TY - JOUR
T1 - Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems
T2 - Are Multiattribute Utility Instruments Fit for Purpose?
AU - Mihalopoulos, Cathrine
AU - Chen, Gang
AU - Scott, James G.
AU - Bucholc, Jessica
AU - Allen, Cassandra
AU - Coghill, David
AU - Jenkins, Peter
AU - Norman, Richard
AU - Ratcliffe, Julie
AU - Richardson, Jeffrey
AU - Stathis, Stephen
AU - Viney, Rosalie
N1 - Funding Information:
Conflict of Interest Disclosures: Dr Viney reported membership in the EuroQol Group. Dr Viney reported being the Vice-Chair of the EuroQol Group Scientific Executive Committee. Dr Viney also reports membership in the EuroQol Group's Valuation Working Group. Dr Viney also reported receiving funding from EuroQol for unrelated projects outside the submitted work. Dr Coghill reported receiving personal fees from Shire/Takeda, Novartis, Medice, and Servier and other from Oxford University Press and Cambridge University Press outside the submitted work. Dr Norman is an editor for Value in Health and had no role in the peer-review process of this article. No other disclosures were reported.
Funding Information:
Funding/Support: This study was supported by a National Health and Medical Research Project (NHMRC) project grant, APP1105187.
Funding Information:
Conflict of Interest Disclosures: Dr Viney reported membership in the EuroQol Group. Dr Viney reported being the Vice-Chair of the EuroQol Group Scientific Executive Committee. Dr Viney also reports membership in the EuroQol Group’s Valuation Working Group. Dr Viney also reported receiving funding from EuroQol for unrelated projects outside the submitted work. Dr Coghill reported receiving personal fees from Shire / Takeda , Novartis , Medice, and Servier and other from Oxford University Press and Cambridge University Press outside the submitted work. Dr Norman is an editor for Value in Health and had no role in the peer-review process of this article. No other disclosures were reported.
Publisher Copyright:
© 2023 International Society for Pharmacoeconomics and Outcomes Research, Inc.
PY - 2023/5
Y1 - 2023/5
N2 - Objectives: The objective of this study was to compare the concurrent and construct validity, as well as the sensitivity of 5 multiattribute utility instruments (MAUIs), including the Assessment of Quality of Life-6D (AQoL-6D), EQ-5D-Y, Health Utilities Index (HUI)-2 and HUI-3, and the Child Health Utility 9D, 1 generic pediatric quality of life instrument, with 3 routinely collected outcome measures in Australian mental health services (Strengths and Difficulties Questionnaire, Clinical Global Assessment Scale [CGAS] and the Health of the Nation Outcome Scale for Children and Adolescents) in children and adolescents diagnosed of internalizing (eg, anxiety/depression), externalizing (eg, attention deficit hyperactivity disorder/conduct disorders), and trauma/stress related mental disorders. Methods: A cross-sectional survey of measures, including demographic and basic treatment information, in children/adolescents recruited via 5 child and youth mental health services in Queensland and Victoria, Australia. Measures were either proxy or self-report completed, the CGAS and the Health of the Nation Outcome Scale for Children and Adolescents were clinician completed. Results: The sample included 426 participants and had a mean age of 13.7 years (range 7-18 years). Utilities (as calculated from MAUIs) were generally lower in older adolescents and those with internalizing disorders. All MAUIs and self-reported clinical measures significantly correlated with each other (absolute correlation range 0.40-0.90), with the AQoL-6D showing generally higher levels of correlations. Correlations between the MAUIs and clinician/proxy-reported measures were weak, regardless of diagnosis (absolute correlation range 0.09-0.47). Generally, EQ-5D-Y, HUI-2, and AQoL-6D were more sensitive than Child Health Utility 9D and HUI-3 when distinguishing between different severities according to clinician-assessed CGAS (effect size range 0.17-0.84). Conclusions: The study showed that the commonly used MAUIs had good concurrent and construct validity compared with routinely used self-complete measures but poor validity when compared with clinician/proxy-completed measures. These findings generally held across different diagnoses.
AB - Objectives: The objective of this study was to compare the concurrent and construct validity, as well as the sensitivity of 5 multiattribute utility instruments (MAUIs), including the Assessment of Quality of Life-6D (AQoL-6D), EQ-5D-Y, Health Utilities Index (HUI)-2 and HUI-3, and the Child Health Utility 9D, 1 generic pediatric quality of life instrument, with 3 routinely collected outcome measures in Australian mental health services (Strengths and Difficulties Questionnaire, Clinical Global Assessment Scale [CGAS] and the Health of the Nation Outcome Scale for Children and Adolescents) in children and adolescents diagnosed of internalizing (eg, anxiety/depression), externalizing (eg, attention deficit hyperactivity disorder/conduct disorders), and trauma/stress related mental disorders. Methods: A cross-sectional survey of measures, including demographic and basic treatment information, in children/adolescents recruited via 5 child and youth mental health services in Queensland and Victoria, Australia. Measures were either proxy or self-report completed, the CGAS and the Health of the Nation Outcome Scale for Children and Adolescents were clinician completed. Results: The sample included 426 participants and had a mean age of 13.7 years (range 7-18 years). Utilities (as calculated from MAUIs) were generally lower in older adolescents and those with internalizing disorders. All MAUIs and self-reported clinical measures significantly correlated with each other (absolute correlation range 0.40-0.90), with the AQoL-6D showing generally higher levels of correlations. Correlations between the MAUIs and clinician/proxy-reported measures were weak, regardless of diagnosis (absolute correlation range 0.09-0.47). Generally, EQ-5D-Y, HUI-2, and AQoL-6D were more sensitive than Child Health Utility 9D and HUI-3 when distinguishing between different severities according to clinician-assessed CGAS (effect size range 0.17-0.84). Conclusions: The study showed that the commonly used MAUIs had good concurrent and construct validity compared with routinely used self-complete measures but poor validity when compared with clinician/proxy-completed measures. These findings generally held across different diagnoses.
KW - child and adolescent mental health
KW - cost-utility analysis
KW - economic evaluation
KW - multiattribute utility instruments
KW - outcome measures
KW - quality-adjusted life-years (QALYs)
KW - utility weights
KW - young people's mental health
UR - http://www.scopus.com/inward/record.url?scp=85148381810&partnerID=8YFLogxK
U2 - 10.1016/j.jval.2022.12.007
DO - 10.1016/j.jval.2022.12.007
M3 - Article
C2 - 36535579
AN - SCOPUS:85148381810
SN - 1098-3015
VL - 26
SP - 733
EP - 741
JO - Value in Health
JF - Value in Health
IS - 5
ER -
