How to Measure Quality of Life for Cost-Effectiveness Analyses of Personality Disorders: A Systematic Review

Abstract

Objective: To assess the construct validity and responsiveness of four generic health related quality of life (HRQL) measures in personality disorders (PDs).Methods: A systematic review was undertaken. Ten databases were searched and reference lists scrutinised to identify relevant studies. Relevant data were extracted accordingly. A narrative synthesis was performed of the evidence on construct validity including known groups validity (detecting differences in HRQL scores between two different groups), convergent validity (strength of association between generic HRQL and other measures (e.g. symptom) and responsiveness (differences in generic HRQL measure scores in responders/non-responders or correlation with changes in other measures).Results: Ten studies were identified, with 6 for the EQ-5D, two involving SF-36 and another 2 the SF-12, but none on the SF-6D. Evidence indicated that the EQ-5D, SF-36 and SF-12 were probably valid measures within PDs. Four studies demonstrated that the EQ-5D Index was able to detect changes in patients. Conclusion:Generic HRQL measures appear appropriate for use in people with PDs in terms of psychometric performance. However, qualitative concerns remain as to whether they fully reflect the impact of the condition.4

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

“…[60][61][62] This section summarises the results using a simple classification of the evidence: ✓ indicates results in support of validity or responsiveness and ✗ indicates an inconsistent or non-significant result. The results on validity have been divided into known-group differences across severity groups typically defined using symptoms, known differences against a normal case-control group and convergence with a measure of the condition.…”

Recovering Quality of Life (ReQoL): a new generic self-reported outcome measure for use with people experiencing mental health difficulties

“…For personality disorders, the EQ-5D may be suitable but lacks the content validity to fully reflect the impact of the condition. 16 In terms of the SWEMWBS, there is limited evidence on its validity in the area of mental health. 10 , 11 …”

Cost-Effectiveness of Short-Term Inpatient Psychotherapy Based on Transactional Analysis in Patients With Personality Disorder

“…For the economic evaluation, the effects were measured in health-related quality of life years (QALYs) using the EQ-5D-3L [42]. The EQ-5D is a standardised instrument and has shown to be sensitive to change in PD patients [43]. Five health states were measured: 'mobility', 'self-care', 'usual activities', 'pain/discomfort', and 'anxiety/depression'.…”