Health Economics Bristol, Population Health Sciences, University of Bristol, Bristol, UK
Population Health Sciences, University of Bristol, Bristol, UK.
BMJ Open. 2020 May 15;10(5):e034569. doi: 10.1136/bmjopen-2019-034569.
To determine the response process validity, feasibility of completion, acceptability and preferences for three patient-reported outcome measures that could be used in economic evaluation-the EQ-5D-5L, ICECAP-A and ICECAP-O-in people requiring kidney care.
Participants were asked to 'think-aloud' while completing the EQ-5D-5L, ICECAP-A and ICECAP-O, followed by a semistructured interview. Five raters identified errors or struggles in completing the measures from the think-aloud component of the transcripts. Patient preferences for measures were extracted from the semistructured interview.
Eligible patients were identified through a large UK secondary care renal centre.
In total, 30 participants were included in the study, consisting of patients attending renal outpatients for chronic kidney disease (n=18), with a functioning kidney transplant (n=6) and receiving haemodialysis (n=6).
Participants had few errors and struggles in completing the EQ-5D-5L (11% error rate, 3% struggle rate), ICECAP-A (2% error rate, 2% struggle rate) and ICECAP-O (4% error rate, 3% struggle rate). The main errors with the EQ-5D-5L were judgements that did not comply with the 'your health today' instruction. Comprehension errors were most prominent on ICECAP-O. Judgement errors were the only errors reported on ICECAP-A. Although the EQ-5D-5L had slightly more errors and struggles, it was the measure most preferred, with participants able to make a clearer link with EQ-5D-5L and their health condition.
The EQ-5D-5L, ICECAP-A and ICECAP-O are feasible for people requiring kidney care to complete and can be included in studies conducting economic evaluations of kidney care interventions. Further research is required to assess how health (eg, EQ-5D) and capability (eg, ICECAP) measures can be included in an economic evaluation simultaneously, as well as what ICECAP measure(s) to include when patient groups straddle the age ranges for ICECAP-A (18 years and older) and ICECAP-O (65 years and older).
确定可用于肾脏护理经济评估的三种患者报告结局测量工具（EQ-5D-5L、ICECAP-A 和 ICECAP-O）的反应过程有效性、完成可行性、可接受性和偏好。
要求参与者在完成 EQ-5D-5L、ICECAP-A 和 ICECAP-O 时“出声思考”，然后进行半结构化访谈。五位评估者从“出声思考”部分的转录本中确定完成测量时的错误或困难。从半结构化访谈中提取患者对测量方法的偏好。
通过英国大型二级保健肾脏中心确定合格患者。
共有 30 名参与者纳入研究，包括慢性肾病的肾脏门诊就诊患者（n=18）、有功能的肾移植患者（n=6）和接受血液透析患者（n=6）。
参与者在完成 EQ-5D-5L（11%的错误率，3%的困难率）、ICECAP-A（2%的错误率，2%的困难率）和 ICECAP-O（4%的错误率，3%的困难率）时错误和困难很少。EQ-5D-5L 的主要错误是不符合“您今天的健康状况”指令的判断。ICECAP-O 上最突出的是理解错误。ICECAP-A 报告的唯一错误是判断错误。尽管 EQ-5D-5L 的错误和困难略多，但它是最受欢迎的测量方法，参与者能够更清楚地将 EQ-5D-5L 与其健康状况联系起来。
EQ-5D-5L、ICECAP-A 和 ICECAP-O 适用于需要肾脏护理的患者完成，可纳入肾脏护理干预措施经济评估研究。需要进一步研究如何同时将健康（如 EQ-5D）和能力（如 ICECAP）测量纳入经济评估，以及当患者群体跨越 ICECAP-A（18 岁及以上）和 ICECAP-O（65 岁及以上）年龄范围时应包含哪些 ICECAP 测量。
