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Empirical validity of multi-attribute utility measures in the perinatal and paediatric contexts

A preference-based approach to measuring the benefits of health care interventions commonly used by health economists is the multi-attribute utility measure, which is essentially a health status classification system with pre-existing preference weights that can be attached to each permutation of responses. A series of studies is being undertaken to test the empirical validity of multi-attribute utility measures, such as the EQ-5D, SF-6D and Health Utilities Index, in the perinatal and paediatric contexts. Tests of empirical validity establish whether multi-attribute utility measures generate utility scores that reflect peoples’ preferences in practice and are the crucial requirement for health economists wishing to establish the psychometric integrity of the measures. The degree to which alternative measures reflect external indicators of health status will be tested using the relative efficiency statistic and receiver operating characteristic curves. The following studies are being undertaken:

(i)    A total of 2064 women recruited into the IMPACT Study, a cluster randomised controlled trial of community postnatal care coordinated by the University of Birmingham, completed the SF-36 health status measure at 4 months and 12 months postpartum. Their responses will be converted into utility scores using the SF-6D utility algorithm. The empirical validity of these utility scores will be tested against self-reported health status and morbidity indicators, such as the Edinburgh Postnatal Depression Scale.

(ii)    A total of 623 women recruited into the Sheffield trial of community postnatal support workers completed the EQ-5D and SF-36 health status measure at 6 weeks and 6 months postpartum. Their responses will be converted into utility scores using the York A1 tariff set and the SF-6D utility algorithm, respectively. The empirical validity of these utility scores will be tested against self-reported health status and morbidity indicators, such as the Edinburgh Postnatal Depression Scale and the Duke Functional Social Support measure.

(iii)    A total of 217 children, aged between 4-11 years, with persistent bilateral otitis media with effusion have been recruited into a double-blind randomised controlled trial of topical intra-nasal steroids (the GNOME Study). The children’s parents completed the EQ-5D and the Health Utilities Index (Marks II and III) measures at baseline, 3 months and 9 months. The empirical validity of the converted utility scores will be tested against a range of childhood health measures.