Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems: Are Multiattribute Utility Instruments Fit for Purpose?

Mihalopoulos, C; Chen, G; Scott, JG; Bucholc, J; Allen, C; Coghill, D; Jenkins, P; Norman, R; Ratcliffe, J; Richardson, J; Stathis, S; Viney, R

Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems: Are Multiattribute Utility Instruments Fit for Purpose?

Mihalopoulos, C Chen, G Scott, JG Bucholc, J Allen, C Coghill, D Jenkins, P Norman, R Ratcliffe, J Richardson, J Stathis, S Viney, R

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Publisher:: ELSEVIER SCIENCE INC
Publication Type:: Journal Article
Citation:: Value Health, 2023, 26, (5), pp. 733-741
Issue Date:: 2023-05

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Field	Value	Language
dc.contributor.author	Mihalopoulos, C
dc.contributor.author	Chen, G
dc.contributor.author	Scott, JG
dc.contributor.author	Bucholc, J
dc.contributor.author	Allen, C
dc.contributor.author	Coghill, D
dc.contributor.author	Jenkins, P
dc.contributor.author	Norman, R
dc.contributor.author	Ratcliffe, J
dc.contributor.author	Richardson, J
dc.contributor.author	Stathis, S
dc.contributor.author	Viney, R https://orcid.org/0000-0002-0039-9635
dc.date.accessioned	2023-10-03T04:31:10Z
dc.date.available	2022-12-05
dc.date.available	2023-10-03T04:31:10Z
dc.date.issued	2023-05
dc.identifier.citation	Value Health, 2023, 26, (5), pp. 733-741
dc.identifier.issn	1098-3015
dc.identifier.issn	1524-4733
dc.identifier.uri	http://hdl.handle.net/10453/172442
dc.description.abstract	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.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER SCIENCE INC
dc.relation	http://purl.org/au-research/grants/nhmrc/1105187
dc.relation	http://purl.org/au-research/grants/nhmrc/GNT1105187
dc.relation.ispartof	Value Health
dc.relation.isbasedon	10.1016/j.jval.2022.12.007
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1117 Public Health and Health Services, 1402 Applied Economics
dc.subject.classification	Health Policy & Services
dc.subject.classification	3801 Applied economics
dc.subject.classification	4203 Health services and systems
dc.subject.classification	4407 Policy and administration
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Mental Health
dc.subject.mesh	Quality of Life
dc.subject.mesh	Health Status
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Australia
dc.subject.mesh	Nucleotidyltransferases
dc.subject.mesh	Reproducibility of Results
dc.subject.mesh	Humans
dc.subject.mesh	Nucleotidyltransferases
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Reproducibility of Results
dc.subject.mesh	Mental Health
dc.subject.mesh	Health Status
dc.subject.mesh	Quality of Life
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Australia
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Humans
dc.subject.mesh	Adolescent
dc.subject.mesh	Child
dc.subject.mesh	Mental Health
dc.subject.mesh	Quality of Life
dc.subject.mesh	Health Status
dc.subject.mesh	Surveys and Questionnaires
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Cross-Sectional Studies
dc.subject.mesh	Australia
dc.subject.mesh	Nucleotidyltransferases
dc.subject.mesh	Reproducibility of Results
dc.title	Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems: Are Multiattribute Utility Instruments Fit for Purpose?
dc.type	Journal Article
utslib.citation.volume	26
utslib.location.activity	United States
utslib.for	1117 Public Health and Health Services
utslib.for	1402 Applied Economics
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
dc.date.updated	2023-10-03T04:31:08Z
pubs.issue	5
pubs.publication-status	Published
pubs.volume	26
utslib.citation.issue	5

Abstract:

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.

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http://hdl.handle.net/10453/172442