Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff

Comans, Tracy; Nguyen, Kim‐Huong; Ratcliffe, Julie; Rowen, Donna; Mulhern, Brendan

doi:10.1007/s40273-020-00913-7

Cited by 15 publications

(14 citation statements)

References 50 publications

(57 reference statements)

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“…The measures considered in this study sought exclusively preferences from the general public, except for the AQoL-8D, that included also people with mental health problems [15]. While the development of the DEMQOL and AD-5D contained a separate valuation study with carers and people with mild dementia, the final scoring algorithm is, however, based on views of the general population [28,77,78]. Yet, Rowen and colleagues have shown that people with dementia and carers of people with dementia gave systematically lower values than members of the general population that could impact the results of CUA and subsequent resource allocation decisions [79].…”

Section: Selection Of Measure(s) and Future Researchmentioning

confidence: 99%

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Engel

Bucholc

Mihalopoulos

et al. 2020

Health Qual Life Outcomes

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Background Assessing the cost-effectiveness of interventions for people with dementia, based on cost per quality-adjusted life years (QALYs) gained, requires that the measures used to derive QALYs are preference-based whilst also being valid, feasible to use, comprehensible and acceptable for people with dementia. The aim of this study was to assess the content and face validity of six preference-based measures (PBMs) within the context of dementia. Methods Qualitative focus groups and interviews were conducted with community-dwelling individuals with mild dementia and carers of people with dementia. After exploring participants’ understanding of ‘quality of life’ (QoL), six PBMs were assessed for content and face validity: two measures assessing health-related QoL (EQ-5D-5L and AQoL-8D); two covering broader aspects of capability wellbeing and social care-related QoL (ICECAP-O and ASCOT); and two dementia-specific QoL measures (DEMQOL-U and AD-5D). A random mix of one health-related QoL measure, one wellbeing measure, and one dementia-specific measure was explored in each session. All sessions were audiotaped and transcribed verbatim. Data were analysed thematically. Results Nine individuals with mild dementia and 17 carers of people with dementia participated across 4 focus groups and 10 interviews. Participants perceived 9 broad QoL domains as relevant to them: Activity, Autonomy, Cognition, Communication, Coping, Emotions, End-of-Life, Physical Functioning, and Relationships. These domains had limited overlap with the content of the six PBMs. Assessment of face validity was summarized into eight themes: (1) ambiguous questions, (2) double –barrelled questions, (3) difficult/abstract questions, (4) judgemental/confronting questions, (5) lack of relevance and comprehensiveness, (6) response options, (7) layout/format and (8) proxy-response. There was no clear preference for one of the six measures explored; participants identified advantages and disadvantages across all measures. Although particularly designed for individuals with dementia, dementia-specific QoL measures were not always favoured over non-specific measures. Conclusion Given the shortcomings of PBMs identified in this study, further empirical comparative analyses are necessary to guide the selection of PBMs for future dementia research.

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Section: Selection Of Measure(s) and Future Researchmentioning

confidence: 99%

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Engel

Bucholc

Mihalopoulos

et al. 2020

Health Qual Life Outcomes

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“…For this study, the DCE TTO choice sets comprised a series of pairwise choices between QOL-ACC quality of life states described as alternative levels of the six dimensions of the QOL-ACC with differing survival durations (the survival duration attribute comprised four levels: 1, 4, 7 and 10 years). Survival duration levels were determined with reference to two main considerations, firstly, survival duration levels applied in other similar valuation studies applying the DCE TTO method and resulting in meaningful and interpretable values [ 30 – 32 ], and secondly, the need to present a range of realistic survival duration levels for the population of interest, dependent older people with limited remaining life expectancy.…”

Section: Methodsmentioning

confidence: 99%

Valuing the Quality-of-Life Aged Care Consumers (QOL-ACC) Instrument for Quality Assessment and Economic Evaluation

Ratcliffe

Bourke

et al. 2022

PharmacoEconomics

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Objective This paper reports on the valuation of the classification system for the Quality-of-Life Aged Care Consumers (QOL-ACC) instrument using a discrete choice experiment (DCE) with duration with a large sample of older people receiving aged care services. Methods A DCE with 160 choice sets of two quality-of-life state–survival duration combinations blocked into 20 survey versions, with eight choice sets in each version, was designed and administered through an on-line survey to older Australians receiving aged care services in home and via interviewer facilitation with older people in residential aged care settings. Model specifications investigating preferences with respect to survival duration and interactions between QOL-ACC dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale to generate a value set suitable for application in quality assessment and for the calculation of quality-adjusted life-years for use in economic evaluation. Results In total, 953 older people completed the choice experiment with valid responses. The estimation results from econometric model specifications indicated that utility increased with survival duration and decreased according to quality-of-life impairment levels. An Australian value set (range − 0.56 to 1.00) was generated for the calculation of utilities for all QOL-ACC states. Conclusion The QOL-ACC is unique in its focus on measuring and valuing quality of life from the perspective of older people themselves, thereby ensuring that the preferences of aged care service users are the primary focus for quality assessment and economic evaluation. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-022-01158-2.

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“…Other studies measured generic PBMs including EQ-5D-3L (n = 4), EQ-5D bolton/bolt-off measures (n = 2), SF-6D v2 (n = 4), EQ-5D-5L plus Adult Social Care Outcomes Toolkit (ASCOT) (n = 1), the informal caregivers' life quality measure CarerQol-7D (n = 8) and infant health-related quality of life instrument measure (IQI) (n = 1). Various condition-specific PBMs were also valued, such as the European Organisation for Research and Treatment of Cancer (EORTC) utility measure instrument QLU-C10D [82] (n = 6), the impact of self-management on quality of life in diabetes measure HASMID, a tool for palliative and supportive care ICECAP-SCM [25], diabetic retinopathy measure DRU-I [20], traumatic brain injury outcome measure QOLIBRI-OS [77], Alzheimer measure AD-5D [24] and cerebral palsy measure CP-6D [19,24] (Fig. 2).…”

Section: Sample Size and Pbm Measuresmentioning

confidence: 99%

Discrete Choice Experiments in Health State Valuation: A Systematic Review of Progress and New Trends

Wang

Rowen

Brazier

et al. 2023

Appl Health Econ Health Policy

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Background Discrete choice experiments (DCEs) are increasingly used in health state valuation studies. Objective This systematic review updates the progress and new findings of DCE studies in the health state valuation, covering the period since the review of June 2018 to November 2022. The review reports the methods that are currently being used in DCE studies to value health and study design characteristics, and, for the first time, reviews DCE health state valuation studies published in the Chinese language. Methods English language databases PubMed and Cochrane, and Chinese language databases Wanfang and CNKI were searched using the self-developed search terms. Health state valuation or methodology study papers were included if the study used DCE data to generate a value set for a preference-based measure. Key information extracted included DCE study design strategies applied, methods for anchoring the latent coefficient on to a 0-1 QALY scale and data analysis methods. Results Sixty-five studies were included; one Chinese language publication and 64 English language publications. The number of health state valuation studies using DCE has rapidly increased in recent years and these have been conducted in more countries than prior to 2018. Wide usage of DCE with duration attributes, D-efficient design and models accounting for heterogeneity has continued in recent years. Although more methodological consensus has been found than in studies conducted prior to 2018, this consensus may be driven by valuation studies for common measures with an international protocol (the 'model' valuation research). Valuing long measures with well-being attributes attracted attention and more realistic design strategies (e.g., inconstant time preference, efficient design and implausible states design) were identified. However, more qualitative and quantitative methodology study is still necessary to evaluate the effect of those new methods. Conclusions The use of DCEs in health state valuation continues to grow dramatically and the methodology progress makes the method more reliable and pragmatic. However, study design is driven by international protocols and method selection is not always justified. There is no gold standard for DCE design, presentation format or anchoring method. More qualitative and quantitative methodology study is recommended to evaluate the effect of new methods before researchers make methodology decisions.

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Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff

Abstract: This is a repository copy of Valuing the AD-5D dementia utility instrument : an estimation of a general population tariff.

Cited by 15 publications

References 50 publications

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

A qualitative exploration of the content and face validity of preference-based measures within the context of dementia

Valuing the Quality-of-Life Aged Care Consumers (QOL-ACC) Instrument for Quality Assessment and Economic Evaluation

Discrete Choice Experiments in Health State Valuation: A Systematic Review of Progress and New Trends

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