A Qualitative Assessment of the Content Validity of the ICECAP-A and EQ-5D-5L and Their Appropriateness for Use in Health Research

Abstract

PurposeThe ICECAP-A and EQ-5D-5L are two index measures appropriate for use in health research. Assessment of content validity allows understanding of whether a measure captures the most relevant and important aspects of a concept. This paper reports a qualitative assessment of the content validity and appropriateness for use of the eq-5D-5L and ICECAP-A measures, using novel methodology.MethodsIn-depth semi-structured interviews were conducted with research professionals in the UK and Australia. Informants were purposively sampled based on their professional role. Data were analysed in an iterative, thematic and constant comparative manner. A two stage investigation - the comparative direct approach - was developed to address the methodological challenges of the content validity research and allow rigorous assessment.ResultsInformants viewed the ICECAP-A as an assessment of the broader determinants of quality of life, but lacking in assessment of health-related determinants. The eq-5D-5L was viewed as offering good coverage of health determinants, but as lacking in assessment of these broader determinants. Informants held some concerns about the content or wording of the Self-care, Pain/Discomfort and Anxiety/Depression items (EQ-5D-5L) and the Enjoyment, Achievement and attachment items (ICECAP-A). ConclusionUsing rigorous qualitative methodology the results suggest that the ICECAP-A and EQ-5D-5L hold acceptable levels of content validity and are appropriate for use in health research. This work adds expert opinion to the emerging body of research using patients and public to validate these measures.

Comparing Measurement Properties of the EQ-5D-3L, ICECAP-O, and ASCOT in Frail Older Adults

“…Qualitative research may be helpful to include the perspective of older adults in assessing the content validity of the measures. A few studies have already used a qualitative or mixed approach for ASCOT and the adult population version of ICECAP [9,13,60,61]. Furthermore, to help researchers select the most appropriate instrument, we would suggest further work that concentrates on differences between ICECAP-O and ASCOT.…”

Choice of Outcome Measure in an Economic Evaluation: A Potential Role for the Capability Approach

“…NICE technology appraisals avoid this given the stated preference for the use of the EQ-5D, at least in terms of adult conditions; there is less specificity around measuring HR-QoL for children, and the public health and social care guidance are even less prescriptive. The sensitivities of each measure to different patient groups and health or social conditions will become evident with time; there is already research being undertaken which is comparing the measures [38,60,61].…”

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

“…Despite the positive emerging evidence for the psychometric properties of the ICECAP-A [32][33][34][35] and EQ-5D-5L [6][7][8][9], no evidence is yet available for the context of opiate dependence. Even though some supporting evidence for the EQ-5D-3L and other similar health-focused measures exists for this context [36][37][38][39], such measures are used with caution in economic evaluations [40,41].…”