Given increasing interest in using the capability approach for health economic evaluations and a growing literature, this paper aims to synthesise current information about the characteristics of capability instruments and their application in health economic evaluations. A systematic literature review was conducted to assess studies that contained information on the development, psychometric properties and valuation of capability instruments, or their application in economic evaluations. The review identified 98 studies and 14 instruments for inclusion. There is some evidence on the psychometric properties of most instruments. Most papers found moderate-to-high correlation between health and capability measures, ranging between 0.41 and 0.64. ASCOT, ICECAP-A, -O and -SCM instruments have published valuation sets, most frequently developed using best–worst scaling. Thirteen instruments were originally developed in English and one in Portuguese; however, some translations to other languages are available. Ten economic evaluations using capability instruments were identified. The presentation of results show a lack of consensus regarding the most appropriate way to use capability instruments in economic evaluations with discussion about capability-adjusted life years (CALYs), years of capability equivalence and the trade-off between maximisation of capability versus sufficient capability. There has been increasing interest in applying the capability-based approach in health economic evaluations, but methodological and conceptual issues remain. There is still a need for direct comparison of the different capability instruments and for clear guidance on when and how they should be used in economic evaluations.

/pdf/capability-instruments-in-economic-evaluations-of-health-4uiq8k4qtv.pdf

Capability instruments in economic evaluations of health-related interventions: a comparative review of the literature

The purpose of this paper is to establish the influence of shopping motivations on Chinese fashion retail engagement relative to demographics, monthly spend on fashion items and high street/electronic commerce (e-commerce) preference. This is to determine how international fashion retailers should design more effective retails channels, expanding upon established theory in Hedonic and utilitarian motivations. While earlier research suggests shopping motivations associate with demographics while influencing retail channel preference and consumer spending, much of this exploration is Western focused, with all variables being influential. However, the degree to which these apply to China, and the unique fingerprint of influential motivations remains unknown. This paper answers these questions to allow international retailers to develop more efficient marketing strategies and design more effective retail channels.,In all, 403 Chinese consumers generalisable to the broader population were surveyed on their hedonic and utilitarian motivations to shop for fashion apparel in high street and e-commerce environments. Statistical analysis was commenced through direct logistic regression and MANOVA.,Demographics have limited association with shopping motivations, with gender and age only producing small effect sizes, while occupation, income and education has no significance. High street store preference is influenced by adventure and social shopping and e-commerce preference only by idea shopping. Spending over ¥1k per month on fashion apparel is influenced by gratification and idea shopping, and regular spending habits inspired by value shopping.,This empirical paper characterises the fingerprint of shopping motivations’ influence as singular to China while proving their limitation and need for a wider plethora of influential factors to be recognised.

/pdf/what-influences-chinese-fashion-retail-shopping-motivations-4s3iikw034.pdf

What influences Chinese fashion retail? Shopping motivations, demographics and spending

Background: Although previous studies have shown that a high level of health literacy can improve patients’ ability to engage in health-related shared decision-making (SDM) and improve their quality of life, few studies have investigated the role of eHealth literacy in improving patient satisfaction with SDM (SSDM) and well-being.
Objective: This study aims to assess the relationship between patients’ eHealth literacy and their socioeconomic determinants and to investigate the association between patients’ eHealth literacy and their SSDM and well-being.
Methods: The data used in this study were obtained from a multicenter cross-sectional survey in China. The eHealth Literacy Scale (eHEALS) and Investigating Choice Experiments Capability Measure for Adults were used to measure patients’ eHealth literacy and capability well-being, respectively. The SSDM was assessed by using a self-administered questionnaire. The Kruskal-Wallis one-way analysis of variance and Wilcoxon signed-rank test were used to compare the differences in the eHEALS, SSDM, and Investigating Choice Experiments Capability Measure for Adults scores of patients with varying background characteristics. Ordinary least square regression models were used to assess the relationship among eHealth literacy, SSDM, and well-being adjusted by patients’ background characteristics.
Results: A total of 569 patients completed the questionnaire. Patients who were male, were highly educated, were childless, were fully employed, were without chronic conditions, and indicated no depressive disorder reported a higher mean score on the eHEALS. Younger patients (SSDM≥61 years=88.6 vs SSDM16-30 years=84.2) tended to show higher SSDM. Patients who were rural residents and were well paid were more likely to report good capability well-being. Patients who had a higher SSDM and better capability well-being reported a significantly higher level of eHealth literacy than those who had lower SSDM and poorer capability well-being. The regression models showed a positive relationship between eHealth literacy and both SSDM (β=.22; P<.001) and well-being (β=.26; P<.001) after adjusting for patients’ demographic, socioeconomic status, lifestyle, and health status variables.
Conclusions: This study showed that patients with a high level of eHealth literacy are more likely to experience optimal SDM and improved capability well-being. However, patients’ depressive status may alter the relationship between eHealth literacy and SSDM.
Trial Registration:

The Association Between Patients' eHealth Literacy and Satisfaction With Shared Decision-making and Well-being: Multicenter Cross-sectional Study.

Objective

This study aimed to assess the psychometric properties of three generic preference-based measures and compare their performance in a sample of Hong Kong general population.



Methods

Data used for this analysis were obtained from a cross-sectional telephone-based survey in July 2020. Participants were asked to complete several measures, including The EuroQol five-dimensional five levels (EQ-5D-5L), Recovering Quality of Life-Utility Index (ReQoL-UI) and ICEpop CAPability measure for adults (ICECAP-A). Acceptability, reliability, convergent and discriminant validity of three measures were assessed as well as the agreement between these instruments.



Results

Based on data from 500 participants to the survey, a lower mean score of the ICECAP-A (mean = 0.85) was observed compared to the other two measures (meanReQoL-UI = 0.92; meanEQ-5D-5L = 0.92). All three measures showed an acceptable internal consistency reliability (Cronbach’s alpha = 0.74, 0.82 and 0.77, respectively) as well as good test–retest reliability (intra-class correlation coefficient = 0.74, 0.82 and 0.77, respectively). Correlation analyses confirmed satisfactory convergent validity and the ability of the measures to differentiate between participants with different health or from socioeconomic status groups. The Bland–Altman plot revealed poor agreement between the three measures.



Conclusions

This study confirmed that EQ-5D-5L, ReQoL-UI and ICECAP-A were psychometrically robust to measure HRQoL in the general HK population. The EQ-5D-5L was more suitable for assessing physical HRQoL, whereas the ICECAP-A and ReQoL-UI were more appropriate for measuring interventions aimed at improving people’s well-being and mental health.

/pdf/measuring-health-related-quality-of-life-and-well-being-a-38m07uzyp7.pdf

Measuring health-related quality of life and well-being: a head-to-head psychometric comparison of the EQ-5D-5L, ReQoL-UI and ICECAP-A.

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. 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+). 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). 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.

/pdf/capability-of-well-being-validation-of-the-hungarian-version-1w4gidfmab.pdf

Capability of well-being: validation of the Hungarian version of the ICECAP-A and ICECAP-O questionnaires and population normative data

This study adapts the ICECAP measure for Adults (ICECAP-A) to assess its capacity to measure the quality of life in China for economic evaluation. Qualitative and quantitative methods were used to translate the ICECAP-A measure for wellbeing, established by the University of Birmingham, UK, to the Chinese cultural context. A focus group discussion solved the appropriateness and wording of the ICECAP attributes in Chinese; and a randomly selected sample of 1000 adults aged over 18 years were online surveyed. We conducted psychometric tests and compared the factors influencing the ICECAP-A measure with those influencing EQ-5D-3 L. Members of the focus group discussion agreed that the five attributes of the ICECAP-A measure are sufficient to evaluate wellbeing in China. However, the terms “being settled” and “friendship” were changed to “stability” and “kindness” for the Chinese cultural context. Our results show that the Chinese version of ICECAP-A has good internal consistency with an overall Cronbach’s Alpha coefficient of 0.7999. The concurrent validity indicates that ICECAP-A is moderately correlated with EQ-5D-3 L (r ≤ 0.52). The ICECAP-A measure can be adapted to evaluate wellbeing in China, but cultural changes to the wording are necessary. It is a valid measurement of wellbeing and can complement the EQ-5D already used in China. However, further work is still needed to evaluate the sensitivity of the ICECAP-A measure in relation to public health and social care.

/pdf/adaptation-and-assessments-of-the-chinese-version-of-the-15vhbjy4zq.pdf

Adaptation and assessments of the Chinese version of the ICECAP-A measurement.

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.
 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.
 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. 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.

/pdf/assessing-the-reliability-and-validity-of-the-icecap-a-44eo1vvpg6.pdf

Assessing the reliability and validity of the ICECAP-A instrument in Chinese type 2 diabetes patients.

BACKGROUND The Chinese government removed the price ceiling of most drugs in June 2015 to establish a market-driven pricing system. The purpose of this study is to examine the impact of the elimination of drug ceiling price (EDCP) policy on drug prices. METHODS Using a national macro-level dataset, we employed an interrupted time series method to study the abrupt level and gradual trend changes of Chinese and Western medicine consumer price index (CPI) between June 2014 and June 2017. RESULTS The policy exerted level change on Chinese medicine CPI, increasing 0.201% (95% CI 0.026% to 0.376%, p = 0.026). And the trend in Chinese medicine CPI was still decreased nonsignificantly after the EDCP policy. However, there was no significant price change in Western medicine. CONCLUSION The EDCP policy has different effects on the prices of Chinese and Western medicines. Therefore, we need to pay more attention to the drug pricing mechanism in the future.

Yao Xiong

Papers

Adaptation and assessments of the Chinese version of the ICECAP-A measurement.

Assessing the reliability and validity of the ICECAP-A instrument in Chinese type 2 diabetes patients.

Does price deregulation increase drug price in China? An interrupted time series analysis.

PCR148 Validation of the Chinese Version of the Icecap-O Questionnaires Among Older People with Disabilities