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Open Access 14-05-2023

Assessing the validity and responsiveness of a generic preference quality of life measure in the context of posttraumatic stress disorder

Authors: Sheradyn R. Matthews, Marja Elizabeth, Larissa N. Roberts, Billingsley Kaambwa, Tracey D. Wade, Reginald D. V. Nixon

Published in: Quality of Life Research | Issue 10/2023

Abstract

Purpose

There is limited research exploring the usefulness of generic preference-based quality of life (GPQoL) measures used to facilitate economic evaluation in the context of posttraumatic stress disorder (PTSD). The aim of the current study was to explore the validity and responsiveness of a common GPQoL measure (Assessment of Quality of Life 8 Dimension [AQoL-8D]) in relation to a PTSD condition-specific outcome measure (Posttraumatic Stress Disorder Checklist for the DSM-5 [PCL-5]).

Method

This aim was investigated in a sample of individuals (N = 147) who received trauma-focused cognitive-behavioural therapies for posttraumatic stress disorder. Convergent validity was investigated using spearman’s correlations, and the level of agreement was investigated using Bland–Altman plots. Responsiveness was investigated by exploring the standardised response means (SRM) from pre-post-treatment across the two measures, which allow the comparison of the magnitude of change between the measures over time.

Results

Correlations between the AQoL-8D (dimensions, utility and summary total scores) and the PCL-5 total score ranged from small to large and agreement between the measures was considered moderate to good. While SRMs were large for the AQoL-8D and PCL-5 total scores, the SRM for the PCL-5 was nearly double that of the AQoL-8D.

Conclusion

Our findings demonstrate that the AQoL-8D has good construct validity but present preliminary evidence that economic evaluations using only GPQoL measures may not fully capture the effectiveness of PTSD treatments.

Available only for authorised users

Although the AQoL-8D was included in the pooled studies for health economic analyses, the primary aim of these studies was to index clinical outcomes following a psychological intervention. Therefore, the present study represents a secondary analysis of this data.

Shearer, J., McCrone, P., & Romeo, R. (2016). Economic Evaluation of Mental Health Interventions: A Guide to Costing Approaches. PharmacoEconomics, 34(7), 651–664. https://doi.org/10.1007/s40273-016-0390-3CrossRefPubMed

Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the Economic Evaluation of Health Care Programmes. Oxford University Press.

Knapp, M., & Wong, G. (2020). Economics and mental health: The current scenario. World Psychiatry, 19(1), 3–14. https://doi.org/10.1002/wps.20692CrossRefPubMedPubMedCentral

Slade, T., Johnston, A., Oakley Browne, M., Andrews, G., & Whiteford, H. (2009). 2007 National Survey of Mental Health and Wellbeing: Methods and Key Findings. Australian and New Zealand Journal of Psychiatry, 43, 594–605. https://doi.org/10.1080/00048670902970882CrossRefPubMed

Kezelman, N., Hossack, N., Stavropoulos, P., & Burley, P. (2015). The cost of unresolved childhood trauma and abuse in adults in Australia. Adults Surviving Child Abuse and Pegasus Economics.

Giacco, D., Matanov, A., & Priebe, S. (2013). Symptoms and subjective quality of life in post-traumatic stress disorder: A longitudinal study. PLoS ONE, 8(4), 1–7. https://doi.org/10.1371/journal.pone.0060991CrossRef

Scoglio, A. A. J., Reilly, E. D., Girouard, C., Quigley, K. S., Carnes, S., & Kelly, M. M. (2022). Social functioning in individuals with post-traumatic stress disorder: A systematic review. Trauma, Violence, & Abuse, 23(2), 356–371. https://doi.org/10.1177/1524838020946800CrossRef

Luyten, J., Naci, H., & Knapp, M. (2016). Economic evaluation of mental health interventions: An introduction to cost-utility analysis. Evidence Based Mental Health, 19(2), 49–53. https://doi.org/10.1136/eb-2016-102354CrossRefPubMed

Department of Health. (2017). Technical Guidelines for preparing assessment reports for the Medical Services Advisory Committee—Service Type: Investigative (p. 230). http://www.msac.gov.au/internet/msac/publishing.nsf/Content/0BD63667C984FEEACA25801000123AD8/$File/InvestigativeTechnicalGuidelines-December-2016-Version-3.0.pdf

10.

National Institute for Health and Care Excellence. (2013). Guide to the methods of technology appraisal 2013 (p. 93). https://www.nice.org.uk/process/pmg9/resources/guide-to-the-methods-of-technology-appraisal-2013-pdf-2007975843781

11.

Finch, A. P., Brazier, J. E., & Mukuria, C. (2018). What is the evidence for the performance of generic preference-based measures? A systematic overview of reviews. The European Journal of Health Economics, 19(4), 557–570. https://doi.org/10.1007/s10198-017-0902-xCrossRefPubMed

12.

Brooks, R. (1996). EuroQol: The current state of play. Health Policy, 37(1), 53–72. https://doi.org/10.1016/0168-8510(96)00822-6CrossRefPubMed

13.

Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of health economics, 21(2), 271–292. https://doi.org/10.1016/S0167-6296(01)00130-8CrossRefPubMed

14.

Horsman, J., Furlong, W., Feeny, D., & Torrance, G. (2003). The health utilities index (HUI®): Concepts, measurement properties and applications. Health and quality of life outcomes, 1(1), 1–13. https://doi.org/10.1186/1477-7525-1-54CrossRef

15.

Devlin, N. J., & Brooks, R. (2017). EQ-5D and the EuroQol group: Past, present and future. Applied Health Economics and Health Policy, 15(2), 127–137. https://doi.org/10.1007/s40258-017-0310-5CrossRefPubMedPubMedCentral

16.

Abdin, E., Chong, S. A., Seow, E., Peh, C. X., Tan, J. H., Liu, J., Hui, S. F. S., Chua, B. Y., Sim, K., Verma, S., Vaingankar, J. A., & Subramaniam, M. (2019). A comparison of the reliability and validity of SF-6D, EQ-5D and HUI3 utility measures in patients with schizophrenia and patients with depression in Singapore. Psychiatry Research, 274, 400–408. https://doi.org/10.1016/j.psychres.2019.02.077CrossRefPubMed

17.

Mulhern, B., Mukuria, C., Barkham, M., Knapp, M., Byford, S., Soeteman, D., & Brazier, J. (2014). Using generic preference-based measures in mental health: Psychometric validity of the EQ-5D and SF-6D. The British Journal of Psychiatry, 205(3), 236–243. https://doi.org/10.1192/bjp.bp.112.122283CrossRefPubMed

18.

Dams, J., Rimane, E., Steil, R., Renneberg, B., Rosner, R., & König, H. H. (2021). Reliability, validity and responsiveness of the EQ-5D-5L in assessing and valuing health status in adolescents and young adults with posttraumatic stress disorder: A randomized controlled trail. Psychiatric quarterly, 92(2), 459–471. https://doi.org/10.1007/s11126-020-09814-6CrossRefPubMed

19.

Crick, K., Al Sayah, F., Ohinmaa, A., & Johnson, J. A. (2018). Responsiveness of the anxiety/depression dimension of the 3- and 5-level versions of the EQ-5D in assessing mental health. Quality of Life Research, 27(6), 1625–1633. https://doi.org/10.1007/s11136-018-1828-1CrossRefPubMed

20.

Richardson, J., Iezzi, A., Khan, M. A., & Maxwell, A. (2014). Validity and reliability of the assessment of quality of life (AQoL)-8D multi-attribute utility instrument. The Patient - Patient-Centered Outcomes Research, 7(1), 85–96. https://doi.org/10.1007/s40271-013-0036-xCrossRefPubMed

21.

Bovin, M. J., Marx, B. P., Weathers, F. W., Gallagher, M. W., Rodriguez, P., Schnurr, P. P., & Keane, T. M. (2016). Psychometric properties of the PTSD checklist for diagnostic and statistical manual of mental disorders-fifth edition (PCL-5) in veterans. Psychological Assessment, 28(11), 1379–1391. https://doi.org/10.1037/pas0000254CrossRefPubMed

22.

Richardson, J., Sinha, K., Iezzi, A., & Khan, M. A. (2014). Modelling utility weights for the assessment of quality of life (AQoL)-8D. Quality of Life Research, 23(8), 2395–2404. https://doi.org/10.1007/s11136-014-0686-8CrossRefPubMed

23.

Schnurr, P. P., Hayes, A. F., Lunney, C. A., McFall, M., & Uddo, M. (2006). Longitudinal analysis of the relationship between symptoms and quality of life in veterans treated for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 74(4), 707–713. https://doi.org/10.1037/0022-006X.74.4.707CrossRefPubMed

24.

Vogt, D., Smith, B. N., Fox, A. B., Amoroso, T., Taverna, E., & Schnurr, P. P. (2017). Consequences of PTSD for the work and family quality of life of female and male US Afghanistan and Iraq War veterans. Social psychiatry and psychiatric. https://doi.org/10.1007/s00127-016-1321-5CrossRef

25.

Weathers, F. W., Bovin, M. J., Lee, D. J., Sloan, D. M., Schnurr, P. P., Kaloupek, D. G., Keane, T. M., & Marx, B. P. (2018). The clinician-administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychological Assessment, 30, 383–395. https://doi.org/10.1037/pas0000486CrossRefPubMed

26.

Resick, P. A., Monson, C. M., & Chard, K. M. (2016). Cognitive processing therapy for PTSD: A comprehensive manual. Guilford Publications.

27.

National Institute for Health and Care Excellence [NICE]. (2018). Post-traumatic Stress Disorder [NICE guideline No. 116]. 49.

28.

Phoenix Australia. (2020). Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD. https://www.phoenixaustralia.org/australian-guidelines-for-ptsd/

29.

Clinical Research Unit for Anxiety and Depression, St Vincent’s Hospital, & University of New South Wales. (n.d.). THIS WAY UP. THIS WAY UP. Retrieved August 6, 2021, from https://thiswayup.org.au/

30.

Matthews, S. R., Elizabeth, M., Roberts, L. N., & Nixon, R. D. (2022). Client versus clinicians’ standards of clinically meaningful change and the effects of treatment expectations on therapeutic outcomes in individuals with posttraumatic stress disorder. Behavior Therapy, 53(3), 560–570. https://doi.org/10.1016/j.beth.2021.12.007CrossRefPubMed

31.

Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSD at www.ptsd.va.gov.

32.

Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The posttraumatic stress disorder checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of traumatic stress, 28(6), 489–498. https://doi.org/10.1002/jts.22059CrossRefPubMed

33.

Morris, S. B. (2008). Estimating effect sizes from pretest-posttest-control group designs. Organizational research methods, 11(2), 364–386. https://doi.org/10.1177/1094428106291059CrossRef

34.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). London: Routledge.

35.

Kaambwa, B., Mpundu-Kaambwa, C., Adams, R., Appleton, S., Martin, S., & Wittert, G. (2018). Suitability of the Epworth Sleepiness Scale (ESS) for economic evaluation: An assessment of its convergent and discriminant validity. Behavioral Sleep Medicine, 16(5), 448–470. https://doi.org/10.1080/15402002.2016.1228647CrossRefPubMed

36.

Harrison, M. J., Davies, L. M., Bansback, N. J., McCoy, M. J., Verstappen, S. M. M., Watson, K., & Symmons, D. P. M. (2009). The comparative responsiveness of the EQ-5D and SF-6D to change in patients with inflammatory arthritis. Quality of Life Research, 18(9), 1195–1205. https://doi.org/10.1007/s11136-009-9539-2CrossRefPubMedPubMedCentral

37.

van Hateren, K. J. J., Alkhalaf, A., Kleefstra, N., Groenier, K. H., de Jong, P. E., de Zeeuw, D., Gans, R. O. B., Struck, J., Bilo, H. J. G., Gansevoort, R. T., & Bakker, S. J. L. (2012). Comparison of midregional pro–A-type natriuretic peptide and the N-terminal pro–B-type natriuretic peptide for predicting mortality and cardiovascular events. Clinical Chemistry, 58(1), 293–297. https://doi.org/10.1373/clinchem.2011.166348CrossRefPubMed

38.

Bland, J. M., & Altman, D. (1986). Statistical methods for assessing agreement between two methods of clinical measurement. The Lancet, 327(8476), 307–310. https://doi.org/10.1016/S0140-6736(86)90837-8CrossRef

39.

Giavarina, D. (2015). Lessons in biostatistics. Biochem Medica, 25(2), 141–151. https://doi.org/10.11613/BM.2015.015CrossRef

40.

Hansford, M., & Jobson, L. (2021). Associations between relationship quality, social network resources, appraisals, coping, and posttraumatic stress disorder symptoms. Psychological Trauma: Theory, Research, Practice, and Policy, 13(5), 575–585. https://doi.org/10.1037/tra0001015CrossRefPubMed

41.

Kaambwa, B., Gill, L., McCaffrey, N., Lancsar, E., Cameron, I. D., Crotty, M., Gray, L., & Ratcliffe, J. (2015). An empirical comparison of the OPQoL-Brief, EQ-5D-3 L and ASCOT in a community dwelling population of older people. Health and quality of life outcomes, 13(1), 1–17. https://doi.org/10.1186/s12955-015-0357-7CrossRef

42.

Chen, G., Flynn, T., Stevens, K., Brazier, J., Huynh, E., Sawyer, M., Roberts, R., & Ratcliffe, J. (2015). Assessing the health-related quality of life of Australian adolescents: An empirical comparison of the child health utility 9D and EQ-5D-Y instruments. Value in Health, 18(4), 432–438. https://doi.org/10.1016/j.jval.2015.02.014CrossRefPubMed

43.

Ratcliffe, J., Stevens, K., Flynn, T., Brazier, J., & Sawyer, M. (2012). An assessment of the construct validity of the CHU9D in the Australian adolescent general population. Quality of life research, 21(4), 717–725. https://doi.org/10.1007/s11136-011-9971-yCrossRefPubMed

44.

Luxton, D. D., Skopp, N. A., & Maguen, S. (2010). Gender differences in depression and PTSD symptoms following combat exposure. Depression and anxiety, 27(11), 1027–1033. https://doi.org/10.1002/da.20730CrossRefPubMed

45.

Tran, K., Moulton, K., Santesso, N., & Rabb, D. (2016). Cognitive processing therapy for post-traumatic stress disorder: a systematic review and meta-analysis. Canadian Agency for Drugs and Technologies in Health.

Title: Assessing the validity and responsiveness of a generic preference quality of life measure in the context of posttraumatic stress disorder
Authors: Sheradyn R. Matthews
Marja Elizabeth
Larissa N. Roberts
Billingsley Kaambwa
Tracey D. Wade
Reginald D. V. Nixon
Publication date: 14-05-2023
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 10/2023
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-023-03432-y

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Assessing the validity and responsiveness of a generic preference quality of life measure in the context of posttraumatic stress disorder

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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