratcliffe & Jeff Richardson, 2016. "Mapping between 6 Multiattribute Utility Instruments," Medical Decision Making, , vol. 36(2), pages 160-175, February.
    2. Gunasekara, Fiona Imlach & Carter, Kristie & Blakely, Tony, 2012. "Comparing self-rated health and self-assessed change in health in a longitudinal survey: Which is more valid?," Social Science & Medicine, Elsevier, vol. 74(7), pages 1117-1124.
    3. Carmen Selva-Sevilla & Paula Ferrara & Manuel Gerónimo-Pardo, 2020. "Interchangeability of the EQ-5D and the SF-6D, and comparison of their psychometric properties in a spinal postoperative Spanish population," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(4), pages 649-662, June.
    4. Lene Lunde, 2013. "Can EQ-5D and 15D be used interchangeably in economic evaluations? Assessing quality of life in post-stroke patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 539-550, June.
    5. Victor Champonnois & Olivier Chanel, 2016. "How useful are (Censored) Quantile Regressions for Contingent Valuation?," Working Papers 2016.12, FAERE - French Association of Environmental and Resource Economists.

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