Assessments of Health Utilities in Patients With Metabolic Dysfunction-Associated Steatohepatitis: Cross-Walk Between Disease-Specific Chronic Liver Disease Questionnaire, Short Form SF-6D, and EuroQol EQ-5D Instruments

Background and Aims

The EuroQol-5D (EQ-5D) is a commonly used measure of health utilities to calculate quality-adjusted life years. For the clinical trials that use Chronic Liver Disease Questionnaire-nonalcoholic fatty liver disease (CLDQ-NAFLD) or Short Form-36 (SF-36), ability to convert the health-related quality of life scores (CLDQ-NAFLD or SF-36) to EQ-5D scores provides a valuable method to estimate health utility.

Methods

Baseline data of noncirrhotic metabolic dysfunction-associated steatohepatitis (MASH) patients were used in this study. We used 2 cross-walk algorithms to estimate EQ-5D scores. The first algorithm used 6 domains of CLDQ-NAFLD in a fractional logistic model to yield EQ-5D estimates. The other algorithm included calculation of SF-6D utility scores from SF-36 items, which were fed into a regression model that estimated EQ-5D scores from SF-6D scores.

Results

There were 883 MASH patients with CLDQ-NAFLD and SF-36 data: 25% ≥65 years, 44% male, 80% obese (body mass index >30), 67% type 2 diabetes, 62% F3 fibrosis, and 38% F1B/F2 fibrosis. The mean estimated EQ-5D scores were 0.851 (standard deviation = 0.146) according to CLDQ-NAFLD-based algorithm and 0.853 (standard deviation = 0.097) according to the SF-36-based algorithm. The correlations between the 2 estimated EQ-5D scores were up to +0.74. Similar to the total sample, the differences between the mean EQ-5D estimates using either calculation method did not exceed 0.012 in all studied subgroups (by age, sex, obesity, type 2 diabetes, and fibrosis stage).

Conclusion

Both cross-walk algorithms for the calculation of the EQ-5D utility scores in MASH patients were estimable with CLDQ-NAFLD or SF-36 instruments. A high positive correlation was seen between the total score and subgroup estimates using either method.