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Journal ArticleDOI

Measuring Health and Broader Well-Being Benefits in the Context of Opiate Dependence: The Psychometric Performance of the ICECAP-A and the EQ-5D-5L

TL;DR: The ICECAP-A and EuroQol five-dimensional questionnaire (EQ-5D-5L) have been used for the economic evaluation of treatments for substance use disorders.
About: This article is published in Value in Health.The article was published on 2016-09-01 and is currently open access. It has received 35 citations till now. The article focuses on the topics: Construct validity & Criterion validity.
Citations
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Journal ArticleDOI
01 Apr 2019-BMJ Open
TL;DR: Differences in health between housed and homeless people are better understood as a ‘cliff’, and the exception was problems related to anxiety, which were substantially more common in homeless people than any of the housed groups.
Abstract: Objectives To compare health-related quality of life and prevalence of chronic diseases in housed and homeless populations. Design Cross-sectional survey with an age-matched and sex-matched housed comparison group. Setting Hostels, day centres and soup runs in London and Birmingham, England. Participants Homeless participants were either sleeping rough or living in hostels and had a history of sleeping rough. The comparison group was drawn from the Health Survey for England. The study included 1336 homeless and 13 360 housed participants. Outcome measures Chronic diseases were self-reported asthma, chronic obstructive pulmonary disease (COPD), epilepsy, heart problems, stroke and diabetes. Health-related quality of life was measured using EQ-5D-3L. Results Housed participants in more deprived neighbourhoods were more likely to report disease. Homeless participants were substantially more likely than housed participants in the most deprived quintile to report all diseases except diabetes (which had similar prevalence in homeless participants and the most deprived housed group). For example, the prevalence of chronic obstructive pulmonary disease was 1.1% (95% CI 0.7% to 1.6%) in the least deprived housed quintile; 2.0% (95% CI 1.5% to 2.6%) in the most deprived housed quintile; and 14.0% (95% CI 12.2% to 16.0%) in the homeless group. Social gradients were also seen for problems in each EQ-5D-3L domain in the housed population, but homeless participants had similar likelihood of reporting problems as the most deprived housed group. The exception was problems related to anxiety, which were substantially more common in homeless people than any of the housed groups. Conclusions While differences in health between housed socioeconomic groups can be described as a ‘slope’, differences in health between housed and homeless people are better understood as a ‘cliff’.

64 citations

Journal ArticleDOI
TL;DR: There is 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.
Abstract: 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.

37 citations

Journal ArticleDOI
TL;DR: A methodological case study designed to explore the impact of changing the evaluative space within an economic evaluation from health to capability well-being and the decision-making rule from health maximization to the maximization of sufficient capability.
Abstract: Conventional practice within the United Kingdom and beyond is to conduct economic evaluations with "health" as evaluative space and "health maximization" as the decision-making rule. However, there is increasing recognition that this evaluative framework may not always be appropriate, and this is particularly the case within public health and social care contexts. This article presents a methodological case study designed to explore the impact of changing the evaluative space within an economic evaluation from health to capability well-being and the decision-making rule from health maximization to the maximization of sufficient capability. Capability well-being is an evaluative space grounded on Amartya Sen's capability approach and assesses well-being based on individuals' ability to do and be the things they value in life. Sufficient capability is an egalitarian approach to decision making that aims to ensure everyone in society achieves a normatively sufficient level of capability well-being. The case study is treatment for drug addiction, and the cost-effectiveness of 2 psychological interventions relative to usual care is assessed using data from a pilot trial. Analyses are undertaken from a health care and a government perspective. For the purpose of the study, quality-adjusted life years (measured using the EQ-5D-5L) and years of full capability equivalent and years of sufficient capability equivalent (both measured using the ICECAP-A [ICEpop CAPability measure for Adults]) are estimated. The study concludes that different evaluative spaces and decision-making rules have the potential to offer opposing treatment recommendations. The implications for policy makers are discussed.

33 citations

Journal ArticleDOI
TL;DR: The ICECAP-A measure can be adapted to evaluate wellbeing in China, but cultural changes to the wording are necessary and it is a valid measurement of wellbeing and can complement the EQ-5D already used in China.
Abstract: 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.

25 citations

Journal ArticleDOI
TL;DR: The ICECAP-A is correlated with health-related quality of life but is most appropriately regarded as a complement for and not a substitute to the EuroQol 5-dimension 3-level and EuroQOL 5- dimension 5-level in particular.

20 citations

References
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Book
01 Dec 1969
TL;DR: The concepts of power analysis are discussed in this paper, where Chi-square Tests for Goodness of Fit and Contingency Tables, t-Test for Means, and Sign Test are used.
Abstract: Contents: Prefaces. The Concepts of Power Analysis. The t-Test for Means. The Significance of a Product Moment rs (subscript s). Differences Between Correlation Coefficients. The Test That a Proportion is .50 and the Sign Test. Differences Between Proportions. Chi-Square Tests for Goodness of Fit and Contingency Tables. The Analysis of Variance and Covariance. Multiple Regression and Correlation Analysis. Set Correlation and Multivariate Methods. Some Issues in Power Analysis. Computational Procedures.

115,069 citations

Book
07 Dec 1989
TL;DR: In this article, the authors propose three basic concepts: devising the items, selecting the items and selecting the responses, from items to scales, reliability and validity of the responses.
Abstract: 1. Introduction 2. Basic concepts 3. Devising the items 4. Scaling responses 5. Selecting the items 6. Biases in responding 7. From items to scales 8. Reliability 9. Generalizability theory 10. Validity 11. Measuring change 12. Item response theory 13. Methods of administration 14. Ethical considerations 15. Reporting test results Appendices

9,316 citations

Posted Content
TL;DR: The fourth edition of the Methods for the Economic Evaluation of Health Care Programmes as mentioned in this paper has been thoroughly revised and updated, making it essential reading for anyone commissioning, undertaking, or using economic evaluations in health care, including health service professionals, health economists, and health care decision makers.
Abstract: The purpose of economic evaluation is to inform decisions intended to improve healthcare. The new edition of Methods for the Economic Evaluation of Health Care Programmes equips the reader with the necessary tools and understanding required to undertake evaluations by providing an outline of key principles and a 'tool kit' based on the authors' own experiences of undertaking economic evaluations. Building on the strength of the previous edition, the accessible writing style ensures the text is key reading for the non-expert reader, as no prior knowledge of economics is required. The book employs a critical appraisal framework, which is useful both to researchers conducting studies and to decision-makers assessing them. Practical examples are provided throughout to aid learning and understanding. The book discusses the analytical and policy challenges that face health systems in seeking to allocate resources efficiently and fairly. New chapters include 'Principles of economic evaluation' and 'Making decisions in healthcare' which introduces the reader to core issues and questions about resource allocation, and provides an understanding of the fundamental principles which guide decision making. A key part of evidence-based decision making is the analysis of all the relevant evidence to make informed decisions and policy. The new chapter 'Identifying, synthesising and analysing evidence' highlights the importance of systematic review, and how and why these methods are used. As methods of analysis continue to develop, the chapter on 'Characterising, reporting and interpreting uncertainty' introduces the reader to recent methods of analysis and why characterizing uncertainty matters for health care decisions. The fourth edition of Methods for the Economic Evaluation of Health Care Programmes has been thoroughly revised and updated, making it essential reading for anyone commissioning, undertaking, or using economic evaluations in health care, including health service professionals, health economists, and health care decision makers.

8,314 citations

Journal ArticleDOI
TL;DR: The EuroQol instrument is intended to complement other forms of quality of life measures, and it has been purposefully developed to generate a cardinal index of health, thus giving it considerable potential for use in economic evaluation.

5,362 citations

Journal ArticleDOI
TL;DR: A 5-level version of the EQ-5D has been developed by the EuroQol Group and further testing is required to determine whether the new version improves sensitivity and reduces ceiling effects.
Abstract: This article introduces the new 5-level EQ-5D (EQ-5D-5L) health status measure. EQ-5D currently measures health using three levels of severity in five dimensions. A EuroQol Group task force was established to find ways of improving the instrument's sensitivity and reducing ceiling effects by increasing the number of severity levels. The study was performed in the United Kingdom and Spain. Severity labels for 5 levels in each dimension were identified using response scaling. Focus groups were used to investigate the face and content validity of the new versions, including hypothetical health states generated from those versions. Selecting labels at approximately the 25th, 50th, and 75th centiles produced two alternative 5-level versions. Focus group work showed a slight preference for the wording 'slight-moderate-severe' problems, with anchors of 'no problems' and 'unable to do' in the EQ-5D functional dimensions. Similar wording was used in the Pain/Discomfort and Anxiety/Depression dimensions. Hypothetical health states were well understood though participants stressed the need for the internal coherence of health states. A 5-level version of the EQ-5D has been developed by the EuroQol Group. Further testing is required to determine whether the new version improves sensitivity and reduces ceiling effects.

5,345 citations