Living Up to a Good Death: Complexities and Constraints in End of Life Choices

Round, Jeff; Llewellyn, Henry

doi:10.1007/978-3-319-28267-1_14

Cited by 4 publications

(3 citation statements)

References 30 publications

(27 reference statements)

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“…Furthermore, our analysis contributes to the wider debate in which the appropriateness of standard economic methods in palliative care has been questioned, with some researchers proposing that the QALY framework be either modified or completely substituted. 43–45 However, wider question of the appropriateness of standard economic methods and tools in palliative care is a much bigger question – beyond the scope of this analysis – and will require further research. Such research would, for example, involve a careful examination of other generic health economic instruments, in addition to the EQ-5D, to assess their ability to detect changes in palliative care populations when compared with palliative care–specific instruments.…”

Section: Discussionmentioning

confidence: 99%

Does the EQ-5D capture the concerns measured by the Palliative care Outcome Scale? Mapping the Palliative care Outcome Scale onto the EQ-5D using statistical methods

2017

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Differences between the Palliative care Outcome Scale and the EQ-5D do not undermine the qualities of either instrument when used for their own purposes. However, due to conceptual differences, the EQ-5D does not capture some of the concerns measured by the Palliative care Outcome Scale, and therefore, mapping onto the EQ-5D is unlikely to provide an appropriate basis for estimating utilities for conducting economic evaluations in palliative care studies.

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Section: Discussionmentioning

confidence: 99%

Does the EQ-5D capture the concerns measured by the Palliative care Outcome Scale? Mapping the Palliative care Outcome Scale onto the EQ-5D using statistical methods

2017

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“…Standard economic instruments have been criticised for failing to do this [ 10 , 11 ] However, there are important differences between the two instruments, mainly due to conceptual differences in their respective evaluative frameworks. The POS-E measures impact on health (or utility), whereas the ICECAP-SCM gives more attention to broader impacts on capability and wellbeing and is particularly important where health outcomes are not the focus of evaluation, such as social care interventions [ 55 ]. Nevertheless, because palliative and end-of-life care include aspects of both health (e.g.…”

Section: Discussionmentioning

confidence: 99%

Development of a Patient-Reported Palliative Care-Specific Health Classification System: The POS-E

Dzingina

Higginson

McCrone

et al. 2017

Patient

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BackgroundGeneric preference-based measures are commonly used to estimate quality-adjusted life-years (QALYs) to inform resource-allocation decisions. However, concerns have been raised that generic measures may be inappropriate in palliative care.ObjectiveOur objective was to derive a health-state classification system that is amenable to valuation from the ten-item Palliative Care Outcome Scale (POS), a widely used patient-reported outcome measure in palliative care.MethodsThe dimensional structure of the original POS was assessed using factor analysis. Item performance was assessed, using Rasch analysis and psychometric criteria, to enable the selection of items that represent the dimensions covered by the POS. Data from six studies of patients receiving palliative care were combined (N = 1011) and randomly split into two halves for development and validation. Analysis was undertaken on the development data, and results were validated by repeating the analysis with the validation dataset.ResultsFollowing Rasch and factor analyses, a classification system of seven items was derived. Each item had two to three levels. Rasch threshold map helped identify a set of 14 plausible health states that can be used for the valuation of the instrument to derive a preference-based index.ConclusionCombining factor analysis and Rasch analysis with psychometric criteria provides a valid method of constructing a classification system for a palliative care-specific preference-based measure. The next stage is to obtain preference weights so the measure can be used in economic evaluations in palliative care.Electronic supplementary materialThe online version of this article (doi:10.1007/s40271-017-0224-1) contains supplementary material, which is available to authorized users.

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“…Although analytic approaches have been tailored for use in health and care interventions, there remain problems in applying the recommended economic evaluation methods for generating QALYs across all population groups. For example, difficulties in applying standard economic approaches to patients near the end-of-life have been discussed ( Coast, 2014 ; Normand, 2009 ; Round, 2012 , 2016 ). Another important population group where challenges in applying the standard approach are evident, is children and young people (CYP), defined here as those aged under 18 years old ( Detrick, 1999 ).…”

Section: Introductionmentioning

confidence: 99%

Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

et al. 2021

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Methods for measuring outcomes suitable for economic evaluations of health and care interventions have primarily focused on adults. The validity of such methods for children and young people is questionable in areas including the outcome domains measured and how they are measured and valued, with most existing measures narrowly focusing on health. Novel methods for assessing benefits beyond health by focusing on a person's capability have also concentrated on adults to date. This paper aims to set out the rationale for capability measures in children and young people. It argues for the need to expand the evaluative space beyond health functioning towards broader capabilities, with children and young people playing an integral role in capability measure development. Drawing from existing literature, specific challenges related to the identification, measurement, and valuation of capabilities in children and young people are also discussed. Finally, the practical implications for conducting economic evaluation when measuring and valuing capabilities at different stages across the life‐course are illustrated. We develop an alternative framework based on conceiving capabilities as evolving across the life‐course. This framework may also be helpful in thinking about how to model health outcomes across the life‐course.

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Living Up to a Good Death: Complexities and Constraints in End of Life Choices

Abstract: General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available:

Cited by 4 publications

References 30 publications

Does the EQ-5D capture the concerns measured by the Palliative care Outcome Scale? Mapping the Palliative care Outcome Scale onto the EQ-5D using statistical methods

Does the EQ-5D capture the concerns measured by the Palliative care Outcome Scale? Mapping the Palliative care Outcome Scale onto the EQ-5D using statistical methods

Development of a Patient-Reported Palliative Care-Specific Health Classification System: The POS-E

Challenges in developing capability measures for children and young people for use in the economic evaluation of health and care interventions

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