PS 1-52 HEALTH LITERACY AND LOGICAL INCONSISTENCIES IN VALUATIONS OF HYPOTHETICAL HEALTH STATES: RESULTS FROM THE CANADIAN EQ-5D-5L VALUATION STUDY

Sunday, October 23, 2016
Bayshore Ballroom ABC, Lobby Level (Westin Bayshore Vancouver)
Poster Board # PS 1-52

Fatima Al Sayah, PhD1, Jeffrey A Johnson, PhD1, Arto Ohinmaa, PhD1, Feng Xie, PhD2 and Nick Bansback, PhD3, (1)School of Public Health, University of Alberta, Edmonton, AB, Canada, (2)McMaster University, Hamilton, ON, Canada, (3)University of British Columbia; Centre for Clinical Epidemiology and Evaluation; Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada
Purpose: To examine the association between health literacy (the ability to obtain, read, understand, and communicate about health-related information needed to make informed health decisions) and logical inconsistencies of time trade off valuations of hypothetical health states described by the 5-level EuroQol 5 dimensions questionnaire (EQ-5D-5L) classification system.

Method: Data from the EQ-5D-5L Canadian Valuation study were used. Health literacy was assessed using 3 previously validated screening questions. A valuation was considered logically inconsistent if a respondent: 1) gave the same or lower value for a very mild health state compared to the value given to 55555; or 2) gave the same or lower value for a very mild health state compared to value assigned to the majority of the health states that are dominated by the very mild health state.

Result: The average age of the 1209 respondents was 48 (SD=17) years, and 45% were male. 7% of respondents reported inadequate health literacy, and 11% of respondents had logical inconsistencies. Respondents with inadequate health literacy were more likely to report a lower level of education, lower income, be of non-white ethnicity, be born outside Canada, reside in rural areas, have more comorbidities and previous experience with illness and have lower self-reported health. In adjusted logistic regression models, respondents with inadequate health literacy were 2.2 (95%CI: 1.2, 4.0; p=0.014) times more likely to provide a logical inconsistent valuation compared to those with adequate health literacy. More specifically, those who had problems in “understanding written information” (OR=1.7; 95%CI: 1.1, 2.8; p=0.031) and “reading health information” (OR=2.5; 95%CI: 1.6, 4.1; p<0.001) were more likely to have a logical inconsistency compared to those who did not. However, lacking “confidence in completing medical forms“ was not associated with logical inconsistencies.

Conclusion: Health literacy was associated with logical inconsistencies in valuations of hypothetical health states described by the EQ-5D-5L classification system. Valuations studies should consider assessing health literacy skills of participants, and explore better ways to introduce the valuation tasks or use simpler approaches of eliciting preferences of hypothetical health states for individuals with inadequate health literacy.

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