From clinically relevant outcome measures to quality of life in epilepsy: A time trade-off study

Reina J A de Kinderen*, Ben F M Wijnen, Gerard van Breukelen, Debby Postulart, Marian H J M Majoie, Albert P Aldenkamp, Silvia M A A Evers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


OBJECTIVES: A proposed method for bridging the gap between clinically relevant epilepsy outcome measures and quality-adjusted life years is to derive utility scores for epilepsy health states. The aim of this study is to develop such a utility-function and to investigate the impact of the epilepsy outcome measures on utility.

METHODS: Health states, based on clinically important epilepsy attributes (e.g. seizure frequency, seizure severity, side-effects), were valued by a sample of the Dutch population (N=525) based on the time trade-off method. In addition to standard demographics, every participant was asked to rate 10 or 11 different health state scenarios. A multilevel regression analysis was performed to account for the nested structure of the data.

RESULTS: Results show that the best health state (no seizures and no side-effects) is estimated at 0.89 and the worst state (seizures type 5 twice a day plus severe side-effects) at 0.22 (scale: 0-1). An increase in seizure frequency, occurrence of side-effects, and seizure severity were all significantly associated with lower utility values. Furthermore, seizure severity has the largest impact on quality of life compared with seizure frequency and side-effects.

CONCLUSIONS: This study provides a utility-function for transforming clinically relevant epilepsy outcome measures into utility estimates. We advise using our utility-function in economic evaluations, when quality of life is not directly measured in a study and hence, no health state utilities are available, or when there is convincing empirical evidence of the insensitivity of a generic quality-of-life-instrument within epilepsy.

Original languageEnglish
Pages (from-to)24-31
Number of pages8
JournalEpilepsy Research
Publication statusPublished - Sept 2016


  • Quality of life
  • Preference-based
  • Cost-utility
  • Time trade-off
  • Epilepsy
  • EQ-5D
  • TTO


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