Using preference based measures in mental health conditions: The psychometric validity of the EQ-5D and SF-6D

Background: Generic preference based measures (EQ-5D and SF-6D) can be used in the economic evaluation of mental health interventions. However there are inconsistent findings regarding the psychometric properties of the instruments. Aims: To investigate the psychometric performance of the measures across a range of mental health conditions using seven existing datasets. Methods: The feasibility, construct validity and responsiveness of the EQ-5D and SF-6D were assessed in comparison to condition specific indicators. Results: Strong evidence for validity and responsiveness in common mental health and personality disorder samples was found. The psychometric performance in schizophrenia was more inconsistent. Conclusions: EQ-5D and SF-6D can be used in the economic evaluation of interventions for common mental health problems and personality disorders with some confidence. In schizophrenia, the measurement of quality of life may be improved by developing a condition-specific preference based measure. Declaration of interests: John Brazier developed SF-6D. Michael Barkham developed the CORE-OM.

[1]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[2]  B. Mowry,et al.  Structured interview for DSM-IV personality: SIDP-IV , 1998 .

[3]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[4]  R. Verheul,et al.  The burden of disease in personality disorders: diagnosis-specific quality of life. , 2008, Journal of personality disorders.

[5]  O C Ukoumunne,et al.  Cost-effectiveness of brief cognitive behaviour therapy versus treatment as usual in recurrent deliberate self-harm: a decision-making approach , 2003, Psychological Medicine.

[6]  T. T. Haug,et al.  The validity of the Hospital Anxiety and Depression Scale. An updated literature review. , 2002, Journal of psychosomatic research.

[7]  A. David,et al.  Adherence therapy for people with schizophrenia , 2006, British Journal of Psychiatry.

[8]  T. Johnson,et al.  The MATISSE study: a randomised trial of group art therapy for people with schizophrenia , 2010, BMC psychiatry.

[9]  R. Liberman,et al.  Brief Psychiatric Rating Scale (BPRS) Expanded Version (4.0): Scales, Anchor Points, and Administration Manual , 1993 .

[10]  Peter B. Jones,et al.  Measuring the benefits of treatment for psychosis: validity and responsiveness of the EQ–5D , 2009, British Journal of Psychiatry.

[11]  D. Lamping,et al.  Estimating preference-based single index measures for dementia using DEMQOL and DEMQOL-Proxy. , 2012, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[12]  Stefan Leucht,et al.  What does the PANSS mean? , 2005, Schizophrenia Research.

[13]  R. Brooks.  EuroQol: the current state of play. , 1996, Health policy.

[14]  P. Dolan,et al.  Modeling valuations for EuroQol health states. , 1997, Medical care.

[15]  J. Catalan,et al.  Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study. , 2004, Journal of personality disorders.

[16]  J. Brazier,et al.  The estimation of a preference-based measure of health from the SF-36. , 2002, Journal of health economics.

[17]  T. Brugha,et al.  Clinical effectiveness of health visitor training in psychologically informed approaches for depression in postnatal women: pragmatic cluster randomised trial in primary care , 2009, BMJ : British Medical Journal.

[18]  M. Barkham,et al.  Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM , 2002, British Journal of Psychiatry.

[19]  J. Brazier,et al.  A checklist for judging preference-based measures of health related quality of life: learning from psychometrics. , 1999, Health economics.

[20]  M. Barkham,et al.  Suitability and utility of the CORE–OM and CORE–A for assessing severity of presenting problems in psychological therapy services based in primary and secondary care settings , 2005, British Journal of Psychiatry.

[21]  R. Snaith,et al.  The hospital anxiety and depression scale. , 2013, Acta psychiatrica Scandinavica.

[22]  M. Barkham,et al.  The rationale for developing and implementing core outcome batteries for routine use in service settings and psychotherapy outcome research , 1998 .

[23]  W. Stiles,et al.  Stability of the CORE-OM and the BDI-I prior to therapy: evidence from routine practice. , 2007, Psychology and psychotherapy.

[24]  Michael Barkham,et al.  CORE: Clinical Outcomes in Routine Evaluation , 2000 .

[25]  John Brazier,et al.  How Valid and Responsive Are Generic Health Status Measures, such as EQ-5D and SF-36, in Schizophrenia? A Systematic Review , 2011, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.

[26]  J. Brazier.  Is the EQ–5D fit for purpose in mental health? , 2010, British Journal of Psychiatry.

[27]  W. Cleveland.  Robust Locally Weighted Regression and Smoothing Scatterplots , 1979 .

[28]  G. Baker,et al.  The development of a QALY measure for epilepsy: NEWQOL-6D , 2012, Epilepsy & Behavior.

[29]  M. Barkham,et al.  Service profiling and Outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies : Patient-Focused Research , 2001 .

[30]  J. Brazier,et al.  The Estimation of a Preference-Based Measure of Health From the SF-12 , 2004, Medical care.

[31]  J. Brazier,et al.  A systematic review of the validity and responsiveness of EQ-5D and SF-6D for depression and anxiety , 2012 .

[32]  C. Terwee,et al.  On assessing responsiveness of health-related quality of life instruments: Guidelines for instrument evaluation , 2003, Quality of Life Research.

[33]  Stefan Leucht,et al.  Clinical implications of Brief Psychiatric Rating Scale scores. , 2005, The British journal of psychiatry : the journal of mental science.

[34]  M. Barkham,et al.  Diagnosing depression in primary care using self-completed instruments: UK validation of PHQ-9 and CORE-OM. , 2007, The British journal of general practice : the journal of the Royal College of General Practitioners.

[35]  Lewis A. Opler,et al.  Reliability and validity of the positive and negative syndrome scale for schizophrenics , 1988, Psychiatry Research.

[36]  John Brazier,et al.  Measuring and valuing mental health for use in economic evaluation , 2008, Journal of health services research & policy.

[37]  G. Bonsel,et al.  Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L) , 2011, Quality of Life Research.

[38]  R. Timman,et al.  Assessment of the burden of disease among inpatients in specialized units that provide psychotherapy. , 2005, Psychiatric services.

[39]  M. Barkham,et al.  Using Rasch analysis to form plausible health states amenable to valuation: the development of CORE-6D from a measure of common mental health problems (CORE-OM) , 2011, Quality of Life Research.

[40]  Michael J. Campbell,et al.  Cost-effectiveness and cost-utility of tricyclic antidepressants, selective serotonin reuptake inhibitors and lofepramine , 2006, British Journal of Psychiatry.

[41]  D. Lamping,et al.  Improving the measurement of QALYs in dementia: developing patient- and carer-reported health state classification systems using Rasch analysis. , 2012, Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research.