Developing a broader measure for economic evaluation

Lead Research Organisation: University of Birmingham
Department Name: Health Service Management Centre

Abstract

We aim to develop a new measure that looks at all aspects of quality of life, not just health, and can be used to assess value for money (cost-effectiveness). Such a measure will be important for estimating the cost-effectiveness of health interventions that impact on quality of life generally.
The National Health Service has a set amount of money to spend on providing services. Because of this it has to decide which services to provide and which services not to provide. Many of these decisions are made by thinking about whether the amount of money spent is worth the extra health that is achieved. For some services, especially public health interventions, looking just at health is problematic because these services do not just affect people’s health. For example, teenage pregnancy services might result in better education and life opportunities.
This new measure for use in cost-effectiveness studies will be developed by talking to people to find out what is important to them and why. The resulting important aspect of people’s lives will then be valued using survey techniques. These values can then be used in assessments of cost-effectiveness.

Technical Summary

Economic evaluation requires monetary measures or a single outcome for use across all interventions to assist decisions about service provision or technology adoption. The quality-adjusted life-year (QALY) has become the dominant measure for use in economic evaluation. Interventions such as public health, mental health and complex interventions, however, are not well served by this measure as they may impact broadly on quality of life rather than health per se. Economic evaluation for such interventions thus requires assessments of outcome going beyond the narrow health confines whilst still being amenable for use within economic evaluation.

Work on the MRC HSRC programme Investigating Choice Experiments for Preferences of Older People (ICEPOP) has successfully developed ? through extensive qualitative work and subsequent links with Amartya Sen?s capability theory ? a more general quality of life index that could potentially be used for such interventions. This measure is being used in intervention studies but it has been developed for use in older people and is not directly applicable to younger populations. This proposal seeks to develop and extend this capability measure for use across the entire adult population.

The research will take place in four phases. The first phase will use in-depth interviews with up to 40 informants to explore whether the attributes derived from older people are applicable to the adult population and to define conceptual attributes for an adult population. The second phase will use repeat semi-structured interviews with up to 25 informants to develop meaningful terminology for an adult population. The third phase will use interviewer administered best-worst scaling discrete choice experiments with 400 respondents to obtain values representing the importance of these attributes from an adult population. The final phase will explore the validity and reliability of the measure.

Iterative constant-comparative methods will be used to analyse all qualitative data. Discrete choice experiments will be analysed using regression techniques.

Publications


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Al-Janabi H (2013) An investigation of the construct validity of the ICECAP-A capability measure. in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Al-Janabi H (2012) Development of a self-report measure of capability wellbeing for adults: the ICECAP-A. in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Al-Janabi H (2013) Can capabilities be self-reported? A think aloud study. in Social science & medicine (1982)
Goranitis I (2016) The validity and responsiveness of the ICECAP-A capability-well-being measure in women with irritative lower urinary tract symptoms. in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
Keeley T (2015) A longitudinal assessment of the responsiveness of the ICECAP-A in a randomised controlled trial of a knee pain intervention. in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation
 
Description CVZ workshop - Netherlands
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
Description ICECAP recommended by NICE
Geographic Reach National 
Policy Influence Type Citation in other policy documents
 
Description NICE citizen's council - ICECAP for social services
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description NICE public health workshop 2012
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description SCIE guidance on economic evaluation in social care
Geographic Reach National 
Policy Influence Type Citation in other policy documents
 
Description MRC Early Career Research Fellowship in the Economics of Health
Amount £276,684 (GBP)
Funding ID G1002334 
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom of Great Britain & Northern Ireland (UK)
Start 06/2011 
End 05/2014
 
Description MRC trials hub for methodology research
Amount £14,600 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom of Great Britain & Northern Ireland (UK)
Start 10/2010 
End 06/2011
 
Description NHMRC Project grant
Amount £822,660 (GBP)
Funding ID 1006334 
Organisation Australian Government 
Department National Health and Medical Research Council (Australia)
Sector Public
Country Australia, Commonwealth of
Start 04/2011 
End 03/2014
 
Title ICECAP-A 
Description A capability measure for use in economic evaluation and for use among the general adult population. A descriptive system has been developed but values are not yet available. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2010 
Provided To Others? Yes  
Impact See www.birmingham.ac.uk/icecap Measure already being used in a number of studies and clinical trials 
URL http://www.birmingham.ac.uk/icecap
 
Description capability collaboration 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Department Faculty of Public Health and Policy
Country United Kingdom of Great Britain & Northern Ireland (UK) 
Sector Academic/University 
PI Contribution contribution to papers
Collaborator Contribution contributions to paperscontribution to papers
Impact 18457341, 18657346, 20724670
Start Year 2007
 
Description capability collaboration 
Organisation University of Glasgow
Department School of Social and Political Sciences Glasgow
Country United Kingdom of Great Britain & Northern Ireland (UK) 
Sector Academic/University 
PI Contribution contribution to papers
Collaborator Contribution contributions to paperscontribution to papers
Impact 18457341, 18657346, 20724670
Start Year 2007
 
Title ICECAP-A 
Description Capability measure for use in economic evaluation for the general adult population 
IP Reference  
Protection Copyrighted (e.g. software)
Year Protection Granted 2010
Licensed No
Impact Use of measure in research studies e.g. clinical trials
 
Description @ICECAPm twitter account 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Twitter account focused on the ICECAP measures started late 2013.

January 2016: currently has 209 followers and has tweeted 224 times.
Year(s) Of Engagement Activity 2013,2014,2015,2016,2017
URL https://twitter.com/icecapm
 
Description PRO publication 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact Al-Janabi H, Coast J. ICECAP-A: Developing a measure of an adult's capabilities. Patient Reported Outcomes Newsletter. 2009: 42, Fall.

none
Year(s) Of Engagement Activity 2009