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The quality-adjusted life year (QALY) is a generic measure of disease burden, including both the quality and the quantity of life lived. [1] [2] It is used in economic evaluation to assess the value of medical interventions. [1] One QALY equates to one year in perfect health. [2] QALY scores range from 1 (perfect health) to 0 (dead). [3]
As such, the ICER facilitates comparison of interventions across various disease states and treatments. In 2009, NICE set the nominal cost-per-QALY threshold at £50,000 for end-of-life care because dying patients typically benefit from any treatment for a matter of months, making the treatment's QALYs small. [3]
In HTAs it is usually expressed in quality-adjusted life years (QALYs). If, for example, intervention A allows a patient to live for three additional years than if no intervention had taken place, but only with a quality of life weight of 0.6, then the intervention confers 3 * 0.6 = 1.8 QALYs to the patient.
The Health Utilities Index (HUI) is a rating scale used to measure general health status and health-related quality of life (HRQoL). HUI questionnaires are designed to map onto two classification systems, HUI-2 and HUI-3, capable of measuring 24,000 and 972,000 unique health states, respectively.
For example, two treatments may provide the same extension of life, but one treatment might reduce the burden on the healthcare system while the other does not. These two treatments would be seen as providing the same value under the evLYG metric, despite the additional benefits provided by the latter.
Cost-effectiveness studies using QALYs, for example, do not discount time at different ages differently. [14] This age-weighting function applies only to the calculation of DALYs lost due to disability. Years lost to premature death are determined from the age at death and life expectancy.
The main steps in the translation process are forward translation, back translation, and cognitive debriefing (Animation video: Translating Patient Reported Outcome Measures for Use Around the World - The Example of EQ-5D). The goal of translation is to produce an EQ-5D version that has the same meaning as the English source version.
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