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Discrepancies between the Dermatology Life Quality Index and utility scores

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Abstract

Objective

In many jurisdictions, deterioration in quality of life assessed with Dermatology Life Quality Index (DLQI) is used for medical and reimbursement decisions in various dermatological conditions such as psoriasis. However, utility values for health states defined by the DLQI have not yet been evaluated. Therefore, we aim to estimate utilities for different health states described by the ten items of the DLQI.

Methods

A cross-sectional survey was performed in a convenience sample of the general population. Seven DLQI health states with total scores of 6, 11 and 16 (3–3 and 1 states, respectively) were developed. All of them were different from each other in the number of affected items and severity levels of impairment. The 10-year time trade-off method was used to value health states.

Results

Mean utilities elicited by the respondents (n = 308) for the three 6-, three 11- and one 16-point DLQI health states were 0.62–0.75, 0.59–0.66, and 0.56, respectively. In half of the six pairwise comparisons, where health states with the same total DLQI score were compared, significant difference between utilities was found. In eight out of the 15 comparisons between health states with different DLQI scores, utilities were not significantly different.

Conclusions

Utility values for health states with identical DLQI total score may significantly vary. This result might be generalisable to various patient populations, in which the DLQI is used; nevertheless, further research is needed. The discrepancies between DLQI scores and utilities might have an impact on medical and reimbursement decisions as they make the utility gain from treatment uncertain.

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Acknowledgments

The authors are grateful to Mrs. Vivien Papp-Surányi, an undergraduate student at the Faculty of Economics, Corvinus University of Budapest, for her assistance in carrying out the web survey.

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Authors and Affiliations

  1. Department of Health Economics, Corvinus University of Budapest, Fővám tér 8., Budapest, 1093, Hungary

    Fanni Rencz, Petra Baji, László Gulácsi, Márta Péntek & Valentin Brodszky

  2. Semmelweis University Doctoral School of Clinical Medicine, Üllői út 26., Budapest, 1085, Hungary

    Fanni Rencz

  3. Department of Dermatology, Venereology and Dermatooncology, Semmelweis University, Mária u. 41., Budapest, 1085, Hungary

    Sarolta Kárpáti & Adrienn Katalin Poór

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  1. Fanni Rencz
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Correspondence to Valentin Brodszky.

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The authors declare that they have no conflict of interest.

Ethical standard

Ethical approval was obtained from Semmelweis University Regional and Institutional Committee of Science and Research Ethics (Reference No. 58./2015).

Human and animal rights

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.

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

Appendix: Example TTO task

Appendix: Example TTO task

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Rencz, F., Baji, P., Gulácsi, L. et al. Discrepancies between the Dermatology Life Quality Index and utility scores. Qual Life Res 25, 1687–1696 (2016). https://doi.org/10.1007/s11136-015-1208-z

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