Helter Timea Mariann, Coast Joanna, Łaszewska Agata, Stamm Tanja, Simon Judit
Department of Health Economics, Center for Public Health, Medical University of Vienna, Austria.
Health Economics Bristol, Population Health Sciences, Bristol Medical School, University of Bristol, UK.
BJPsych Open. 2022 Jun 27;8(4):e117. doi: 10.1192/bjo.2022.514.
There is increasing evidence that assessing outcomes in terms of capability provides information beyond that of health-related quality of life (HRQoL) for outcome evaluation in mental health research and clinical practice.
To assess similarities and differences in the measurement properties of the ICECAP-A capability measure and Oxford Capabilities Questionnaire for Mental Health (OxCAP-MH) in people with schizophrenia experiencing depression, and compare these measurement properties with those of (a) the EuroQol EQ-5D-5L and EuroQol Visual Analogue Scale (EQ-VAS) and (b) mental health-specific (disease-specific) measures.
Using data for 100 patients from the UK, measurement properties were compared using correlation analyses, Bland-Altman plots and exploratory factor analysis. Responsiveness was assessed by defining groups who worsened, improved or remained unchanged, based on whether there was a clinically meaningful change in the instrument scores between baseline and 9-month follow-up assessments.
The two capability instruments had stronger convergent validity with each other (Spearman's rho = 0.677) than with the HRQoL (rho = 0.354-0.431) or the mental health-specific (rho = 0.481-0.718) instruments. The OxCAP-MH tended to have stronger correlations with mental health-specific instruments than the ICECAP-A, whereas the ICECAP-A had slightly stronger correlation with the EQ-VAS. Change scores on the capability instruments correlated weakly with change scores on the HRQoL scales (rho = 0.131-0.269), but moderately with those on mental health-specific instruments for the ICECAP-A (rho = 0.355-0.451) and moderately/strongly on the OxCAP-MH (rho = 0.437-0.557).
Assessing outcomes in terms of capabilities for people with schizophrenia and depression provided more relevant, mental health-specific information than the EQ-5D-5L or the EQ-VAS. The ICECAP-A and the OxCAP-MH demonstrated similar psychometric properties, but the OxCAP-MH was more correlated with disease-specific instruments.
越来越多的证据表明，在心理健康研究和临床实践中，从能力角度评估结果能提供超出健康相关生活质量（HRQoL）的信息，用于结果评估。
评估ICECAP - A能力量表和牛津心理健康能力问卷（OxCAP - MH）在患有抑郁症的精神分裂症患者中的测量属性的异同，并将这些测量属性与（a）欧洲五维度健康量表EQ - 5D - 5L和欧洲五维度健康视觉模拟量表（EQ - VAS）以及（b）心理健康特定（疾病特定）量表的测量属性进行比较。
使用来自英国的100名患者的数据，通过相关性分析、布兰德 - 奥特曼图和探索性因子分析比较测量属性。根据基线和9个月随访评估之间工具分数是否有临床意义的变化，定义病情恶化、改善或无变化的组来评估反应度。
这两种能力工具彼此之间的收敛效度（斯皮尔曼相关系数rho = 0.677）比与HRQoL量表（rho = 0.354 - 0.431）或心理健康特定量表（rho = 0.481 - 0.718）更强。与ICECAP - A相比，OxCAP - MH与心理健康特定量表的相关性往往更强，而ICECAP - A与EQ - VAS的相关性略强。能力工具的变化分数与HRQoL量表的变化分数相关性较弱（rho = 0.131 - 0.269），但与ICECAP - A的心理健康特定量表的变化分数相关性中等（rho = 0.355 - 0.451），与OxCAP - MH的变化分数相关性中等/强（rho = 0.437 - 0.557）。
对于患有精神分裂症和抑郁症的患者，从能力角度评估结果比EQ - 5D - 5L或EQ - VAS提供了更相关的、特定于心理健康的信息。ICECAP - A和OxCAP - MH表现出相似的心理测量属性，但OxCAP - MH与疾病特定量表的相关性更强。
