A systematic review, psychometric analysis and qualitative assessment of generic preference-based measures of health in mental health populations and the estimation of mapping functions from widely used specific measures
Top Cited Papers
- 1 May 2014
- journal article
- research article
- Published by National Institute for Health and Care Research in Health Technology Assessment
- Vol. 18 (34), 1-+
- https://doi.org/10.3310/hta18340
Abstract
Background: Generic preference-based measures of health like the EQ-5D and SF-6D (R) are increasingly being used in economic evaluation and outcome assessment. However, there are concerns as to whether or not these generic measures are appropriate for use in people with mental health problems. Objectives: The EQ-5D and SF-36 (R) (including its derivatives the SF-12 (R) and SF-6D) were assessed using the psychometric criteria of validity and responsiveness using quantitative and qualitative methods. Another aim was to estimate mapping functions between the EQ-5D and SF-6D and condition-specific measures, where appropriate. Design: Four studies were undertaken to examine the appropriateness of the measures: (1) a systematic review of quantitative evidence on validity and responsiveness; (2) a further quantitative assessment of these criteria using existing data sets; (3) a review of qualitative research on the quality of life of people with mental health problems; and (4) qualitative semistructured interviews of people with a full range of problems. A fifth study estimated mapping functions between mental health-specific measures and the EQ-5D and SF-6D. Setting: A choice of venue was offered for the interviews including the participant's own home, a room at the university or a centre frequently used by mental health services. Participants: The interviews were undertaken with 19 people with a broad range of mental health problems at varying levels of severity. Main outcome measures: The reviews included the EQ-5D and SF-36 (and the SF-12 and SF-6D). The psychometric analysis included the Hospital Anxiety and Depression Scale (HADS), Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM), Generalised Anxiety Disorder Assessment (GAD-7), General Health Questionnaire (GHQ-12) and Patient Health Questionnaire (PHQ-9). Results: (1) and (2) The EQ-5D and SF-36 achieved an adequate level of performance in depression, and to some extent in anxiety and personality disorder. Results from the psychometric analyses in schizophrenia and bipolar disorder have been more mixed. (3) A framework analysis of 13 studies identified six major themes. (4) The interview data fitted the themes from the review well and resulted in minor modifications to the themes. The final set of themes comprised: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; hope and hopelessness; and physical health. Conclusions: The EQ-5D and SF-36 achieved mixed results in the quantitative testing against psychometric criteria. The qualitative analysis suggests this is because they provide a very limited coverage of themes identified by people with mental health problems. Recommendations for future work include the development of new preference-based measures in mental health that are based on, or substantially revise, an existing measure.Keywords
Funding Information
- National Institute for Health Research
This publication has 98 references indexed in Scilit:
- A Review of Generic Preference-Based Measures of Health-Related Quality of Life in Visual DisordersValue in Health, 2012
- How Valid and Responsive Are Generic Health Status Measures, such as EQ-5D and SF-36, in Schizophrenia? A Systematic ReviewValue in Health, 2011
- Self-esteem is associated with premorbid adjustment and positive psychotic symptoms in early psychosisBMC Psychiatry, 2011
- Development of a self-report measure of capability wellbeing for adults: the ICECAP-AQuality of Life Research, 2011
- Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L)Quality of Life Research, 2011
- The MATISSE study: a randomised trial of group art therapy for people with schizophreniaBMC Psychiatry, 2010
- Screening for mood and anxiety disorders with the five-item, the three-item, and the two-item Mental Health InventoryPsychiatry Research, 2009
- Methods for the synthesis of qualitative research: a critical reviewBMC Medical Research Methodology, 2009
- Physical and mental health-related quality of life among older people with schizophreniaSchizophrenia Research, 2009
- Mapping the EQ-5D Index from the SF-12: US General Population Preferences in a Nationally Representative SampleMedical Decision Making, 2006