Article2000

Estimation of Utilities for the Effects of Depression From the SF-12

Leslie Andrew Lenert · Cathy Donald Sherbourne · Catherine A. Sugar · Kenneth Brooks Wells

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Health Systems, Economic Evaluations, Quality of Life Mental Health Treatment and Access Economic and Environmental Valuation

Abstract

BACKGROUND: Utilities for health conditions, including major depressive disorder, have a theoretical relationship to health-related quality of life (HRQOL). Because of the complexity of utility measurement and the existence of large numbers of completed studies with HRQOL data but not utility data, it would be desirable to be able to estimate utilities from measurements of HRQOL. OBJECTIVE: The objective of this study was to estimate utility for remission in major depression by use of information on associated variation in Short Form 12 (SF-12) scores. DESIGN: A mapping function for SF-12 scores (based on a 6-health-state model with patient-weighted preferences) was applied to longitudinal data from a large naturalistic study to estimate changes in utilities. SUBJECTS: Preference ratings for states were performed in a convenience sample of depressed primary care patients (n = 140). Outcomes were evaluated in patients in the Course of Depression Study (n = 295) with a DSM III diagnosis of depression at the onset of the study. MEASURES: From clinical interview data, differences in utilities and global physical and mental health-related quality of life at 1- and 2-year follow-up were compared for patients who did and did not experience remission as determined by the Course of Depression Interview. RESULTS: Remission of depression resulted in health status improvement, as measured by the SF-12, equivalent to a gain of 0.11 quality-adjusted life-years over 2 years. CONCLUSIONS: Utilities for changes in health status, associated with a clinical change in depression, can be modeled from the SF-12 scales, which results in utilities within the range of estimates described in the literature.

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1996A 12-Item Short-Form Health Survey 1992Measuring Functioning and Well-Being: The Medical Outcomes Study Approach 1993The Beaver Dam Health Outcomes study 1998Deriving a Preference-Based Single Index from the UK SF-36 Health Survey 1999Functioning and Utility for Current Health of Patients With Depression or Chronic Medical Conditions in Managed, Primary Care Practices 1998SF-36 Summary Scores 1998Patient-assigned health state utilities for depression-related outcomes: differences by depression severity and antidepressant medications 1999The design of Partners in Care: evaluating the cost-effectiveness of improving care for depression in primary care

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