New HEDS Discussion Paper - Estimating a preference-based index for mental health from the Recovering Quality of Life (ReQoL) measure : valuation of ReQoL-UI

Anju Devianee Keetharuth, Donna Rowen, Jakob Bue Björner and John Brazier

Dr Anju Devianee Keetharuth

Abstract

Objectives There are increasing concerns about the appropriateness of generic preference-based measures to capture health benefits in the area of mental health. This study estimates preference weights for a new measure, Recovering Quality of Life (ReQoL-10), to better capture the benefits of mental health care.

Methods Psychometric analyses of a larger sample of mental health service users (n = 4266) using confirmatory factor analyses and item response theory (IRT) were used to derive a health state classification system and inform the selection of health states for utility assessment. A valuation survey with members of the UK public representative in terms of age, gender and region was conducted using face-to-face interviewer administered time-trade-off (TTO) with props. A series of regression models were fitted to the data and the best performing model selected for the scoring algorithm.

Results The ReQoL-UI classification system comprises six mental health items and one physical health (PH) item. Sixty-four health states were valued by 305 participants. The preferred model was a random effects model, with significant and consistent coefficients and best model fit. Estimated utilities modelled for all health states ranged from -0.195 (state worse than dead) to 1 (best possible state).

Conclusions The development of the ReQoL-UI is based on a novel application of IRT methods for generating the classification system and selecting health states for valuation. Conventional TTO was used to elicit utility values that are modelled to enable the generation of QALYs for use in cost-utility analysis of mental health interventions.

Download the HEDS Discussion Paper here

ReQoL - Focus of UoS research feature

A team led by Professor John Brazier, together with colleagues from ScHARR – Dr Anju Keetharuth, Dr Jill Carlton, Dr Lizzie Taylor Buck and Janice Connell – and Professor Michael Barkham from the Department of Psychology, are the focus of one of the University's current research features, for their work with ReQoL.

For the full feature, please see link below.

https://www.sheffield.ac.uk/research/features/recovering-quality-life

Visit the ReQoL website

HEDS researchers collaborate on new SIPHER consortium to drive policy reform and tackle health inequalities

https://sipher.ac.uk/

A new national public health research consortium, co-led by Professor Petra Meier from ScHARR's Public Health section, is set to drive policy reform in order to tackle inequalities and improve the population’s health. HEDS colleagues, Professor Alan Brennan, Professor Aki Tsuchiya, Professor John Brazier and Dr Suzy Paisley are all involved in the research. 

The innovative SIPHER consortium – a new centre for Systems science In Public Health Economic Research – will provide evidence to support cost-effective action across different policy sectors, including economic growth, education and housing at different scales of government.

The consortium was launched as part of a £25 million funding programme from the UK Prevention Research Partnership (UKPRP) into understanding and influencing the social economic and environmental factors that affect our health.

Professor Meier, SIPHER Director and Professor of Public Health at the University of Sheffield, said: “We know that the conditions in which we are born and live are the key drivers of health and health inequalities. We also know that tackling these social determinants of health requires actions across many policy sectors, such as housing, education or employment.

Professor Meier said about the project: "SIPHER’s vision is a shift from public health policy to healthy public policy. This means all policy sectors working together to tackle health inequalities and improve the population’s health." 

The UKPRP is a partnership between four charities (British Heart Foundation, Cancer Research UK, Wellcome Trust and The Health Foundation), four UK Research and Innovation research councils (Medical Research Council, Economic and Social Research Council, National Environmental Research Council and Engineering and Physical Sciences Research Council) and four health and social care departments (Chief Scientist Office, Health and Care Research Wales, Health and Social Care Research and Development Northern Ireland and National Institute for Health Research).

For further details, see the University press release

Global Expert Panel Publishes New Recommendations on the Use of Health State Utilities in Cost-Effectiveness Models

ISPOR Value in Health

Global Expert Panel Publishes New Recommendations on the 

Use of Health State Utilities in Cost-Effectiveness Models  

A Report of the ISPOR Good Practices for Outcomes Research Task Force 

Value in Health, the official journal of ISPOR—the professional society for health economics and outcomes research, announced today the publication of new recommendations from the Health State Utilities in Cost-Effectiveness Models ISPOR Good Practices for Outcomes Research Task Force. The report, “Identification, Review, and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report,” was published in the March 2019 issue of Value in Health. 

The task force report provides recommendations for researchers who identify, review, and synthesize health state utilities (HSUs) for use in cost-effectiveness models; analysts who use the results in models; and reviewers who critically appraise the suitability and validity of the HSUs selected for use in models. The report provides guidance regarding:

1. The iterative nature of searching for HSUs, reviewing and synthesizing the evidence identified and their application in cost-effectiveness models 
2. Minimum reporting standards for HSUs used in cost-effectiveness models
3. Use of HSUs in cost-effectiveness models

The task force report’s internationally applicable SpRUCE checklist should be used by reviewers of manuscripts and reports of modelling work to ensure the suitability, validity, and quality of the HSUs are sufficient to inform healthcare policy making.   

Professor John Brazier

“This report provides guidance for identifying, reviewing, and synthesizing health state utilities from the literature and using health state utilities in cost-effectiveness models,” said author John Brazier, PhD, Dean and Professor of Health Economics, School of Health and Related Research, University of Sheffield, Sheffield, England, UK. 

“This task force report was written to correct current poor practice in health state utility identification. Analysts frequently cite dated values used in previous cost-effectiveness models without undertaking basic quality checks of the data in the original source material, such as the relevance of the patient population, utility instrument, elicitation method or sources of the preference weights. These shortcuts can render the results uninterpretable when health state utilities derived from a variety of methods and populations are pieced together.” These task force recommendations and the ISPOR SpRUCE checklist offer a structured and more transparent basis for identifying and reporting the HSUs used in a cost-effectiveness model.”

The Importance of Health State Utilities:

Health state utilities, which estimate the value of a health state on a scale where 1 represents full health and 0 represents dead, are used to inform policy decisions in many parts of the world. Preference value estimates are usually obtained by querying a sample of the general population or a patient population. If HSUs are not available from clinical trial data and conducting a study to collect this evidence is not feasible, HSUs are often obtained from the literature. This approach can be problematic because analysts frequently cite outdated evidence used in previous evaluations, systematic reviews of the literature are rarely undertaken for HSUs, and current reporting standards of HSUs used in cost-effectiveness models are often poor.

This is the third ISPOR Good Practices for Outcomes Research Task Force Report on the topic of HSUs. The previous reports are: Estimating Health-State Utility for Economic Models in Clinical Studies: an ISPOR Good Research Practices Task Force Report (2016) and Mapping to Estimate Health-State Utility from Non–Preference-Based Outcome Measures: An ISPOR Good Practices for Outcomes Research Task Force Report (2017).

ABOUT ISPOR

ISPOR, the professional society for health economics and outcomes research (HEOR), is an international, multistakeholder, nonprofit dedicated to advancing HEOR excellence to improve decision making for health globally. The Society is the leading source for scientific conferences, peer-reviewed and MEDLINE^®-indexed publications, good practices guidance, education, collaboration, and tools/resources in the field.

Web: www.ispor.org | LinkedIn: www.linkedin.com/company/ispororg | Twitter: www.twitter.com/ispororg (@ISPORorg) | YouTube: www.youtube.com/ispororg | Facebook: www.facebook.com/ispororg | Instagram: www.instagram.com/ispororg

ABOUT VALUE IN HEALTH

Value in Health (ISSN 1098-3015) is an international, indexed journal that publishes original research and health policy articles that advance the field of health economics and outcomes research to help healthcare leaders make evidence-based decisions. The journal’s 2017 impact factor score is 5.494. Value in Health is ranked 3rd among 94 journals in healthcare sciences and services, 3rd among 79 journals in health policy and services, and 6th among 353 journals in economics. Value in Health is a monthly publication that circulates to more than 10,000 readers around the world.

Web: www.ispor.org/valueinhealth | Twitter: www.twitter.com/isporjournals (@ISPORjournals)

ABOUT ISPOR GOOD PRACTICES FOR OUTCOMES RESEARCH TASK FORCE REPORTS

ISPOR has earned an international reputation for research excellence based, in part, on its Good Practices for Outcomes Research Task Force Reports. These highly cited reports are expert consensus recommendations on good practice standards for outcomes research (clinical, economic, and patient-reported outcomes) and on the use of this research in healthcare decision making. ISPOR Task Forces comprise subject matter experts representing different stakeholders from diverse work environments (ie, regulators, payers, manufacturers, technology assessors, etc from research, government, academic, and industry sectors around the world). All ISPOR Good Practices for Outcomes Research Reports are published in the Society’s scientific journal, Value in Health, and are made freely available as part of the Society’s mission. The Society’s Good Practices for Outcomes Research Reports have been recognized with an ASAE “Power of A” award that acknowledges innovative, effective, and broad-reaching programs that have a positive impact on the world.

Identification, Review and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report

ISPOR 

HEDS colleagues - involved in the Task Force on using utlities in cost effectiveness models - have contributed to a ISPOR report Identification, Review and Use of Health State Utilities in Cost-Effectiveness Models: An ISPOR Good Practices for Outcomes Research Task Force Report

 

Lead author, Professor John Brazier spoke about the paper: This article is an ISPOR Task Force report that aims to improve current poor practice in using health state utility values in cost-effectiveness models written by a team that includes our very own Roberta Ara, Suzy Paisley and myself. 


Analysts frequently cite dated values used in previous cost-effectiveness models without undertaking basic quality checks of the data in the original source material, such as the relevance of the patient population, utility instrument, elicitation method or the sources of the preference weights. These shortcuts can render the results uninterpretable as HSUs derived from a variety of methods and populations are pieced together. 

This task force report provides guidance for researchers on how to identify, review and synthesise HSU estimates for use in cost-effectiveness models. The SpRUCE checklist provides minimum reporting [U1] criteria to judge the appropriateness of the HSUs selected for use and is suitable for use across different international settings. 

HEDS PhD Opportunity - Valuing well-being alongside health: What can and should be done?

HEDS PhD Opportunity - Valuing well-being alongside health: What can and should be done?

Details

Health preferences inform resource allocation decisions around which treatments are recommended for use on the basis of their relative cost-effectiveness. Typically generic preference-based measures of health that can be used across all conditions are used to generate quality adjusted life years (QALYs) to inform cost-effectiveness analyses. The QALY combines both quantity and quality of life by assigning a value to quality of life on a 0 (for states as bad as being dead) to 1 (for full health) scale where values below 0 indicate that the state is worse than being dead. A generic preference-based measure of health consists of: 1) a classification system that is used to describe the health of a person and 2) a value set that generates a utility value that reflects how good or bad people think living in the health state would be. 

Recent research has focused on widening the classification system used to measure health to capture aspects beyond health to focus on domains such as quality of life. This presents challenges for the methods used to elicit utility values and the scope of the QALY itself and its role in informing cost-effectiveness analyses. Research challenges remain around the valuation of measures including: whose preferences to use (patients or general public); which elicitation technique to use; data collection mode; selection of states for valuation; how to aggregate and use these preferences to inform decisions around healthcare resource allocation. 

This PhD will contribute to methodological developments and understanding in the area of eliciting preferences for states that combine both health and wellbeing. The PhD will involve a literature review and primary research using a mixed methods approach involving both qualitative and quantitative research. The student will initially conduct a literature review of valuation methodology to inform the primary data collection. Qualitative work involving interviewers and/or focus groups will be undertaken to explore appropriate elicitation techniques and protocols, and whose preferences to use. Informed by the results of the qualitative work, a larger valuation survey will be conducted to further explore appropriate techniques and data collection mode. 

This project will be contributing methodological research to the Extending the QALY project, which is developing a broad measure of quality of life for use in economic evaluations across health and social care https://scharr.dept.shef.ac.uk/e-qaly/about-the-project/. The Extending the QALY project is funded by a Medical Research Council Industry Collaboration Award with the Euroqol Group. 

This PhD project aligns strongly with the Health Economics and Decision Science work theme of measuring and valuing health. The student will work closely with the ScHARR Outcomes group and benefit from engagement with current preference elicitation work. 

Funding Notes

The UPGRC Scholarships for Medicine, Dentistry & Health are 3.5 years in duration and cover fees and stipend at Home/EU level. Overseas students may apply but will need to fund the fee differential between Home and Overseas rate from another source. 

This project is also being advertised for the China Scholarship Council Award, further details can be found here: https://www.sheffield.ac.uk/postgraduate/phd/scholarships/csc 

The deadline for applications is 5pm on the 23rd January. 

Professor John Brazier

For further details you can send enquiries to  Professor John Brazier or  Dr Donna Rowan

Dr Donna Rowan

Professor John Brazier discussing SF6D

ScHARR's Dean and Professor of Health Economics John Brazier discussing the SF6D - the most widely used measure of general health in clinical studies throughout the world.



It currently generates eight dimension scores and two summary scores for physical and mental health. Whilst such scores provide an excellent means for judging the effectiveness of health care interventions, they have only a limited application in economic evaluation because they are not based on preferences.

EQ-5D-5L: Smaller steps but a major step change?

Professor John Brazier has written a collaborative editorial alongside Professor Andrew Briggs and Professor Sterling Bryan for Health Economics journal.

Professor Brazier said: "NICE uses a three level version of the EQ-5D to estimate QALYs. The potential adoption of the new five level version by NICE has important implications for resource allocation in the NHS. This editorial looks at the arguments for adopting the new five level version (EQ-5D-5L) over the existing three level version."

You can read the editorial here

http://onlinelibrary.wiley.com/doi/10.1002/hec.3627/full

Call for papers - PROMS Research Conference

The PROMS Research Conference will be hosted by the Centre for Patient Reported Outcomes Research at the University of Birmingham, UK on 20th June 2018.
Abstract submission is open. They welcome oral and poster abstracts from clinicians, researchers, patient partners, industry, SMEs and others working in the field. Professor John Brazier (HEDS, YH CLAHRC) is part of the organising committee.

Abstract Guidelines
All abstracts should be submitted via the abstract submission website. Abstract submission will close on Wednesday 28th February 2018.
Abstracts should be written in plain text and be a maximum of 300 words. Tables and images are not allowed in the abstract.

https://www.birmingham.ac.uk/facilities/mds-cpd/conferences/proms-2018/abstract.aspx

Conference venue © University of Birmingham 

Themes for this year:

Minimising PROs waste – in Research and beyond
Pushing the boundaries of patient & public involvement in PROs research
Digital capture of PROs
Cutting edge methods

We are open to receive other relevant work in the field, including clinical submissions.

Submitting authors can amend abstracts until the close date. Authors will be notified of abstract acceptance during week commencing 9th April. All correspondence regarding the abstracts will be sent to the submitting author. Please note that presenters of abstracts are not automatically registered for the conference.

New Edition of Measuring and Valuing Health Benefits for Economic Evaluation released

The second edition of the highly popular Measuring and Valuing Health Benefits for Economic Evaluation has been published.

Measuring and
 Valuing Health Benefits
for Economic Evaluation

Written by HEDS colleagues Professor John Brazier, Professor Julie Ratcliffe (Flinders Health Economics Group), Professor Aki Tsuchiya and Professor Joshua Salomon from the Harvard School of Public Health.,

• The book addresses all relevant theoretical and practical considerations in the measurement and valuation of health benefits. It contains practical applications to help clarify understanding and make relevant links to the real world, and includes a glossary of key terms to aid understanding of common terms used by practitioners.

Measuring and Valuing Health Benefits for Economic Evaluation examines the measurement and valuation of health benefits, reviews the explosion of theoretical and empirical work in the field, and explores an area of research that continues to be a major source of debate. It addresses the key questions in the field including the definition of health, the techniques of valuation, and the problem of choosing the right instrument. This is an ideal resource for anyone wishing to gain a specialised understanding of health benefit measurement in economic evaluation, especially those working in the fields of health economics, public sector economics, pharmacoeconomics and health services research.

• Measuring and Valuing Health Benefits for Economic
  Evaluation
  examines the measurement and
  valuation of health benefits, reviews the
  explosion of theoretical and empirical work in
  the field, and explores an area of research that
  continues to be a major source of debate. It
  addresses the key questions in the field including
  the definition of health, the techniques of
  valuation, and the problem of choosing the
  right instrument.
  This is an ideal resource for anyone wishing to
  gain a specialised understanding of health benefit
  measurement in economic evaluation, especially
  those working in the fields of health economics,
  publ

New to this Edition:

• Covers all new measures of health and wellbeing for example ICECAP, ASCOT and numerous condition-specific measures and revisions to existing widely used ( measures for example 5 level version of EQ-5D, DF-6D V2 and AQoL-2.

• Fully revised to take into account new research into the social weighting of a QALY, use of the internet to collect data, use of health state utility values in cost effectiveness models, and new version of TTO.
• Order online at www.oup.com and enter promotional code AMFLY1Q at checkout to save 20%
• https://global.oup.com/academic/product/measuring-and-valuing-health-benefits-for-economic-evaluation-9780198725923?q=Measuring%20and%20Valuing%20Health%20Benefits%20for%20Economic%20Evaluation&lang=en&cc=gb
  Order online at

Professor John Brazier makes it onto the Web of Science Highly Cited Researcher List (Again)

Professor John Brazier

Professor John Brazier has once again made it onto the Thompson Reuter's Web of Science List of Highly Cited Researchers for 2016. Professor Brazier who is also our Director of Research at ScHARR was one of only three esteemed colleagues from The University of Sheffield to make the list and one from just a quartet of researchers in the area of Economics and Business based in the UK. 

His most cited work according to WoS was as lead author on the paper The estimation of a preference-based measure of health from the SF-36 which has 1287 citations and can be downloaded as an Open Access pre print from here: http://eprints.whiterose.ac.uk/474/1/brazierje10.pdf 

The Application of Psychometrics for Measuring Health Outcomes and Quality of Life - Basic/Intermediate (Part 1) - 2 1/2 days course - Monday, 13th - Wednesday, 15th February 2017

Dr Anju Keetharuth from HEDS will be leading the first part of a two part course on Application of Psychometrics for Measuring Health Outcomes and Quality of Life. It will cover the core psychometric and statistical methods used in scale construction and the development of multi-item patient-reported outcome measures (PROMs). Sessions will be delivered by ScHARR staff Professor John Brazier, Anju and external staff Georgina Jones - Leeds Beckett University) and Jakob Bue Bjorner - Optum Patient Insights, who have an international reputation in psychometric methods and questionnaire development, analysis and interpretation. The course will be interactive and practical. Sessions will be delivered using lectures and individual and small group practical exercises using real world examples.

Who will benefit from this course?

The course content is aimed at participants with no prior knowledge of psychometrics or those who wish to refresh and gain more theoretical and practical knowledge in this area. The course content is set at a basic/intermediate level. It will focus on classical methods of test construction and test of differential item function, but will also provide an introduction to modern psychometric methods such as Rasch models, item response theory and factor analysis for categorical data. It will be relevant to researchers, students, clinicians and other health care professionals and members of the pharmaceutical industry interested in using or developing PROMs.

Learning Outcomes

By the end of this course participants should be able to:

• Identify the key stages involved in scale construction and development
• Understand the qualitative process involved in the development of a PROM and item generation
• Describe the different ways of scoring and scaling a PROM and the theory underpinning these
• Understand exploratory (EFA) and confirmatory (CFA) factor analysis and be able to carry out EFA using SPSS
• Understand what is meant by reliability, validity, and responsiveness and be able to analyse and interpret these using SPSS
• Explore the above concepts using datasets from a range of existing disease-specific and generic PROMs
• Be aware of the use of different software other than SPSS where applicable.

Course Materials

All course materials will be provided on a USB together with hard copies of handouts/exercises as required for the course.

Participants are asked to supply their own Laptop throughout the course. Participants will work on laptops using SPSS during the course.  Working knowledge of SPSS would be beneficial but is not essential. If you do not have access to SPSS on your laptop, then a link to download will be provided prior to starting the course.

Further Learning (Advanced Part 2)

An advanced course will be run immediately following on from this course (Wednesday, 15th - Friday, 17th February 2017) which will cover Rasch models, item response theory, confirmatory factor analysis and factor analysis for categorical data in more detail using MPlus software. 

Dates

PART 1 - 2.5-day course: Monday, 13th - Wednesday, 15th February 2017

PART 2 - 2.5-day course: Wednesday, 15th - Friday, 17th February 2017

Times:

Start: Day 1 (Monday, 13th February 2017) - 9am for Registration & Refreshments with a prompt course start of 9:30am

Finish: Day 3 (Wednesday, 15th February 2017) - 1pm (with lunch provided)

FEES - Part 1

£990 - Early Bird Fee - For bookings received on or before Sunday, 11th December 2016

£1,290 - Standard Fee - For bookings received on or after Monday, 12th December 2016

FEES - Part 2

£840 - Early Bird Fee - For bookings received on or before Sunday, 11th December 2016

£1,140 - Standard Fee - For bookings received on or after Monday, 12th December 2016

FEES - Discounted Full Course

£1,540 - Early Bird Fee - For bookings received on or  before Sunday, 11th December 2016

£1,850 - Standard Fee - For bookings received on or after Monday, 12th December 2016

NB:  All fees do not include any accommodation.  We do have a preferential rate at Halifax Hall for our delegates (subject to availability).  Booking details and contact information will be automatically provided upon receipt of your online booking (a booking reference will be given along with the name and contact details of the person this should be booked directlywith, to ensure you receive our preferential rate of £65 per night/room).

Booking and Payment

Halifax Hall

Provisional bookings are now being accepted. Please email scharr-scu@sheffield.ac.uk to reserve your place. You will then be contacted when the course has gone live on our Online Store, where all our bookings and payments are initially processed.

Bookings are processed via our Online Store. Payment is by Credit/Debit Card or PayPal. If your employer is paying your fees and they would prefer to be invoiced, then please select the Invoice Option for the course and ensure that all invoice details are provided (contact email address, full address, purchase order number etc) and also forward a copy of the Purchase Order to scharr-scu@sheffield.ac.uk. Your booking will not be completed until all information has been provided.

If you have any queries relating to fees and payment, please do not hesitate to contact us.

Venue

Halifax Hall Hotel and Conference Centre, Endcliffe Vale Rd, Sheffield, S10 3ER.

http://www.halifaxhall.co.uk/

Contact

For further information please do not hesitate to contact us via email at scharr-scu@sheffield.ac.uk

or call +44 (0)114 222 2968.