Centre for Health Economics at Warwick, Warwick Medical School, University of Warwick, Coventry, United Kingdom; Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom.
Soc Sci Med. 2023 Jun;327:115928. doi: 10.1016/j.socscimed.2023.115928. Epub 2023 Apr 29.
The Mental Well-being Adjusted Life Year (MWALY) is an alternative outcome measure to the quality-adjusted life year (QALY) in economic evaluations of interventions aimed at improving mental well-being. However, there is a lack of preference-based mental well-being instruments for capturing population mental well-being preferences.
To derive a UK preference-based value set for the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS).
225 participants that were interviewed between December 2020 and August 2021 completed 10 composite time trade-off (C-TTO) and 10 discrete choice experiment (DCE) interviewer-administered exercises. Heteroskedastic Tobit and conditional logit models were used to model C-TTO and DCE responses respectively. The DCE utility values were rescaled to a C-TTO comparable scale through anchoring and mapping. An inverse variance weighting hybrid model (IVWHM) was used to derive weighted-average coefficients from the modelled C-TTO and DCE coefficients. Model performance was assessed using statistical diagnostics.
The valuation responses confirmed the feasibility and face validity of the C-TTO and DCE techniques. Apart from the main effects models, statistically significant associations were estimated between the predicted C-TTO value and participants' SWEMWBS scores, gender, ethnicities, education levels, and the interaction terms between age and useful feeling. The IVWHM was the most optimal model with the fewest logically inconsistent coefficients and the lowest pooled standard errors. The utility values generated by the rescaled DCE models and the IVWHM were generally higher than those of the C-TTO model. The predictive ability of the two DCE rescaling methods was similar according to the mean absolute deviation and root mean square deviation statistics.
This study has produced the first preference-based value set for a measure of mental well-being. The IVWHM provided a desirable blend of both C-TTO and DCE models. The value set derived by this hybrid approach can be used for cost-utility analyses of mental well-being interventions.
心理幸福感调整生命年（MWALY）是一种用于评估旨在改善心理健康的干预措施的经济效果的替代质量调整生命年（QALY）的结果衡量指标。然而，在捕捉人群心理健康偏好方面，缺乏基于偏好的心理健康工具。
为短式 Warwick-Edinburgh 心理健康量表（SWEMWBS）推导一个英国基于偏好的效用值。
2020 年 12 月至 2021 年 8 月期间，225 名参与者完成了 10 项复合时间权衡（C-TTO）和 10 项离散选择实验（DCE）访谈式管理练习。使用异方差 Tobit 和条件逻辑回归模型分别对 C-TTO 和 DCE 反应进行建模。通过锚定和映射，将 DCE 效用值转换为可比 C-TTO 尺度。使用逆方差加权混合模型（IVWHM）从模型化的 C-TTO 和 DCE 系数中得出加权平均系数。通过统计诊断评估模型性能。
估值反应证实了 C-TTO 和 DCE 技术的可行性和表面有效性。除了主要效应模型外，还估计了预测的 C-TTO 值与参与者的 SWEMWBS 分数、性别、族裔、教育水平以及年龄与有用感觉之间的交互项之间的统计学显著关联。IVWHM 是最优化模型，具有最少的逻辑不一致系数和最低的汇总标准误差。经缩放的 DCE 模型和 IVWHM 生成的效用值通常高于 C-TTO 模型。根据平均绝对偏差和均方根偏差统计数据，两种 DCE 缩放方法的预测能力相似。
本研究生成了第一个用于衡量心理健康的基于偏好的效用值。IVWHM 提供了 C-TTO 和 DCE 模型的理想组合。通过这种混合方法得出的效用值集可用于心理健康干预措施的成本效益分析。
