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Balázs PG, Łaszewska A, Simon J, Brodszky V. Population normative data for OxCAP-MH capability scores. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-024-01696-w. [PMID: 38789619 DOI: 10.1007/s10198-024-01696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
AIM The study aims to establish the first set of normative data for OxCAP-MH capability instrument and to examine its association with sociodemographic and anxiety/depression severity variables. METHODS A large-sample cross-sectional online survey was conducted among the Hungarian adult general population in 2021. OxCAP-MH standardized mean scores were compared across age, sex, education level, residence, employment, and marital status. Linear regression analysis was employed to determine the impact of sociodemographic and anxiety/depression severity on the OxCAP-MH score. RESULTS In total, N = 2000 individuals completed the survey. The sample mean age was 47.1, with female majority (53.4%). Most respondents had completed primary education (51%), were active on labour market (52.4%), lived in larger cities (70.0%), and were married/in relationship (61.1%). Nearly half of the participants reported experiencing depression (48.5%), anxiety (44.3%), and 38.6% reported having both. The mean OxCAP-MH score for the total sample was 67.2 (SD = 14.4), the highest in the non-depressed (74.4) and non-anxious (73.6) subgroups, the lowest among those with extremely severe depression (45.0) and severe anxiety (47.7). Regression results indicated that older individuals (by β = 0.1), males (β = 2.3), those with secondary or higher education (β = 2.7 and 4.5) and students (β = 6.8) had significantly (p<0.01) higher mental capabilities. Respondents with mild, moderate, severe, or extremely severe depression (β = -6.6, -9.6, -13.8, -18.3) and those with mild, moderate, or severe anxiety (β = -4.1, -7.7, -10.3) had lower capability scores. CONCLUSION The OxCAP-MH instrument effectively differentiated capabilities across sociodemographic groups and highlighting the impact of depression and anxiety severity on general population's mental capability.
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Affiliation(s)
- Péter György Balázs
- Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary.
| | - Agata Łaszewska
- Department of Health Economics, Medical University of Vienna, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Medical University of Vienna, Vienna, Austria
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Valentin Brodszky
- Department of Health Policy, Corvinus University of Budapest, Budapest, Hungary
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van der Boor CF, Taban D, Ismail K, Simon J, Roberts B, Fuhr D, Tol WA, Greco G. Measuring refugees' capabilities: translation, adaptation, and valuation of the OxCAP-MH into Juba Arabic for use among South Sudanese male refugees in Uganda. J Patient Rep Outcomes 2024; 8:40. [PMID: 38564035 PMCID: PMC10987405 DOI: 10.1186/s41687-024-00720-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/24/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Forcibly displaced populations are highly vulnerable to psychosocial distress and mental disorders, including alcohol misuse. In an ongoing trial that seeks to develop a transdiagnostic intervention addressing psychological distress and alcohol use disorders among conflict-affected populations, we will carry out a cost-effectiveness evaluation using a capability-based Oxford Capabilities Mental Health (OxCAP-MH) measure. The OxCAP-MH is a 16-item questionnaire developed from the Capability Approach, that covers multiple domains of functioning and welfare. The aim of the current paper is to present the results of the translation, cultural adaptation and valuation of the OxCAP-MH into Juba Arabic for South Sudanese refugees living in Uganda. We adhered to the official Translation and Linguistic Validation process of the OxCAP-MH. To carry out the translation, the Concept Elaboration document, official English version of the OxCAP-MH, and the Back-Translation Review Template were used. Four independent translators were used for forward and back translations. The reconciled translated version was then piloted in two focus group discussions (N = 16) in Rhino refugee settlement. A most important to least important valuation of the sixteen capability domains covered in the OxCAP-MH was also done. RESULTS The Juba Arabic version of the OxCAP-MH was finalized following a systematic iterative process. The content of the Juba Arabic version remained unchanged, but key concepts were adapted to ensure cultural acceptability, feasibility, and comprehension of the measure in the local context of Rhino refugee settlement. Most participants had low levels of literacy and required support with filling in the tool. Participants suggested an additional capability that is currently not reflected in the OxCAP-MH, namely access to food. Furthermore, discussions around the valuation exercise of the sixteen domains led to two separate importance scales, which showed relevant differences. CONCLUSIONS In this context, the OxCAP-MH was considered culturally acceptable. The valuation exercise proved cognitively demanding. Participants voiced confusion over how to answer the questions on the OxCAP-MH instrument due to low levels of literacy. These concerns invite consideration for future research to consider how measures such as the OxCAP-MH can be made more accessible to individuals with low literacy rates in resource poor settings.
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Affiliation(s)
- C F van der Boor
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK.
| | - D Taban
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - K Ismail
- HealthRight International, Plot 855, Mawanda Road -Kamwokya, Kampala, Uganda
| | - J Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, Vienna, 1090, Austria
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - B Roberts
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
| | - D Fuhr
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Achterstraße, 30D-28359, Bremen, Germany
- Health Sciences, University of Bremen, Bremen, Germany
| | - W A Tol
- Department of Public Health, University of Copenhagen, Bartholinsgade 4, bg. 9, 1356 København K, CSS, bg. 9, Building: 9.2.16, Copenhagen, Denmark
- Athena Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - G Greco
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
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Husbands S, Mitchell PM, Kinghorn P, Byford S, Bailey C, Anand P, Peters TJ, Floredin I, Coast J. Is well-becoming important for children and young people? Evidence from in-depth interviews with children and young people and their parents. Qual Life Res 2024; 33:1051-1061. [PMID: 38294665 PMCID: PMC10973085 DOI: 10.1007/s11136-023-03585-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 02/01/2024]
Abstract
PURPOSE This study explores how important well-becoming factors appear to be to children during childhood. We define well-becoming as the indicators which predict children and young people's future wellbeing and opportunities. The priority for this work was to explore whether well-becoming might be an important factor to include in outcome measures for children and young people. The inclusion of well-becoming indicators could ensure that opportunities to invest in promoting wellbeing in children's futures are not missed. METHODS In-depth, qualitative interviews (N = 70) were undertaken with children and young people aged 6-15 years and their parents. Analysis used constant comparison and framework methods to investigate whether well-becoming factors were considered important by informants to children and young people's current wellbeing. RESULTS The findings of the interviews suggested that children and young people and their parents are concerned with future well-becoming now, as factors such as future achievement, financial security, health, independence, identity, and relationships were identified as key to future quality of life. Informants suggested that they considered it important during childhood to aspire towards positive outcomes in children and young people's futures. CONCLUSION The study findings, taken alongside relevant literature, have generated evidence to support the notion that future well-becoming is important to current wellbeing. We have drawn on our own work in capability wellbeing measure development to demonstrate how we have incorporated a well-becoming attribute into our measures. The inclusion of well-becoming indicators in measures could aid investment in interventions which more directly improve well-becoming outcomes for children and young people.
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Affiliation(s)
- Samantha Husbands
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK.
| | - Paul Mark Mitchell
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Philip Kinghorn
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK
| | - Sarah Byford
- King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, SE5 8AF, UK
| | - Cara Bailey
- School of Nursing, Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Paul Anand
- Economics, The Open University, Milton Keynes, UK
- Department of Social Policy and Intervention, Oxford University, Oxford, UK
- Centre for Philosophy of Social and Natural Sciences, London School of Economics, London, UK
| | - Tim J Peters
- Population Health Sciences, Bristol Medical School, Bristol Dental School, University of Bristol, Bristol, BS1 2LY, UK
| | - Isabella Floredin
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1NU, UK
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van Kaam FE, Rohrbach PJ, van den Akker-Van Marle ME, van Furth EF, Dingemans AE. Sensitivity to change in well-being and health-related quality of life in adults with eating disorder symptoms: ICECAP-A versus EQ-5D-5L. Int J Eat Disord 2024; 57:593-601. [PMID: 38240329 DOI: 10.1002/eat.24142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE Economic evaluations of treatments help to inform decisions on allocating health care resources. These evaluations involve comparing costs and effectiveness in terms of quality of life. To calculate quality-adjusted life years, generic health related quality of life is often used, but is criticized for not being sensitive to change in mental health populations. Another approach, using experienced well-being measured through capabilities with the ICECAP-A, has been proposed as an alternative. The aim of this study was to investigate whether changes in individuals with eating disorder (ED) symptoms can be better captured using health related quality of life (EQ-5D-5L) or well-being (ICECAP-A). METHOD Measurements at two time points with an interval of 1 year were used from a sample of 233 participants with self-reported ED symptoms. An analysis of variance was used to test whether the EQ-5D-5L and ICECAP-A differed in sensitivity to change over time. In order to compare the two questionnaires in terms of clinically significant outcome, the reliable change index and clinical cut-off score were calculated. RESULTS The two questionnaires did not differ in sensitivity to change. More individuals had recovered but also more had deteriorated according to the EQ-5D-5L compared to the ICECAP. DISCUSSION The present study revealed no differences in sensitivity to change in health-related quality of life or well-being in individuals with ED symptoms in the context of mild clinical change. Results corroborated the pervasiveness of low quality of life in this population, even after alleviation of ED symptoms. PUBLIC SIGNIFICANCE STATEMENT Measuring treatment benefits in terms of improvements in quality of life is an integral part of economic evaluations in health care. It was expected that these treatment benefits would be better captured as changes in well-being (measured with the ICECAP-A) than as changes in health-related quality of life (measured with the EQ-5D-5L) for individuals with ED symptoms. Based on the results of this study, no preference for one of the two approaches was found.
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Affiliation(s)
- Fleur E van Kaam
- GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
| | - Pieter J Rohrbach
- Department of Clinical Psychology, Open University, Heerlen, The Netherlands
| | - M Elske van den Akker-Van Marle
- Department of Biomedical Data Sciences, Section of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands
| | - Eric F van Furth
- GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexandra E Dingemans
- GGZ Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Mendoza-Jiménez MJ, van Exel J, Brouwer W. On spillovers in economic evaluations: definition, mapping review and research agenda. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01658-8. [PMID: 38261132 DOI: 10.1007/s10198-023-01658-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024]
Abstract
An important issue in economic evaluations is determining whether all relevant impacts are considered, given the perspective chosen for the analysis. Acknowledging that patients are not isolated individuals has important implications in this context. Increasingly, the term "spillovers" is used to label consequences of health interventions on others. However, a clear definition of spillovers is lacking, and as a result, the scope of the concept remains unclear. In this study, we aim to clarify the concept of spillovers by proposing a definition applicable in health economic evaluations. To illustrate the implications of this definition, we highlight the diversity of potential spillovers through an expanded impact inventory and conduct a mapping review that outlines the evidence base for the different types of spillovers. In the context of economic evaluations of health interventions, we define spillovers as all impacts from an intervention on all parties or entities other than the users of the intervention under evaluation. This definition encompasses a broader range of potential costs and effects, beyond informal caregivers and family members. The expanded impact inventory enables a systematic approach to identifying broader impacts of health interventions. The mapping review shows that the relevance of different types of spillovers is context-specific. Some spillovers are regularly included in economic evaluations, although not always recognised as such, while others are not. A consistent use of the term "spillovers", improved measurement of these costs and effects, and increased transparency in reporting them are still necessary. To that end, we propose a research agenda.
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Affiliation(s)
- María J Mendoza-Jiménez
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands.
- Facultad de Ciencias Sociales y Humanísticas, Escuela Superior Politécnica del Litoral (ESPOL), Guayaquil, Ecuador.
| | - Job van Exel
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner Brouwer
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus Centre for Health Economics Rotterdam (EsCHER), Erasmus University Rotterdam, Rotterdam, The Netherlands
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Meili KW, Mulhern B, Ssegonja R, Norström F, Feldman I, Månsdotter A, Hjelte J, Lindholm L. Eliciting a value set for the Swedish Capability-Adjusted Life Years instrument (CALY-SWE). Qual Life Res 2024; 33:59-72. [PMID: 37695477 PMCID: PMC10784385 DOI: 10.1007/s11136-023-03507-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE Our aim was to elicit a value set for Capability-Adjusted Life Years Sweden (CALY-SWE); a capability-grounded quality of life instrument intended for use in economic evaluations of social interventions with broad consequences beyond health. METHODS Building on methods commonly used in the quality-adjusted life years EQ-5D context, we collected time-trade off (TTO) and discrete choice experiment (DCE) data through an online survey from a general population sample of 1697 Swedish participants. We assessed data quality using a score based on the severity of inconsistencies. For generating the value set, we compared different model features, including hybrid modeling of DCE and TTO versus TTO data only, censoring of TTO answers, varying intercept, and accommodating for heteroskedasticity. We also assessed the models' DCE logit fidelity to measure agreement with potentially less-biased DCE data. To anchor the best capability state to 1 on the 0 to 1 scale, we included a multiplicative scaling factor. RESULTS We excluded 20% of the TTO answers of participants with the largest inconsistencies to improve data quality. A hybrid model with an anchor scale and censoring was chosen to generate the value set; models with heteroskedasticity considerations or individually varying intercepts did not offer substantial improvement. The lowest capability weight was 0.114. Health, social relations, and finance and housing attributes contributed the largest capability gains, followed by occupation, security, and political and civil rights. CONCLUSION We elicited a value set for CALY-SWE for use in economic evaluations of interventions with broad social consequences.
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Affiliation(s)
- Kaspar Walter Meili
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sidney, Ultimo, Australia
| | - Richard Ssegonja
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Respiratory, Allergy and Sleep Medicine Research Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Inna Feldman
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Anna Månsdotter
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Jan Hjelte
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Ubels J, Schlander M. Measurement invariance and adapted preferences: evidence for the ICECAP-A and WeRFree instruments. Health Qual Life Outcomes 2023; 21:121. [PMID: 37950250 PMCID: PMC10636898 DOI: 10.1186/s12955-023-02208-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 11/03/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Self-report instruments are used to evaluate the effect of interventions. However, individuals adapt to adversity. This could result in individuals reporting higher levels of well-being than one would expect. It is possible to test for the influence of adapted preferences on instrument responses using measurement invariance testing. This study conducts such a test with the Wellbeing Related option-Freedom (WeRFree) and ICECAP-A instruments. METHODS A multi-group confirmatory factor analysis was conducted to iteratively test four increasingly stringent types of measurement invariance: (1) configural invariance, (2) metric invariance, (3) scalar invariance, and (4) residual invariance. Data from the Multi Instrument Comparison study were divided into subsamples that reflect groups of participants that differ by age, gender, education, or health condition. Measurement invariance was assessed with (changes in) the Comparative Fit Index (CFI), Root Mean Square Error of Approximation (RMSEA), and Root Mean Square Residual (SRMR) fit indices. RESULTS For the WeRFree instrument, full measurement invariance could be established in the gender and education subsamples. Scalar invariance, but not residual invariance, was established in the health condition and age group subsamples. For the ICECAP-A, full measurement invariance could be established in the gender, education, and age group subsamples. Scalar invariance could be established in the health group subsample. CONCLUSIONS This study tests the measurement invariance properties of the WeRFree and ICECAP-A instruments. The results indicate that these instruments were scalar invariant in all subsamples, which means that group means can be compared across different subpopulations. We suggest that measurement invariance of capability instruments should routinely be tested with a reference group that does not experience a disadvantage to study whether responses could be affected by adapted preferences.
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Affiliation(s)
- Jasper Ubels
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany.
| | - Michael Schlander
- Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Mannheim Medical Faculty, University of Heidelberg, Mannheim, Germany
- Alfred-Weber-Institute for Economics, University of Heidelberg, Heidelberg, Germany
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Jhunjhunwala R, Venkatapuram S. How should we prioritise global surgery? A capabilities approach argument for the place of surgery within every health system. BMJ Glob Health 2023; 8:e013100. [PMID: 37949500 PMCID: PMC10649365 DOI: 10.1136/bmjgh-2023-013100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/30/2023] [Indexed: 11/12/2023] Open
Abstract
In the rapidly evolving landscape of global health issues and policy, surgery has historically been sidelined due to concerns about high cost, complexity and other concerns including quantitatively less surgical disease burden in comparison to infectious disease or other health conditions. Now, in the context of pandemics, climate change, shrinking health budgets and other global health security concerns, the hard-won progress in raising the profile of surgical care is at risk, and a reconceptualisation is needed to maintain its position in global healthcare agendas. We challenge the long-standing ethical frameworks that underlie healthcare priority setting, namely cost-effectiveness analysis and human rights, that have contributed to surgery being sidelined for decades. They incompletely account for improvements to life quality and well-being that are possible through surgical healthcare systems. We argue for the Capabilities Approach as an alternative normative framework because it emphasises the moral importance of supporting every person's abilities to be and to do the things they value. Through this framework, we can produce a more comprehensive conception of healthcare that goes beyond biomedical health, and surgical healthcare would ultimately gain a higher priority in valuation of healthcare and non-healthcare interventions.
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Affiliation(s)
- Rashi Jhunjhunwala
- BIDMC Dept of Surgery, Harvard Medical School, Boston, Massachusetts, USA
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Mitchell PM, Morton RL, Hiligsmann M, Husbands S, Coast J. Estimating loss in capability wellbeing in the first year of the COVID-19 pandemic: a cross-sectional study of the general adult population in the UK, Australia and the Netherlands. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:609-619. [PMID: 35871692 PMCID: PMC9308953 DOI: 10.1007/s10198-022-01498-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 06/23/2022] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To estimate capability wellbeing lost from the general adult populations in the UK, Australia and the Netherlands in the first year of the COVID-19 pandemic and the associated social restrictions, including lockdowns. DESIGN Cross-sectional with recalled timepoints. SETTING Online panels in the UK, Australia and the Netherlands conducted in February 2021 (data collected 26 January-2 March 2021). PARTICIPANTS Representative general adult (≥ 18 years old) population samples in the UK (n = 1,017), Australia (n = 1,011) and the Netherlands (n = 1,017) MAIN OUTCOME MEASURE: Participants completed the ICECAP-A capability wellbeing measure in February 2021, and for two recalled timepoints during the initial lockdowns in April 2020 and in February 2020 (prior to COVID-19 restrictions in all three countries). ICECAP-A scores on a 0-1 no capability-full capability scale were calculated for each timepoint. Societal willingness to pay estimates for a year of full capability (YFC) was used to place a monetary value associated with change in capability per person and per country. Paired t tests were used to compare changes in ICECAP-A and YFC from pre- to post-COVID-19-related restrictions in each country. RESULTS Mean (standard deviation) loss of capability wellbeing during the initial lockdown was 0.100 (0.17) in the UK, 0.074 (0.17) in Australia and 0.049 (0.12) in the Netherlands. In February 2021, losses compared to pre-lockdown were 0.043 (0.14) in the UK, 0.022 (0.13) in Australia and 0.006 (0.11) in the Netherlands. In monetary terms, these losses were equivalent to £14.8 billion, AUD$8.6 billion and €2.1 billion lost per month in April 2020 and £6.4 billion, A$2.6 billion and €260 million per month in February 2021 for the UK, Australia and the Netherlands, respectively. CONCLUSIONS There were substantial losses in capability wellbeing in the first year of the COVID-19 pandemic. Future research is required to understand the specific impact of particular COVID-19 restrictions on people's capabilities.
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Affiliation(s)
- Paul Mark Mitchell
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
| | - Rachael L Morton
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, Australia
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Samantha Husbands
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
| | - Joanna Coast
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
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10
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Kinchin I, Leroi I, Kennelly SP, Kochovska S, Brady C, Fitzhenry D, McHale C, Kinghorn P, Coast J. What does a "good life" mean for people living with dementia? A protocol for a think-aloud study informing the value of care. Front Aging Neurosci 2022; 14:1061247. [PMID: 36589541 PMCID: PMC9800871 DOI: 10.3389/fnagi.2022.1061247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Economic evaluation currently focuses almost exclusively on the maximization of health, using the Quality-Adjusted Life-Year (QALY) framework with instruments such as the EQ-5D, with a limited number of health-focused dimensions providing the assessment of health benefit. This evaluative framework is likely to be insufficient for setting priorities in dementia care because of its exclusive concern with health. Data are also often collected from the perspective of a proxy, limiting the voice of those living with dementia in decision-making. This protocol describes a research project that aims to gather the perspectives of people living with dementia, their insights, and preferences for assessing their quality of life to inform economic evaluation outcome measurement and design with a goal of creating a more robust evidence base for the value of healthcare services. Specifically, this study will elucidate what a "good life" means to people living with dementia and how well instruments currently used in economic evaluation meet this description. This project will further test the acceptability of capability wellbeing instruments as self-report instruments and compare them to generic and dementia-specific preference-based instruments. Methods and analysis People living with dementia, diagnosed, or waiting to receive a formal diagnosis and with the capacity to participate in research, will be invited to participate in an hour "think aloud" interview. Participants will be purposefully selected to cover a range of dementia diagnoses, age, and sex, recruited through the integrated care, geriatric, and post-diagnostic clinics at St James' and Tallaght University Hospitals and dementia support groups in the Ireland. During the interview, participants will be invited to reflect on a "good life" and "think aloud" while completing four economic quality of life instruments with a perspective that goes beyond health (AD-5D/QOL-AD, AQOL-4D, ICECAP-O, ICECAP-SCM). An interviewer will then probe areas of difficulty when completing the instruments in a semi-structured way. The analysis will identify the frequency of errors in comprehension, retrieval, judgment, and response from verbatim transcripts. Qualitative data will be analyzed using constant comparison. Ethics The St James's Hospital and Tallaght University Hospital Joint Research Ethics Committee approved the study (Approval Date: 11 April 2022).
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Affiliation(s)
- Irina Kinchin
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin, Ireland,Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) Centre, University of Technology, Sydney, NSW, Australia,*Correspondence: Irina Kinchin,
| | - Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Sean P. Kennelly
- Institute of Memory and Cognition, Tallaght University Hospital, Dublin, Ireland,Department of Medical Gerontology, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Slavica Kochovska
- Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT) Centre, University of Technology, Sydney, NSW, Australia,Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Conor Brady
- Centre for Health Policy and Management, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Deborah Fitzhenry
- Age Related Health Care Outpatient Services, Tallaght University Hospital, Dublin, Ireland
| | - Cathy McHale
- Memory Assessment and Support Service, Tallaght University Hospital, Dublin, Ireland
| | - Philip Kinghorn
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Joanna Coast
- Bristol Population Health Science Institute, University of Bristol, Bristol, United Kingdom
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11
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Pillebout E, Durand-Zaleski I, Farge L, Perrier L, de Chaisemartin C, Dupont JCK, Behaghel L, Rochaix L. Multicentre, randomised, economic evaluation of a web-based interactive education platform, simple or enhanced, for patients with end-stage renal disease: the PIC-R trial protocol. BMJ Open 2022; 12:e062613. [PMID: 36600325 PMCID: PMC9763667 DOI: 10.1136/bmjopen-2022-062613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION End-stage renal disease (ESRD) affects 84 000 persons in France and costs an estimated €4.2 billion. Education about their disease empowers patients and allows improved management of their disease and better health outcomes. This study aims to explore whether the addition of an interactive web-based platform to patient education is effective and cost-effective and additionally whether complementing the platform with social functions and features improves its performance. METHODS AND ANALYSIS Patients with severe, ESRD or post-transplant will be randomised 1:1:1 to either standard therapeutic education; or education using a specific application; or the enhanced interactive app with social features. The total follow-up duration is 18 months. Primary endpoint is the cost utility of using app-based therapeutic intervention; secondary endpoints are: compliance with treatment guidelines, app use (professionals and patients), patients' satisfaction, budget impact analysis. ETHICS AND DISSEMINATION The findings will inform the deployment and reimbursement of the application. The study has ethical approval by the Ile de France ethics committee. Dissemination of the results will be presented at conferences and in peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT03090828.
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Affiliation(s)
| | - Isabelle Durand-Zaleski
- University of Paris, Paris, France
- URCEco DRCI, Assistance Publique - Hopitaux de Paris, Paris, France
| | | | - Lionel Perrier
- Direction of Clinical Research and Innovation, Centre Leon Berard, Lyon, France
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12
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Till M, Abu-Omar K, Ferschl S, Abel T, Pfeifer K, Gelius P. Implementing the capability approach in health promotion projects: Recommendations for implementation based on empirical evidence. EVALUATION AND PROGRAM PLANNING 2022; 95:102149. [PMID: 36029567 DOI: 10.1016/j.evalprogplan.2022.102149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 05/03/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this paper was to develop a framework for the use of the capability approach in health promotion projects, which could guide future projects as well as improve the comparability of the projects' effectiveness. METHOD The study involved a three-stage process comprising a total of six steps. We first developed a theoretical model and then analyzed data from four empirical studies that had implemented projects using the capability approach between 2015 and 2018 in the settings of kindergartens, schools, vocational training, and communities to promote an active lifestyle. Finally, we developed a framework for the use of the capability approach in health promotion projects based on the analysis of the data. RESULTS We developed a theoretical model of the "capability cycle," which was used for further analysis. There were divergent understandings of the capability approach due to existing theoretical constructs that are commonly used by the scientific teams of the projects. Further, the conceptualization, implementation, and evaluation of the capability approach within the four settings showed discrepancies, which inhibited a comparison of their effectiveness. The developed framework comprises recommendations regarding the planning of a project, its implementation, and especially its evaluation in future comparisons of project effectiveness. CONCLUSION This paper provides a comprehensive analysis of four projects for which we developed a framework using a participatory approach. The findings can help research teams in the conceptualization, implementation, and evaluation of future projects that focus on improving capabilities in the field of health promotion. Further, the established framework will help facilitate comparisons of capability-oriented health promotion projects in terms of their effectiveness.
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Affiliation(s)
- Maike Till
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany.
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
| | - Susanne Ferschl
- Department of Sport and Health Sciences, Technical University of Munich, Germany
| | - Thomas Abel
- Department of Social and Preventive Medicine, University of Bern, Switzerland
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
| | - Peter Gelius
- Department of Sport Science and Sport, Division of Physical Activity and Health, Friedrich-Alexander-Universität Erlangen-Nuremberg, Germany
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Sacchetto B, Ornelas J, Calheiros MM. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH): A consumer-based measure for the evaluation of community mental health interventions. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:327-339. [PMID: 35499287 PMCID: PMC10083923 DOI: 10.1002/ajcp.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/19/2022] [Indexed: 06/14/2023]
Abstract
The capabilities approach offers a multidimensional, ecological, and agent-centered framework that may inspire models of intervention and evaluation. A growing number of measures grounded on the capabilities approach for outcome measurement are appearing. Regarding community mental health, new consumer-valued measures-constructed in collaboration with consumers-are here considered crucial for a transformative shift. Meanwhile, new measurements need to provide psychometric evidence to enable proper choice and application. The Achieved Capabilities Questionnaire for Community Mental Health (ACQ-CMH) was developed in collaboration with consumers of community mental health services. It aims to assess consumers' capabilities achieved through program support. The present paper shows advancements in the measure validation through a confirmatory factor analysis within a sample of community mental health consumers (N = 225). Reliability and construct-related validity were also observed. A structural solution composed of five factors and 43 items revealed a better model fit than that obtained in a previous exploratory study. Findings support the reliability, sensibility, and both convergent and discriminant validity of using the ACQ-CMH in the evaluation of community mental health interventions. The ACQ-CMH offers a consumer-valued framework with specific dimensions and indicators of capabilities for use in a routine service evaluation setting.
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Affiliation(s)
- Beatrice Sacchetto
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI)ISPA‐Instituto Universitário (ISPA‐IU)LisbonPortugal
| | - José Ornelas
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI)ISPA‐Instituto Universitário (ISPA‐IU)LisbonPortugal
| | - Maria M. Calheiros
- Centro de Investigação em Ciência Psicológica (CICPSI), Faculdade de PsicologiaUniversidade de LisboaLisboaPortugal
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14
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Tapager I, Joensen LE, Vrangbæk K. The role of self-efficacy, well-being capability and diabetes care assessment for emotional and diabetes management challenges during the COVID-19 pandemic: Findings from a follow-up study. Soc Sci Med 2022; 310:115276. [PMID: 36063674 PMCID: PMC9395231 DOI: 10.1016/j.socscimed.2022.115276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/26/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Ina Tapager
- Department of Public Health, University of Copenhagen, Denmark.
| | | | - Karsten Vrangbæk
- Department of Public Health, University of Copenhagen, Denmark; Department of Political Science, University of Copenhagen, Denmark
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15
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Nakamura CA, Mitchell PM, Peters TJ, Moreno-Agostino D, Araya R, Scazufca M, Hollingworth W. A Validation Study of the EQ-5D-5L and ICEpop Capability Measure for Older People Among Older Individuals With Depressive Symptoms in Brazil. Value Health Reg Issues 2022; 30:91-99. [PMID: 35325703 DOI: 10.1016/j.vhri.2021.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/03/2021] [Accepted: 11/30/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study aimed to assess the known-groups validity of the EQ-5D-5L and the ICEpop Capability Measure for Older People (ICECAP-O), 2 outcome measures used in economic evaluation, among older adults with depressive symptoms in socioeconomically deprived areas of Brazil. We also explored the role of education and income on responses to these measures. METHODS This cross-sectional study used baseline data from PROACTIVE, a cluster randomized controlled trial to evaluate a psychosocial intervention for late-life depression among older adults. Participants aged ≥60 years with a 9-item Patient Health Questionnaire score ≥10 were recruited from 20 primary healthcare clinics. Ordered logistic regression models assessed the association between depressive symptoms severity, income, and education and dimension-level responses on the EQ-5D-5L and ICECAP-O. Multivariable regression models investigated the ability of EQ-5D-5L and ICECAP-O scores to discriminate between depressive symptoms severity levels and other characteristics, including education level and household income. RESULTS A total of 715 participants were included in the study. Depressive symptoms severity was associated with all EQ-5D-5L and ICECAP-O dimensions, except the ICECAP-O enjoyment attribute. In contrast, household income was only associated with the ICECAP-O security attribute. Higher severity of depressive symptoms (9-item Patient Health Questionnaire scores) was also strongly associated with lower (ie, worse) scores on both measures in all models. Education level and household income showed no association with either EQ-5D-5L or ICECAP-O scores. CONCLUSIONS To best of our knowledge, this is the first study that investigated the validity of these 2 measures among older adults in Brazil. Both EQ-5D-5L and ICECAP-O showed evidence of validity in differentiating depressive symptom severity.
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Affiliation(s)
- Carina A Nakamura
- Departamento de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.
| | - Paul M Mitchell
- Health Economics Bristol, Bristol Medical School, University of Bristol, Bristol, England, UK
| | - Tim J Peters
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, England, UK
| | - Darío Moreno-Agostino
- Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Ricardo Araya
- Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England, UK
| | - Marcia Scazufca
- Instituto de Psiquiatria, Hospital das Clinicas, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - William Hollingworth
- Health Economics Bristol, Bristol Medical School, University of Bristol, Bristol, England, UK
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Helter TM, Coast J, Łaszewska A, Stamm T, Simon J. Comparison of capability and health-related quality of life instruments in capturing aspects of mental well-being in people with schizophrenia and depression. BJPsych Open 2022; 8:e117. [PMID: 35758648 PMCID: PMC9301777 DOI: 10.1192/bjo.2022.514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND There is increasing evidence that assessing outcomes in terms of capability provides information beyond that of health-related quality of life (HRQoL) for outcome evaluation in mental health research and clinical practice. AIMS To assess similarities and differences in the measurement properties of the ICECAP-A capability measure and Oxford Capabilities Questionnaire for Mental Health (OxCAP-MH) in people with schizophrenia experiencing depression, and compare these measurement properties with those of (a) the EuroQol EQ-5D-5L and EuroQol Visual Analogue Scale (EQ-VAS) and (b) mental health-specific (disease-specific) measures. METHOD Using data for 100 patients from the UK, measurement properties were compared using correlation analyses, Bland-Altman plots and exploratory factor analysis. Responsiveness was assessed by defining groups who worsened, improved or remained unchanged, based on whether there was a clinically meaningful change in the instrument scores between baseline and 9-month follow-up assessments. RESULTS The two capability instruments had stronger convergent validity with each other (Spearman's rho = 0.677) than with the HRQoL (rho = 0.354-0.431) or the mental health-specific (rho = 0.481-0.718) instruments. The OxCAP-MH tended to have stronger correlations with mental health-specific instruments than the ICECAP-A, whereas the ICECAP-A had slightly stronger correlation with the EQ-VAS. Change scores on the capability instruments correlated weakly with change scores on the HRQoL scales (rho = 0.131-0.269), but moderately with those on mental health-specific instruments for the ICECAP-A (rho = 0.355-0.451) and moderately/strongly on the OxCAP-MH (rho = 0.437-0.557). CONCLUSIONS Assessing outcomes in terms of capabilities for people with schizophrenia and depression provided more relevant, mental health-specific information than the EQ-5D-5L or the EQ-VAS. The ICECAP-A and the OxCAP-MH demonstrated similar psychometric properties, but the OxCAP-MH was more correlated with disease-specific instruments.
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Affiliation(s)
- Timea Mariann Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Austria
| | - Joanna Coast
- Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, UK
| | - Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Austria
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Austria; and Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Austria; and Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
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Helter TM, Kaltenboeck A, Baumgartner J, Mayrhofer F, Heinze G, Sönnichsen A, Wancata J, Simon J. Does the relative importance of the OxCAP-MH's capability items differ according to mental ill-health experience? Health Qual Life Outcomes 2022; 20:99. [PMID: 35751092 PMCID: PMC9233329 DOI: 10.1186/s12955-022-02009-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Some capability dimensions may be more important than others in determining someone's well-being, and these preferences might be dependent on ill-health experience. This study aimed to explore the relative preference weights of the 16 items of the German language version of the OxCAP-MH (Oxford Capability questionnaire-Mental Health) capability instrument and their differences across cohorts with alternative levels of mental ill-health experience. METHODS A Best-Worst-Scaling (BWS) survey was conducted in Austria among 1) psychiatric patients (direct mental ill-health experience), 2) (mental) healthcare experts (indirect mental ill-health experience), and 3) primary care patients with no mental ill-health experience. Relative importance scores for each item of the German OxCAP-MH instrument were calculated using Hierarchical Bayes estimation. Rank analysis and multivariable linear regression analysis with robust standard errors were used to explore the relative importance of the OxCAP-MH items across the three cohorts. RESULTS The study included 158 participants with complete cases and acceptable fit statistic. The relative importance scores for the full cohort ranged from 0.76 to 15.72. Findings of the BWS experiment indicated that the items Self-determination and Limitation in daily activities were regarded as the most important for all three cohorts. Freedom of expression was rated significantly less important by psychiatric patients than by the other two cohorts, while Having suitable accommodation appeared significantly less important by the expert cohort. There were no further significant differences in the relative preference weights of OxCAP-MH items between the cohorts or according to gender. CONCLUSIONS Our study indicates significant between-item but limited mental ill-health related heterogeneity in the relative preference weights of the different capability items within the OxCAP-MH. The findings support the future development of preference-based value sets elicited from the general population for comparative economic evaluation purposes.
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Affiliation(s)
- Timea Mariann Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Alexander Kaltenboeck
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Josef Baumgartner
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Franz Mayrhofer
- Primary Healthcare Center Medizin Mariahilf, Mariahilfer Straße 95, 1060, Vienna, Austria
| | - Georg Heinze
- Institute of Clinical Biometrics, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Andreas Sönnichsen
- Department of General Practice and Family Medicine, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Johannes Wancata
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria. .,Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK. .,Health Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
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Nguyen L, Jokimäki H, Linnosmaa I, Saloniki EC, Batchelder L, Malley J, Lu H, Burge P, Trukeschitz B, Forder J. Valuing informal carers' quality of life using best-worst scaling-Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer). THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2022; 23:357-374. [PMID: 34468882 PMCID: PMC8964536 DOI: 10.1007/s10198-021-01356-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/13/2021] [Indexed: 06/13/2023]
Abstract
This study developed Finnish preference weights for the seven-attribute Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer) and investigated survey fatigue and learning in best-worst scaling (BWS) experiments. An online survey that included a BWS experiment using the ASCOT-Carer was completed by a sample from the general population in Finland. A block of eight BWS profiles describing different states from the ASCOT-Carer were randomly assigned to each respondent, who consecutively made four choices (best, worst, second best and second worst) per profile. The analysis panel data had 32,160 choices made by 1005 respondents. A scale multinomial logit (S-MNL) model was used to estimate preference weights for 28 ASCOT-Carer attribute levels. Fatigue and learning effects were examined as scale heterogeneity. Several specifications of the generalised MNL model were employed to ensure the stability of the preference estimates. The most and least-valued states were the top and bottom levels of the control over daily life attribute. The preference weights were not on a cardinal scale. We observed the position effect of the attributes on preferences associated with the best or second-best choices. A learning effect was found. The established preference weights can be used in evaluations of the effects of long-term care services and interventions on the quality of life of service users and caregivers. The learning effect implies a need to develop study designs that ensure equal consideration to all profiles (choice tasks) in a sequential choice experiment.
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Affiliation(s)
- Lien Nguyen
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland.
| | - Hanna Jokimäki
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ismo Linnosmaa
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Eirini-Christina Saloniki
- Centre for Health Services Studies (CHSS), University of Kent, Kent, UK
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Laurie Batchelder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Juliette Malley
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Hui Lu
- RAND Europe, Cambridge, UK
| | | | - Birgit Trukeschitz
- Research Institute for Economics of Aging, WU Vienna University of Economics and Business, Vienna, Austria
| | - Julien Forder
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
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Husbands S, Mitchell PM, Floredin I, Peters TJ, Kinghorn P, Byford S, Anand P, Bailey C, Coast J. The Children and Young People Quality of Life Study: A protocol for the qualitative development of attributes for capability wellbeing measures for use in health economic evaluation with children and young people. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17801.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Health services face difficult choices regarding how to allocate scarce health and social care resources. Economic evaluation can aid this process of decision making by allowing competing healthcare interventions or services to be compared in terms of their costs and consequences. However, existing use of economic evaluation of health services largely focuses on comparing interventions in terms of their impact on health only, missing factors potentially important to broader wellbeing. The capability approach measures outcomes in terms of what people are able to do and be. It provides an alternative evaluative space for economic evaluation, which may be especially beneficial for populations such as children and young people, for whom health might not be the only outcome of importance to their wellbeing. Study aims: This study aims to develop conceptual attributes and descriptive systems for capability wellbeing measures for children and young people to be used in economic evaluation, using qualitative methods with children and young people directly and their parents/guardians. Methods: Qualitative interviews will be used with children and young people and parents/guardians to develop the conceptual attributes (items) and wording for the capability wellbeing measures. Recruitment will be undertaken through organisations such as schools and charities and online using Facebook. Interviews will be face-to-face or online and will focus on identifying factors important to children and young people’s wellbeing to create an initial draft of the capability wellbeing measures. Subsequent interviews will focus on refining the wording used in the measures. Interviews will be analysed using methods of constant comparison, to explore similarities and differences in what participants considered important to children and young people’s wellbeing and to develop appropriate wording for the measures based on participant responses. Ethics: The study received approval from the University of Bristol Faculty of Health Sciences Research Ethics Committee (reference 77121).
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Shields GE, Pennington B, Bullement A, Wright S, Elvidge J. Out of Date or Best Before? A Commentary on the Relevance of Economic Evaluations Over Time. PHARMACOECONOMICS 2022; 40:249-256. [PMID: 34866171 DOI: 10.1007/s40273-021-01116-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/16/2021] [Indexed: 05/27/2023]
Abstract
The impact of time on the applicability and relevance of historical economic evaluations can be considerable. Ignoring this may lead to the use of weak or invalid evidence to inform important research questions or resource allocation decisions, as historical economic evaluations may have reached different conclusions compared to if a similar study had been conducted more recently. There are multiple factors that contribute towards evidence becoming outdated including changes to the relevant decision problem (e.g. comparators), changes to parameters (such as costs, utilities and resource use) and methodological updates (e.g. recommendations on uncertainty analysis). Researchers reviewing economic evaluations need to consider whether changes over time would influence the study design and results if the evaluation were repeated, to the extent that it is no longer helpful or informative. In this paper, we summarise these key issues and make recommendations about how and whether researchers can future proof their economic evaluations.
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Affiliation(s)
- Gemma E Shields
- Division of Population Health, Health Services Research, and Primary Care, Manchester Centre for Health Economics, The University of Manchester, Manchester, UK.
| | - Becky Pennington
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ash Bullement
- School of Health and Related Research, University of Sheffield, Sheffield, UK
- Delta Hat Ltd, Nottingham, UK
| | - Stuart Wright
- Division of Population Health, Health Services Research, and Primary Care, Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Jamie Elvidge
- Science, Evidence and Analytics Directorate, National Institute for Health and Care Excellence, Manchester, UK
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21
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Łaszewska A, Helter TM, Nagel A, Perić N, Simon J. Patient-reported outcome measures suitable for quality of life/well-being assessment in multisectoral, multinational and multiperson mental health economic evaluations. EVIDENCE-BASED MENTAL HEALTH 2021; 25:85-92. [PMID: 34949634 PMCID: PMC9046758 DOI: 10.1136/ebmental-2021-300334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/07/2021] [Indexed: 12/02/2022]
Abstract
Question The aim was to systematically collate and synthesise existing, publicly available patient-reported outcome measure (PROM) information suitable for quality of life (QOL)/well-being measurement in mental health economic evaluations, with specific focus on their applicability in multisectoral, multinational, multiperson economic evaluations and to develop an electronic PROM compendium with meta-data. Study selection and analysis A systematic literature search for non-disease-pecific PROMs and their versions suitable for the measurement of QOL/well-being or recovery was conducted from 2008 to February 2020. Six criteria were applied to judge their suitability in multisectoral, multinational, multiperson economic evaluations: (i) availability of separate adult and child/adolescent versions, (ii) availability of a proxy-completion option, (iii) assessing outcomes beyond health, (iv) availability of translations (≥2 language versions), (v) availability of a preference-based valuation, (vi) availability of value sets in more than one country. Findings The final ProgrammE in Costing, resource use measurement and outcome valuation for Use in multisectoral National and International health economic evaluAtions (PECUNIA) PROM-MH Compendium includes 204 unique scales, out of which 88 are individual instruments, while the remaining 116 scales belong to 46 PROM families with more than one distinctive version. Out of the total 134 individual PROMs/PROM families, 72% have at least two language versions, 8% measure broader well-being beyond health-related QOL, 11% have preference-based valuation, with multiple country sets available for 60% of these. None of the identified PROMs met all six proposed criteria. Conclusions The PECUNIA PROM-MH Compendium provides a unique overview of the relevant PROMs and their linked meta-data, and should be a helpful tool when choosing a suitable instrument for future mental health economic evaluations.
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Affiliation(s)
- Agata Łaszewska
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Timea Mariann Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Anna Nagel
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Nataša Perić
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Wien, Austria
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22
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Si Y, Li S, Xu Y, Chen G. Validation and comparison of five preference-based measures among age-related macular degeneration patients: evidence from mainland China. Qual Life Res 2021; 31:1561-1572. [PMID: 34853992 DOI: 10.1007/s11136-021-03047-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To compare the psychometric properties of five preference-based measures (PBMs) among patients with age-related macular degeneration (AMD) in mainland China, including three health-related quality of life (HRQoL) measures [the 15D, the Assessment of Quality of Life (AQoL)-7D, and EQ-5D-5L] and two capability wellbeing measures [the ICEpop CAPability measure for Adults (ICECAP-A) and ICECAP measure for Older people (ICECAP-O)]. METHODS A convenience sampling framework was used to successively recruit inpatients with AMD who attended a large ophthalmic hospital in Jinan, China. Psychometric properties (known-group validity, concurrent validity, and sensitivity) were assessed. The agreements between PBMs were reported. RESULTS A valid sample of 210 AMD inpatients (median duration: 12 months) was analyzed. Overall, the AQoL-7D had the best performance based on the psychometric tests been conducted. Sufficient evidence was found on psychometric properties for other 2 preference-based HRQoL measures. The ICECAP-A outperformed ICECAP-O on known-group validity and concurrent validity whereas opposite results were found on sensitivity. The Bland-Altman plots indicate that there was no pair of PBMs that could be used interchangeably. CONCLUSIONS The AQoL-7D had shown better psychometric properties than other four PBMs based on Chinese AMD inpatients. The EQ-5D-5L demonstrated sufficient psychometric properties and given the availability of a Chinese-specific tariff and the recommendations of China guidelines for pharmacoeconomic evaluations, it may be prioritized to be used in China. Capability wellbeing instruments could also be considered given they provide information that goes beyond health. Further evidence on responsiveness and reliability for all five PBMs among AMD patients is required.
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Affiliation(s)
- Yanhui Si
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China
| | - Shunping Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China. .,NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, 250012, China. .,Centre for Health Preference Research, Shandong University, Jinan, 250012, China.
| | - Yanjiao Xu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Melbourne, 3145, Australia
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Farkas M, Huynh E, Gulácsi L, Zrubka Z, Dobos Á, Kovács L, Baji P, Péntek M. Development of Population Tariffs for the ICECAP-A Instrument for Hungary and their Comparison With the UK Tariffs. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1845-1852. [PMID: 34838283 DOI: 10.1016/j.jval.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/27/2021] [Accepted: 06/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The ICEpop CAPability measure for Adults (ICECAP-A) was developed to assess the capability well-being of adults for use in economic evaluations. Currently, ICECAP-A tariffs are available only for the UK population. The objectives of this study were to develop a Hungarian tariff set for the ICECAP-A instrument and to explore intercountry differences between the Hungarian and the UK value sets. METHODS A survey was conducted by computer-assisted personal interviews on a sample representative of the Hungarian adult population (N = 1000) to elicit their preferences regarding ICECAP-A attributes with the use of a best-worst scaling choice task. A latent class multinomial logit model with continuous variance scale was used to estimate the weights for each of the 4 capability levels of all 5 ICECAP-A attributes, namely, attachment, stability, achievement, enjoyment, and autonomy. RESULTS The model identified 2 preference classes with approximately equal share. The first class had a stronger relative preference for autonomy and achievement, whereas the second class had a strong preference for attachment. Multivariate analysis of the classes revealed that women, pensioners, people who are married or living in a partnership, and people with poorer health status are characteristics associated with the latter class membership (preference for attachment). Population tariffs were estimated from the model. Overall, attachment was found to be the most important attribute, followed by stability, enjoyment, achievement, and autonomy. CONCLUSIONS Hungarian tariffs are largely consistent with those found for the United Kingdom; nevertheless, autonomy seems to be less important in Hungary compared with the United Kingdom.
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Affiliation(s)
- Miklós Farkas
- School of Accounting and Finance, University of Bristol, Bristol, England, UK
| | - Elisabeth Huynh
- Department of Health Services Research and Policy, Research School of Population Health, Australian National University, Acton, Australia
| | - László Gulácsi
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary; Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary; Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Ágota Dobos
- Corvinus Center for Foreign Language Education and Research, Corvinus University of Budapest, Budapest, Hungary
| | - Levente Kovács
- Physiological Controls Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Budapest, Hungary.
| | - Márta Péntek
- Health Economics Research Center, University Research and Innovation Center, Óbuda University, Budapest, Hungary
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24
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Baji P, Farkas M, Dobos Á, Zrubka Z, Kovács L, Gulácsi L, Péntek M. Comparing the measurement properties of the ICECAP-A and ICECAP-O instruments in ages 50-70: a cross-sectional study on a representative sample of the Hungarian general population. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2021; 22:1453-1466. [PMID: 34091797 PMCID: PMC8558162 DOI: 10.1007/s10198-021-01325-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE The ICECAP-A and ICECAP-O were validated as capability wellbeing measures of adults aged 18 + and 65 + years, respectively. We aimed to compare their measurement properties in age group 50-70. METHODS Data were derived from a cross-sectional survey among a sample representative for the adult Hungarian population. Respondents aged between 50 and 70 filled in both the ICECAP-A and ICECAP-O questionnaires. We assessed and compared feasibility, agreement, discriminatory power, convergent and content validity of the two instruments and explored the determinants of the differences between the two measures. RESULTS 707 respondents (99.4%) provided full answers to both questionnaires (46.3% women, average age 60.1 years). The instruments showed similar construct and convergent validity and discriminatory power. Pearson-correlations between instrument items were strong (r > 0.5). ICECAP-A and ICECAP-O scores could be calculated from each other with a good confidence (R2 = 0.69 and 0.71). ICECAP-O scores (mean 0.87, SD = 0.12) were systematically higher than ICECAP-A scores (0.85, SD = 0.15) in most subgroups. The difference increased with the deterioration of capability and health, and with age. Regression results showed that employment and health status had larger marginal effect on the ICECAP-A than on the ICECAP-O scores, and these effects were larger than the effect of age on both measures. CONCLUSION Validity of both instruments was confirmed in the age groups 50-70. Given that employment and health status are important determinants of the differences between the two instruments besides age, the possibility of linking the choice between ICECAP-A and ICECAP-O to these factors should be investigated by further research.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
| | - Miklós Farkas
- School of Accounting and Finance, University of Bristol, Bristol, UK
| | - Ágota Dobos
- Corvinus Center for Foreign Language Education and Research, Corvinus University of Budapest, Budapest, Hungary
| | - Zsombor Zrubka
- Health Economics Research Center-University Research and Innovation Center, Óbuda University, Budapest, Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Levente Kovács
- Physiological Controls Research Center-University Research and Innovation Center, Óbuda University, Budapest, Hungary
| | - László Gulácsi
- Health Economics Research Center-University Research and Innovation Center, Óbuda University, Budapest, Hungary
- Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Budapest, Hungary
| | - Márta Péntek
- Health Economics Research Center-University Research and Innovation Center, Óbuda University, Budapest, Hungary
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Helter TM, Kovacs I, Kanka A, Varga O, Kalman J, Simon J. Internal and external aspects of freedom of choice in mental health: cultural and linguistic adaptation of the Hungarian version of the Oxford CAPabilities questionnaire-Mental Health (OxCAP-MH). BMC Psychol 2021; 9:161. [PMID: 34663472 PMCID: PMC8524921 DOI: 10.1186/s40359-021-00660-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background A link between mental health and freedom of choice has long been established, in fact, the loss of freedom of choice is one of the possible defining features of mental disorders. Freedom of choice has internal and external aspects explicitly identified within the capability approach, but received little explicit attention in capability instruments. This study aimed to develop a feasible and linguistically and culturally appropriate Hungarian version of the Oxford CAPabilities questionnaire—Mental Health (OxCAP-MH) for mental health outcome measurement. Methods Following forward and back translations, a reconciled Hungarian version of the OxCAP-MH was developed following professional consensus guidelines of the International Society for Pharmacoeconomics and Outcomes Research and the WHO. The wording of the questionnaire underwent cultural and linguistic validation through content analysis of cognitive debriefing interviews with 11 Hungarian speaking mental health patients in 2019. Results were compared with those from the development of the German version and the original English version with special focus on linguistic aspects.
Results Twenty-nine phrases were translated. There were linguistic differences in each question and answer options due to the high number of inflected, affixed words and word fragments that characterize the Hungarian language in general. Major linguistic differences were also revealed between the internal and external aspects of capability freedom of choices which appear much more explicit in the Hungarian than in the English or German languages. A re-analysis of the capability freedom of choice concepts in the existing language versions exposed the need for minor amendments also in the English version in order to allow the development of future culturally, linguistically and conceptually valid translations.
Conclusion The internal and external freedom of choice impacts of mental health conditions require different care/policy measures. Their explicit consideration is necessary for the conceptually harmonised operationalisation of the capability approach for (mental) health outcome measurement in diverse cultural and linguistic contexts.
Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00660-0.
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Affiliation(s)
- Timea Mariann Helter
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | - Ildiko Kovacs
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Korányi Alley 8-10, Szeged, 6720, Hungary
| | - Andor Kanka
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Korányi Alley 8-10, Szeged, 6720, Hungary
| | - Orsolya Varga
- Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, 26 Kassai Street, Debrecen, Hungary
| | - Janos Kalman
- Department of Psychiatry, Faculty of Medicine, University of Szeged, Korányi Alley 8-10, Szeged, 6720, Hungary
| | - Judit Simon
- Department of Health Economics, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria. .,Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.
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26
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Mitchell PM, Husbands S, Byford S, Kinghorn P, Bailey C, Peters TJ, Coast J. Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions. HEALTH ECONOMICS 2021; 30:1990-2003. [PMID: 34036671 PMCID: PMC7614859 DOI: 10.1002/hec.4363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 05/26/2023]
Abstract
Methods for measuring outcomes suitable for economic evaluations of health and care interventions have primarily focused on adults. The validity of such methods for children and young people is questionable in areas including the outcome domains measured and how they are measured and valued, with most existing measures narrowly focusing on health. Novel methods for assessing benefits beyond health by focusing on a person's capability have also concentrated on adults to date. This paper aims to set out the rationale for capability measures in children and young people. It argues for the need to expand the evaluative space beyond health functioning towards broader capabilities, with children and young people playing an integral role in capability measure development. Drawing from existing literature, specific challenges related to the identification, measurement, and valuation of capabilities in children and young people are also discussed. Finally, the practical implications for conducting economic evaluation when measuring and valuing capabilities at different stages across the life-course are illustrated. We develop an alternative framework based on conceiving capabilities as evolving across the life-course. This framework may also be helpful in thinking about how to model health outcomes across the life-course.
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Affiliation(s)
- Paul Mark Mitchell
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Samantha Husbands
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sarah Byford
- King's Health Economics (KHE), Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philip Kinghorn
- Health Economics Unit (HEU), Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Cara Bailey
- School of Nursing, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Tim J Peters
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Joanna Coast
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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The ICECAP-A instrument for capabilities: assessment of construct validity and test-retest reliability in a general Dutch population. Qual Life Res 2021; 31:687-696. [PMID: 34463861 PMCID: PMC8921020 DOI: 10.1007/s11136-021-02980-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE The ICEpop CAPability measure for Adults (ICECAP-A) assesses five capabilities that are important to one's well-being. The instrument might be an important addition to generic health questionnaires when evaluating quality of life extending beyond health. This study aimed to conduct a psychometric assessment of the Dutch translation of the ICECAP-A. METHODS Construct validity of the instrument was assessed in two ways. First, by measuring correlations with the EQ-5D-5L questionnaire and a measure of self-efficacy and, second, by investigating the ability to distinguish between groups known to differ on the construct the ICECAP-A means to capture. Additionally, test-retest reliability was evaluated. RESULTS In total, 1002 participants representative of the general Dutch population completed an online survey. For test-retest reliability, 252 participants completed the same questionnaire 2 weeks later. The ICECAP-A indicated moderate to strong correlations with the EQ-5D-5L and a strong correlation with self-efficacy. Furthermore, it was capable of differentiating known groups. Moreover, results indicated adequate test-retest reliability with an intraclass correlation coefficient of 0.79. CONCLUSION In summary, results suggest adequate test-retest reliability and construct validity and indicate that the ICECAP-A might be of added value, especially when considering areas outside of the traditional health intervention model.
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Measurement properties of the ICECAP-A capability well-being instrument among dermatological patients. Qual Life Res 2021; 31:903-915. [PMID: 34370186 PMCID: PMC8921030 DOI: 10.1007/s11136-021-02967-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Capability well-being captures well-being based on people's ability to do the things they value in life. So far, no capability well-being measures have been validated in dermatological patients. OBJECTIVES To validate the adult version of the ICEpop CAPability measure (ICECAP-A) in patients with dermatological conditions. We aimed to test floor and ceiling effects, structural, convergent and known-group validity, and measurement invariance. METHODS In 2020, an online, cross-sectional survey was carried out in Hungary. Respondents with self-reported physician-diagnosed dermatological conditions completed the ICECAP-A, Satisfaction with Life Scale (SWLS), WHO-5 Well-Being Index and two dermatology-specific measures, Dermatology Life Quality Index (DLQI) and Skindex-16. RESULTS 618 respondents (mean age 51 years) self-reported a physician-diagnosed dermatological condition, with warts, eczema, onychomycosis, acne and psoriasis being the most common. ICECAP-A performed well with no floor and mild ceiling effects. The violation of local independence assumption was found between the attributes of 'attachment' and 'enjoyment'. ICECAP-A index scores correlated strongly with SWLS and WHO-5 (rs = 0.597-0.644) and weakly with DLQI and Skindex-16 (rs = - 0.233 to - 0.292). ICECAP-A was able to distinguish between subsets of patients defined by education and income level, marital, employment and health status. Multigroup confirmatory factor analysis indicated measurement invariance across most of these subgroups. CONCLUSIONS This is the first study to validate a capability well-being measure in patients with dermatological conditions. The ICECAP-A was found to be a valid tool to assess capability well-being in dermatological patients. Future work is recommended to test measurement properties of ICECAP-A in chronic inflammatory skin conditions.
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Meili KW, Jonsson H, Lindholm L, Månsdotter A. Perceived changes in capability during the COVID-19 pandemic: A Swedish cross-sectional study from June 2020. Scand J Public Health 2021; 50:102-110. [PMID: 34213363 PMCID: PMC8808229 DOI: 10.1177/14034948211023633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Measures against COVID-19 potentially impact quality of life in different ways. The capability approach by Amartya Sen with a broad and consistent framework for measuring quality of life is suited to capture the various consequences. We aimed to examine (a) whether individuals experienced change in 10 capability dimensions during the first half of 2020, (b) which dimensions were affected most, and (c) whether changes were unequally distributed in terms of gender, education, income, geography, housing, living situation and place of birth. METHODS We assessed self-reported capability change in Sweden in 10 capability dimensions in a cross-sectional online survey among 500 participants on a five-item Likert scale. We analysed the distribution of answers by comparing the balance of positive and negative perceived changes and used mixed effects logistic regression to examine associations with background characteristics of the participants. RESULTS Reported perceived negative changes outweighed positive changes, and a higher proportion stated negative perceived changes if they also stated having low capability in the same dimension. In the capabilities of financial situation, political resources and health, the proportions of perceived negative change were highest. Odds for perceived negative change compared to no or positive change were higher for lower incomes, living in smaller municipalities compared to living in medium-sized municipalities, being born outside Europe, living in the south of Sweden, and renting instead of owning housing. CONCLUSIONS Self-reported negative capability change, and associated inequalities related to socioeconomic position, place of birth and regional residence should be of concern for policymakers.
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Affiliation(s)
| | - Håkan Jonsson
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | - Lars Lindholm
- Department of Epidemiology and Global Health, Umeå University, Sweden
| | - Anna Månsdotter
- Department of Epidemiology and Global Health, Umeå University, Sweden.,Public Health Agency of Sweden, Department of Living Conditions and Lifestyles, Sweden
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Millar MR, Gourtsoyannis Y, Jayakumar A. Ethics of vaccination: Should capability measures be used to inform SARS-CoV-2 vaccination strategies? Br J Clin Pharmacol 2021; 88:47-55. [PMID: 33891340 PMCID: PMC8250988 DOI: 10.1111/bcp.14875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 01/02/2023] Open
Abstract
Proposals for SARS-CoV-2 virus vaccination priorities in the UK and in many other countries are heavily influenced by epidemiological models, which use outcome measures such as deaths or hospitalisation. Limiting the values under consideration to those attributable to the direct effects of infection has the advantage of simplifying the models and the process of decision-making. However, the consequences of the pandemic extend beyond outcomes directly attributable to SARS-CoV-2 infection, and include restrictions on educational and work opportunities, access to services, recreational activities, affiliations and relationships with others, freedom of movement (including escaping abusive relationships), and other determinants of human experience. Capability theory gives emphasis to the freedoms that individuals have to express themselves (in doings and beings). Restrictions on freedoms restrict our capabilities. Capability theory has been used to provide a framework for the evaluation and comparison of international development approaches and in the evaluation of public health policy. There is a clustering of disadvantages associated with this pandemic that adds to pre-existing inequalities. Much of the disadvantage engendered in the SARS-CoV-2 pandemic is left out when public health policy is based on a limited range of metrics. Acknowledging the impact of policy across the range of human freedoms at both a national and international level has the potential to improve policy, facilitate the mitigation of direct and indirect adverse consequences, and improve public confidence and the effectiveness of vaccine deployment strategies.
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Marten O, Greiner W. EQ-5D-5L reference values for the German general elderly population. Health Qual Life Outcomes 2021; 19:76. [PMID: 33676523 PMCID: PMC7937199 DOI: 10.1186/s12955-021-01719-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 02/24/2021] [Indexed: 11/10/2022] Open
Abstract
Background Reference values are a helpful tool to facilitate comparisons of sampled values against a specified reference population. The aim is to describe the health profile and to provide visual analogue scale (EQ VAS) and utility reference values for the EQ-5D-5L from a normative sample of the general elderly population (65+) in Germany. Methods We analysed a sub-set of data from the German EQ-5D-5L valuation study using self-reported information based on EQ-5D-5L. We examined the share of respondents in each severity level per dimension as well as means, standard deviations (SD) and 95% confidence intervals for the index and EQ VAS values stratified by age groups and gender. Age was categorised in four groups (65–69, 70–74, 75–79 and > 79 years) to facilitate a more detailed examination of age-related health-related quality of life (HRQoL). Results The average index and EQ VAS scores were 0.84 (SD 0.22) and 73.2 (SD 18.5), respectively. In total, 21.4% reported no problems in all dimensions. With higher age, health problems were reported more frequently, which, in turn, lead to monotonically decreasing index and EQ VAS values. Overall, men reported fewer problems than women and this difference was largest beyond the age of 80. Conclusion HRQoL in the oldest old appears to be less stable and differs from the young elderly. However, the conventional age categorisation of earlier population norms studies seems to mask these differences. Hence, the more detailed provision of EQ-5D-5L reference values for the elderly population seems helpful for future German studies.
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Affiliation(s)
- Ole Marten
- School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany.
| | - Wolfgang Greiner
- School of Public Health, Bielefeld University, Universitaetsstrasse 25, 33615, Bielefeld, Germany
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32
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Till M, Abu-Omar K, Ferschl S, Reimers AK, Gelius P. Measuring capabilities in health and physical activity promotion: a systematic review. BMC Public Health 2021; 21:353. [PMID: 33588799 PMCID: PMC7885491 DOI: 10.1186/s12889-020-10151-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The capability approach by Amartya Sen and Martha Nussbaum has gained increasing attention in the field of public health. As it combines individual, social and structural factors and shifts the focus of attention from the actual behavior towards available options for health behaviors that people can actually choose from, it may help advance our understanding of complex health issues. OBJECTIVES The aim of this article is to identify and describe tools available to measure capabilities within the context of health, with a specific focus on capabilities for health-enhancing physical activity. METHOD We conducted a systematic literature review using 11 databases covering scientific journal articles published in English or German between the years 2000 and 2020 with a focus on capabilities for health or physical activity. RESULTS We found a total of 51 articles meeting our inclusion criteria. Four articles measured capabilities using qualitative methods, one combined qualitative and quantitative methods, while the rest used quantitative methods. We identified a total 11 different capability questionnaires, all showing moderate to good validity/reliability. Only one questionnaire and one interview-based tool specifically dealt with capabilities for health enhancing physical activity. CONCLUSION Although we were able to identify measurement tools for capabilities in health, this review has shown that there is no generic tool available for the measurement across all population- and age-groups, and tools focusing on physical activity are scarce. However, our results can be used as guide for future projects that aim at measuring capabilities.
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Affiliation(s)
- M Till
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany.
| | - K Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - S Ferschl
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - A K Reimers
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
| | - P Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-University, Erlangen Nuremberg, Gebbertstraße 123b, 91058, Erlangen, Germany
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Xiong Y, Wu H, Xu J. Assessing the reliability and validity of the ICECAP-A instrument in Chinese type 2 diabetes patients. Health Qual Life Outcomes 2021; 19:5. [PMID: 33407525 PMCID: PMC7788876 DOI: 10.1186/s12955-020-01632-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/23/2020] [Indexed: 12/26/2022] Open
Abstract
Purpose We aimed to conduct psychometric tests for the Chinese version of ICECAP-A and compare the differences between ICECAP-A and EQ-5D-3L for patients with T2DM and explore the relationship between clinical conditions and ICECAP-A through diabetes-related clinical indicators.
Methods Data were collected from a sample of 492 Chinese T2DM patients. The reliability and validity of the ICECAP-A were verified. Exploratory factor analysis (EFA), correlation analysis and regression analysis were conducted for both the ICECAP-A and EQ-5D-3L.
Results Our results show that the Chinese version of ICECAP-A has good internal consistency with an overall Cronbach’s Alpha coefficient of 0.721. The mean scores of ICECAP-A and EQ-5D-3L are 0.85 vs. 0.94. A weak correlation (r = 0.116) was found between the ICECAP-A tariff and EQ-5D-3L utility. EFA showed that although the five dimensions of the ICECAP-A and EQ-5D-3L scales were loaded into two different factors respectively. However, the two scales captured different dimensions of quality of life and can complement each other. The ICECAP-A, EQ-5D-3L, and EQ-VAS scores showed differences across different socio-demographic characteristics and clinic conditions groups. Conclusion The Chinese version of the ICECAP-A capability instrument can be for assessing outcomes in adults with T2DM. It may capture more dimensions of QoL than traditional Health-related QoL (HRQoL) instruments and may be useful for economic evaluations of health care and social care for people with T2DM or other chronic diseases.
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Affiliation(s)
- Yao Xiong
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, 611130, China.,Center of Health Policy and Governance, Southwestern University of Finance and Economics, Chengdu, 611130, China
| | - Hongyan Wu
- School of Medicine and Health Management, Guizhou Medical University, Guiyang, 550025, China.
| | - Judy Xu
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, 611130, China.,Center of Health Policy and Governance, Southwestern University of Finance and Economics, Chengdu, 611130, China
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Mitchell PM, Husbands S, Sanghera S, Caskey FJ, Scott J, Coast J. Measuring capability wellbeing in adults at different stages of life for use in economic evaluation of health and care interventions: a qualitative investigation in people requiring kidney care. Qual Life Res 2021; 30:2863-2873. [PMID: 33973109 PMCID: PMC8481176 DOI: 10.1007/s11136-021-02851-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE Capability wellbeing measures, such as the ICECAP measures, have been proposed for use in economic evaluations to capture broader outcomes of health and care interventions. The ICECAP measures have been developed to reflect capabilities at different stages of life. Some patient groups include patients of different ages and at different stages of life, so it is not always apparent which ICECAP measure is most relevant. This study explores the impact of age and life stage on completion, where both ICECAP-A and ICECAP-O were completed by the same patient. METHODS A think-aloud study, and an associated semi-structured interview were conducted with people receiving kidney care as a renal outpatient, kidney transplant outpatient, or through receiving facility-based haemodialysis. Qualitative analysis focused on (1) differences in responses across measures by individuals, where attributes had conceptual overlap, (2) key factors in self-reported capability levels, and (3) measure preference. RESULTS Thirty participants were included in the study, with a mix of older and younger adults. Attributes with similar wording across measures produced similar responses compared to attributes where wording differed. Age and health were key factors for self-reported capability levels. ICECAP-A was slightly preferred overall, including by older adults. CONCLUSION This study suggests use of ICECAP-A in patients with certain chronic health conditions that include a mix of adults across the life course. This study highlights the importance of considering the stage of life when using capability measures and in economic evaluations of health and care interventions more generally.
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Affiliation(s)
- Paul Mark Mitchell
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Samantha Husbands
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Sabina Sanghera
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Fergus John Caskey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Jemima Scott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK ,Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Joanna Coast
- Health Economics Bristol (HEB), Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Hackett SS, Zubala A, Aafjes-van Doorm K, Chadwick T, Harrison TL, Bourne J, Freeston M, Jahoda A, Taylor JL, Ariti C, McNamara R, Pennington L, McColl E, Kaner E. A randomised controlled feasibility study of interpersonal art psychotherapy for the treatment of aggression in people with intellectual disabilities in secure care. Pilot Feasibility Stud 2020; 6:180. [PMID: 33292629 PMCID: PMC7677838 DOI: 10.1186/s40814-020-00703-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Rates of aggression in inpatient secure care are higher than in other psychiatric inpatient settings. People with intellectual disabilities in secure care require adapted psychological treatments. Interpersonal art psychotherapy incorporates the use of creative art making approaches by participants, thus reducing sole reliance upon verbal interactions during psychotherapy for people who may have communication difficulties. During interpersonal art psychotherapy, participants are individually supported by their therapist to consider how they conduct relationships. This includes the influence and impact of interpersonal issues resulting in repeated patterns of conflict. The key feasibility objectives were to assess recruitment and retention rates, follow-up rates and trial procedures such as randomisation, allocation and identifying any practical or ethical problems. In addition, a preliminary 'signal' for the intervention was considered and an indicative sample size calculation completed. The acceptability of a potential third trial arm attentional control condition, mindful colouring-in, was assessed using four single-case design studies and a UK trial capacity survey was conducted. METHODS Adult patients with intellectual disabilities in secure care were recruited and randomised to either interpersonal art psychotherapy or delayed treatment in this multi-site study. Outcomes were assessed using weekly observations via the Modified Overt Aggression Scale and a range of self-report measures. Within study reporting processes, qualitative interviews and a survey were completed to inform trial feasibility. RESULTS Recruitment procedures were successful. The target of recruiting 20 participants to the trial from multiple sites was achieved within 8 months of the study opening. All participants recruited to the treatment arm completed interpersonal art psychotherapy. Between-group differences of interpersonal art psychotherapy versus the delayed treatment control showed a 'signal' effect-size of .65 for total scores and .93 in the verbal aggression sub-scale. There were no amendments to the published protocol. The assessment of key feasibility objectives were met and the trial procedures were acceptable to all involved in the research. CONCLUSION This study suggested that a randomised controlled trial of interpersonal art psychotherapy is acceptable and feasible. TRIAL REGISTRATION ISRCTN14326119 (Retrospectively Registered).
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Affiliation(s)
- Simon S. Hackett
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Ania Zubala
- University of the Highlands and Islands, Inverness, UK
| | | | - Thomas Chadwick
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Toni Leigh Harrison
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jane Bourne
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Mark Freeston
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | | | - John L. Taylor
- Cumbria, Northumberland, Tyne & Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Northumbria University, Newcastle upon Tyne, UK
| | - Cono Ariti
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Lindsay Pennington
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Elaine McColl
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
| | - Eileen Kaner
- Newcastle University, Faculty of Medical Sciences, Newcastle upon Tyne, UK
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Himmler S, van Exel J, Brouwer W. Estimating the monetary value of health and capability well-being applying the well-being valuation approach. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2020; 21:1235-1244. [PMID: 32939595 PMCID: PMC7561589 DOI: 10.1007/s10198-020-01231-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/26/2020] [Indexed: 05/08/2023]
Abstract
BACKGROUND Quality of life measures going beyond health, like the ICECAP-A, are gaining importance in health technology assessment. The assessment of the monetary value of gains in this broader quality of life is needed to use these measurements in a cost-effectiveness framework. METHODS We applied the well-being valuation approach to calculate a first monetary value for capability well-being in comparison to health, derived by ICECAP-A and EQ-5D-5L, respectively. Data from an online survey administered in February 2018 to a representative sample of UK citizens aged 18-65 was used (N = 1512). To overcome the endogeneity of income, we applied an instrumental variable regression. Several alternative model specifications were calculated to test the robustness of the results. RESULTS The base case empirical estimate for the implied monetary value of a year in full capability well-being was £66,597. The estimate of the monetary value of a QALY, obtained from the same sample and using the same methodology amounted to £30,786, which compares well to previous estimates from the willingness to pay literature. Throughout the conducted robustness checks, the value of capability well-being was found to be between 1.7 and 2.6 times larger than the value of health. CONCLUSION While the applied approach is not without limitations, the generated insights, especially concerning the relative magnitude of valuations, may be useful for decision-makers having to decide based on economic evaluations using the ICECAP-A measure or, to a lesser extent, other (capability) well-being outcome measures.
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Affiliation(s)
- Sebastian Himmler
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
| | - Job van Exel
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Werner Brouwer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Baji P, Farkas M, Dobos Á, Zrubka Z, Gulácsi L, Brodszky V, Rencz F, Péntek M. Capability of well-being: validation of the Hungarian version of the ICECAP-A and ICECAP-O questionnaires and population normative data. Qual Life Res 2020; 29:2863-2874. [PMID: 32468403 PMCID: PMC7561558 DOI: 10.1007/s11136-020-02542-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2020] [Indexed: 12/24/2022]
Abstract
Purpose We aimed to develop and assess the psychometric characteristics of the Hungarian language version of two well-being capability measures, the ICEpop CAPability measure for Adults/Older people (ICECAP-A/-O), and to establish population norms. Methods A cross-sectional survey was performed involving a representative sample of the Hungarian population. Socio-demographic characteristics, the use and provision of informal care were recorded. The Minimum European Health Module (MEHM), EQ-5D-5L, WHO-5 well-being index, happiness and life satisfaction visual analogue scale (VAS), Satisfaction with Life Scale (SWLS) measures were applied alongside the ICECAP-A (age-group 18–64) and ICECAP-O (age-group 65+). Results Altogether 1568 and 453 individuals completed the ICECAP-A/-O questionnaires, respectively. Cronbach’s alpha was 0.86 for both measures (internal consistency). Subgroup analyses showed positive associations between ICECAP-A/-O scores and marital status, employment, income, health status (MEHM) and informal care use (construct validity). Pearson correlations were strong (r > 0.5; p < 0.01) between ICECAP-A/-O indexes and EQ-5D-5L, WHO-5, happiness and satisfaction VAS and SWLS scores (convergent validity). The age, education, and marital status were no longer significant in the multiple regression analysis. Test–retest average (SD) scores were 0.88 (0.11) and 0.89 (0.10) for the ICECAP-A, and equally 0.86 (0.09) for the ICECAP-O (reliability). Conclusion This is the first study to provide ICECAP-A/-O population norms. Also, it is the first to explore associations with WHO-5 well-being index which, alongside the MEHM measures, enable estimates from routinely collected international health statistics. The Hungarian ICECAP-A/-O proved to be valid and reliable measurement tools. Socio-demographic characteristics had minor or no impact on ICECAP-A/-O. Other influencing factors deserve further investigation in future research. Electronic supplementary material The online version of this article (10.1007/s11136-020-02542-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Petra Baji
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Miklós Farkas
- Department of Accounting and Finance, University of Bristol, Bristol, UK
| | - Ágota Dobos
- Corvinus Center for Foreign Language Education and Research, Corvinus University of Budapest, Budapest, Hungary
| | - Zsombor Zrubka
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - László Gulácsi
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Valentin Brodszky
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Fanni Rencz
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary.,Hungarian Academy of Sciences, Premium Postdoctoral Research Programme, Budapest, Hungary
| | - Márta Péntek
- Department of Health Economics, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary.
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