Outcomes Research:
Measurement, Valuation & Application


Psychometric Parameters of Food Allergy Quality of Life During an Allergen Immunotherapy Trial

Lins de Holanda Coelho G, DunnGalvin A, Greenhawt M, Hourihane JO’B, Fleischer DM, Chen G, Shaker M, Campbell DE, Green TD & Bégin P. Allergy, DOI: 10.1111/all.15323.

This paper present a novel re-analysis of the FAQLQ-PF items using item response theory. The longitudinal performance of individual items and subscales was corroborated, and items with the highest discrimination were identified, showing that the tool is suitable for longitudinal measurements in food allergy treatment trials.

A Global Measure of Patient-Reported Outcome After Injury – Life Back on Track

Chen G, Woode ME, Sia K-L, Ellis N, Citroen C & Harris A. Disability and Rehabilitation, DOI: 10.1080/09638288.2022.2029958. [Download Link]

Life Back on Track (LBoT) is a novel & valid self-reported single-item global measure of the trajectory of wellbeing after a transport accident..

How Is Your Life? Understanding the Relative Importance of Life Domains amongst Older Adults, and Their Associations with Self-Perceived COVID-19 Impacts

Chen G & Olsen JA. Quality of Life Research, DOI: 10.1007/s11136-021-03043-5.

From both revealed and stated preference data there was robust evidence that health, relationships, and standard of living represent the three most important life domains for older adults in Australia. This study also identified diminishing marginal utilities across the levels of each life domain.

Development of a Classification (Descriptive) System for a Preference-Based Quality of Life Measure for Dental Caries (Dental Caries Utility Index - DCUI) among Adolescents

Hettiarachchi RM, Kularatna S, Byrnes J, Chen G, Mulhern B & Scuffham PA. Journal of Public Health Dentistry, DOI: 10.1111/jphd.12490.

The DCUI consists of five dimensions/items (pain/discomfort, difficulty in eating food/drinking, worried, ability to participate in activities, and appearance) and each item adopts a four-level response scale.

Assessing the Psychometric Properties of the Chinese Version of Ten-Item Personality Inventory (TIPI) Among Medical College Students

Shi Z, Li S & Chen G. Psychology Research and Behavior Management, 2022, 15: 1247-1258. DOI: 10.2147/PRBM.S357913.

TIPI-C primarily stands out as a feasible instrument for brief measurements of the Extraversion, Emotional Stability, and Conscientiousness domains. However, the internal consistency coefficients of Agreeableness and Openness were low and the structural validity was not supported.

Lindberg MH, Chen G, Olsen JA & Abelsen B. BMC Public Health, 2022, 22: 969. DOI: 10.1186/s12889-022-13366-8

This study provides a new application of a regression-based method for developing a composite socioeconomic position (SEP) score with empirically derived education and income weights along a [1-10] SEP scale.

Validation and Comparison of Five Preference-based Measures among Age-Related Macular Degeneration Patients: Evidence from Mainland China

Si Y, Li S, Xu Y & Chen G. Quality of Life Research, 2022, 31 (5): 1561-1572. DOI: 10.1007/s11136-021-03047-1.

This study compared the psychometric properties of 5 preference-based measures, including the 15D, AQoL-7D, EQ-5D-5L, ICECAP-A, & ICECAP-O.

Systematic Review of Conceptual, Age, Measurement and Valuation Considerations for Generic Multidimensional Childhood Patient-Reported Outcome Measures

Kwon J, Freijser L, Huynh E, Howell M, Chen G, Khan K, Daher S, Roberts N, Harrison C, Smith S, Devlin N, Howard K, Lancsar E, Bailey C, Craig J, Dalziel K, Hayes A, Mulhern B, Wong G, Ratcliffe J & Petrou S. PharmacoEconomics, 2022, 40 (4): 379–431. DOI: 10.1007/s40273-021-01128-0.

This systematic review identified 110 versions of generic, multidimensional patient-reported outcome measures (PROMs) for children (aged ≤18 years) spanning childhood age groups and conceptual bases of functional, disability and health status, quality of life and health-related quality of life. A supplementary systematic review identified 21 preference-based value sets for 10 PROMs designed to be accompanied by preference-based value sets.

Evaluating Health Related Quality of Life in Older People at Risk of Osteoporotic Fracture: A Head-to-Head Comparison of the EQ-5D-5L and AQoL-6D

Si L, Tu L, Xie Y, Chen G, Hiligsmann M, Yang M, Zhang Y, Zhang X, Jiang Y, Wei Q, Gu J & Palmer AJ. Social Indicators Research, 2022, 160 (2-3), 809–824. DOI: 10.1007/s11205-020-02414-8.

Development and Validation of the Health-Related Quality of Life Instrument for Chinese Infertile Couples: A Mixed-Methods Study Protocol

Shi Z, Mao Z, Nie H, Geng L, Chen G & Li S. Health and Quality of Life Outcomes, 2022, 20: 54. DOI: 10.1186/s12955-022-01957-3

Health-Related Quality of Life and Its Influencing Factors in Patients with Coronary Heart Disease in China

Dou L, Mao Z, Fu Q, Chen G & Li S. Patient Preference and Adherence, 2022, 16: 781-795. DOI: 10.2147/PPA.S347681.

A Longitudinal Cohort Study of Watch and Wait in Complete Clinical Responders after Chemo-Radiotherapy for Localised Rectal Cancer: Study Protocol

Vatandoust S, Watthow D, Sposato L, Michael MZ, Leung J, Gormly K, Chen G, Symonds EL, Tie J, Papanicolas LE, Woods S, Gebski V, Mead K, Kuruni A & Karapetis CS. BMC Cancer, 2022, 22: 222.. DOI: 10.1186/s12885-022-09304-x.

Development of a Preference-Based Heart Disease-Specific Health State Classification System using MacNew Heart Disease-Related Quality of Life Instrument

Kularatna S, Rowen D, Mukuria C, McPhail S, Chen G, Mulhern B, Whitty JA, Byrnes J, Scuffham P, Atherton J, Höfer S & Parsonage W. Quality of Life Research, 2022, 31 (1): 257-268. DOI: 10.1007/s11136-021-02884-4.

This study created a brief heart disease-specific classification system, consisting of 7 dimensions (frustrated, wornout, shortness of breath, chest pain, self-confidence, excluded, physical restriction) with 4 severity levels in each.

Impact of COVID-19 Pandemic on Quality of Life for Children and Adolescents with Food Allergy

Chen G, DunnGalvin A & Campbell DE. Clinical & Experimental Allergy, 2022, 52 (1): 162-166. DOI: 10.1111/cea.13973.

We surveyed parents of children and adolescents with food allergy before and during the pandemic. Parent/carer report of a negative impact was associated with worse quality of life and life satisfaction. Across 14 life domains, statistically significant differences were found for children and adolescents between those with negative and neutral/positive impacts from COVID-19 in 7 domains. The most notable were family life, future security, friendship, and personal relationships.

Assessing the Relative Importance of Key Quality of Life Dimensions for People With and Without a Disability: An Empirical Ranking Comparison Study

Crocker M, Hutchinson C, Mpundu-Kaambwa C, Walker R, Chen G & Ratcliffe J. Health and Quality of Life Outcomes, 2021, 19: 264. DOI: 10.1186/s12955-021-01901-x.

Respondents were asked to rank the importance of 12 quality of life dimensions extracted from the content of established preference‑based quality of life measures (EQ‑5D, AQoL-4D and ASCOT). People with a disability placed relatively higher importance on broader quality of life dimensions (e.g. Control, Independence, Self-care) relative to health status focused dimensions (e.g. Vision, Hearing, Physical mobility). This distinction was less differentiable for those ‘without a disability’.

International Guidelines for Self-Report and Proxy Completion of Paediatric Health-Related Quality of Life Measures: A Protocol for a Systematic Review

Mpundu-Kaambwa C, Chen G, Dalziel K, Devlin N & Ratcliffe J, on behalf of the Quality Of Life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team. BMJ Open, 2021, 11: e052049. DOI: 10.1136/bmjopen-2021-052049.

Deriving Health Utility Indices From a Food Allergy Quality-of-Life Questionnaire

Chen G, DunnGalvin A, Greenhawt M, Shafer M & Campbell DE. Pediatric Allergy and Immunology, 2021, 32 (8): 1773-1780. DOI: 10.1111/pai.13604.

Food Allergy Quality of Life Questionnaire-Parental Form (FAQLQ-PF) is one of the most widely used food allergy specific instruments for assessing the psychosocial impacts of the disease. This study developed mapping algorithms that can predict AQoL-6D or CHU9D health utility scores from FAQLQ-PF. Outputs from this study can facilitate health economic evaluation for food allergy related interventions.

Quality of Care Experience in Aged Care: An Australia-Wide Discrete Choice Experiment to Elicit Preference Weights

Chen G, Ratcliffe J, Milte R, Khadka J & Kaambwa B. Social Science & Medicine, 2021, 289: 114440. DOI: 10.1016/j.socscimed.2021.114440.

Person-centred care is a key dimension of quality of care across health and social care sectors. A preference-based Quality of Care Experience (QCE) in aged care measure was developed in this study. A novel first-stage discrete choice experiment (DCE) and a second-stage quality rating task were designed to empirically estimate the relative importance of six key aged care quality criteria from more than 10,000 Australian general population sample. 

Responsiveness and Convergent Validity of QLU-C10D and EQ-5D-3L in Assessing Short-Term Quality of Life following Esophagectomy

Bulamu NB, Vissapragada R, Chen G, Ratcliffe J, Mudge LA, Smithers MB, Isenring EA, Smith L, Jamieson GG & Watson DI, on behalf of The Australian Immunonutrition Study Group. Health and Quality of Life Outcomes, 2021, 19: 233. DOI: 10.1186/s12955-021-01867-w.

Explaining Subjective Social Status in Two Countries: The Relative Importance of Education, Occupation, Income and Childhood Circumstances

Lindberg MH, Chen G, Olsen JA & Abelsen B. SSM – Population Health, 2021, 15: 100864. DOI: 10.1016/j.ssmph.2021.100864.

This study provides new insights into respondents’ implicit weighting of objective and childhood factors in predicting subjective socioeconomic position (SEP). We have estimated the contribution of each of the commonly used objective SEP indicators (education, occupation & income) in explaining subjective SEP. In addition, we have added childhood SEP as an important determinant of subjective SEP; while controlling for the objective SEP variables, we found that the influence of childhood SEP persisted into adulthood.

The Longitudinal Validity of Proxy-Reported CHU9D

Wolf RT, Ratcliffe J, Chen G & Jeppesen P. Quality of Life Research, 2021, 30 (6): 1747-1756. DOI: 10.1007/s11136-021-02774-9.

Eliciting SF-6Dv2 Health State Utilities using An Anchored Best-Worst Scaling Technique

Osman AMY, Wu J, He X & Chen G. Social Science & Medicine, 2021, 279: 114018. DOI: 10.1016/j.socscimed.2021.114018.

This study proposed using an anchored best-worst scaling technique to develop preference weights directly for a preference-based health-related quality of life instrument.

Valuation of SF-6Dv2 Health States in China Using Time Trade-Off and Discrete-Choice Experiment with A Duration Dimension

Wu J, Xie S, He X, Chen G, Bai G, Feng D, Hu M, Jiang J, Wang X, Wu H, Wu Q & Brazier JE. PharmacoEconomics, 2021, 39 (5): 521-535. DOI: 10.1007/s40273-020-00997-1.

A Global eDelphi Exercise to Identify Core Domains and Domain Items for the Development of a Global Registry of Alopecia Areata Disease Severity and Treatment Safety (GRASS)

Wall D, Meah N, York K, [...], Chen G, [...] & Sinclair R. JAMA Dermatology, 2021, 157 (4): 439-448. DOI: 10.1001/jamadermatol.2020.5839.

This study seeks to reach international consensus regarding the core domains and data items required to build a network of patient registries to monitor real-world demographics and outcomes of alopecia areata.

Mapping MacNew Heart Disease Quality of Life Questionnaire onto Country-Specific EQ-5D-5L Utility Scores: A Comparison of Traditional Regression Models with A Machine Learning Technique

Gao L, Luo W, Tonmukayakul U, Moodie M & Chen G. European Journal of Health Economics, 2021, 22 (2): 341-350. DOI: 10.1007/s10198-020-01259-9.

Relationship between Health-Related Quality of life and Subjective Wellbeing in Asthma

De Albornoz SC & Chen G. Journal of Psychosomatic Research, 2021, 142, 110356. DOI: 10.1016/j.jpsychores.2021.110356.

This study revealed significant heterogeneity on the relative importance of key life domains satisfaction on overall life satisfaction in asthma patients.

Impact of Cyclosporin Treatment on Health-Related Quality of Life of Patients with Alopecia Areata

Lai VWY, Chen G & Sinclair R. Journal of Dermatological Treatment, 2021, 32 (2): 250-257. DOI: 10.1080/09546634.2019.1654068.

The mean health utility for patients with alopecia areata was 0.748.

Health-related Quality of Life and Health Utility Score of Patients with Gastric Cancer: A Multi-Centre Cross-Sectional Survey in China

Xia R, Zeng H, Liu Q, Liu S, Zhang Z, Liu Y, Guo G, Song G, Zhu Y, Wu X, Song B, Liao X, Chen Y, Wei W, Chen G, Chen W & Zhuang G. European Journal of Cancer Care, 2020, 29 (6): e13283. DOI: 10.1111/ecc.13283.

Compared to healthy controls, the mean utility scores of gastric cancer patients were significantly lower, with mean decrements of 0.077, 0.254, 0.249, 0.353 and 0.591 for high-grade intraepithelial neoplasia/CIS, stage I, stage II, stage III and stage IV cancer, using the Chinese-specific EQ-5D-3L 2014 tariff; with mean decrements of 0.039, 0.121, 0.123, 0.182 and 0.309 for the corresponding clinical stages using the Chinese-specific EQ-5D-3L 2018 tariff. In addition, among these clinical stages, the magnitudes of decrement on the EQ-5D-3L index values were not significantly different between stages I to II regardless of which tariff was used.

Filling the Psycho-Social Gap in the EQ-5D: The Empirical Support for Four Bolt-On Dimensions

Chen G & Olsen JA. Quality of Life Research, 2020, 29 (11): 3119-3129. DOI: 10.1007/s11136-020-02576-5.

This study provided empirical support for complementing the current EQ-5D descriptive system with a coherent set of four bolt-on dimensions that will fill its psycho-social gap: vitality, sleep, social relationships, and community connectedness. Such an extended health state classification system would, in particular, be relevant for programme evaluations within the expanding fields of mental health and community care. An interim scoring algorithm developed based on a mapping analysis is also reported.

Valuation Study for a Preference-Based Quality of Life Measure for Dental Caries (Dental Caries Utility Index - DCUI) among Australian Adolescents - Study Protocol

Hettiarachchi R, Kularatna S, Byrnes J, Mulhern B, Chen G & Scuffham PA. BMJ Open, 2020, 10: e038626. DOI: 10.1136/bmjopen-2020-038626.

Do Discrete Choice Experiments Approaches Perform Better Than Time Trade-Off in Eliciting Health State Utilities? Evidence from SF­-6Dv2 in China

Xie S, Wu J, He X, Chen G & Brazier JE. Value in Health, 2020, 23 (10): 1391-1399. DOI: 10.1016/j.jval.2020.06.010.

Two DCE approaches (with/without life duration) are feasible for eliciting health state utility values; however, they are not considered to be easier to understand/answer than TTO. There are systematic differences in the health state utility values generated by 3 approaches. The issue of non-monotonicity from 2 DCE approaches remains a concern.

Mapping the Chinese Version of the EORTC QLQ-BR53 Onto the EQ-5D-5L and SF-6D Utility Scores

Liu T, Li S, Wang M, Sun Q & Chen G. Patient, 2020, 13 (5): 537-555. DOI: 10.1007/s40271-020-00422-x.

Mapping algorithms reported from EORTC QLQ-C30 and/or QLQ-BR23 onto EQ-5D-5L or SF-6Dv1.

Health-Related Quality of Life and Upper-Limb Impairment in Children with Cerebral Palsy: Developing A Mapping Algorithm

Tonmukayakul U, Imms C, Mihalopoulos C, Reddihough D, Carter R, Mulhern B & Chen G. Developmental Medicine & Child Neurology, 2020, 62 (7): 854-860. DOI: 10.1111/dmcn.14488.

Mapping algorithms reported from CP Quality of Life Questionnaire for Children (CPQoL-Child) onto the Child Health Utility 9D (CHU9D). The Manual Ability Classification System (MACS) and the Neurological Hand Deformity Classification (NHDC) explained the impact of the upper limb impairment on HRQoL better than the other classifications.

Mapping the Minnesota Living with Heart Failure Questionnaire (MLHFQ) to EQ-5D-5L in Patients with Heart Failure

Kularatna S, Senanayake S, Chen G & Parsonage W. Health and Quality of Life Outcomes, 2020, 18: 115. DOI: 10.1186/s12955-020-01368-2.

The Simplified Chinese Version of SF-6Dv2: Translation, Cross-Cultural Adaptation and Preliminary Psychometric Testing

Wu J, Xie S, He X, Chen G & Brazier JE. Quality of Life Research, 2020, 29 (5): 1385-1391. DOI: 10.1007/s11136-020-02419-3.

Mapping PedsQL™ Scores onto CHU9D Utility Scores: Estimation, Validation and A Comparison of Alternative Instrument Versions

Sweeney R, Chen G, Gold L, Mensah F & Wake M. Quality of Life Research, 2020, 29 (3): 639-652. DOI: 10.1007/s11136-019-02357-9. [Correction]

This study externally validates the two published mapping algorithms: (a) Self-report 15-item Short-Form PedsQL onto CHU9D & (b) Proxy-report 23-item PedsQL onto CHU9D. Next, a set of new mapping algorithms were developed for use when the Self-report version of the 23-item PedsQL instrument has been employed.

Health State Utility Values Derived from EQ-5D in Psoriatic Patients: A Systematic Review and Meta-Analysis

Yang Z, Li S, Wang X & Chen G. Journal of Dermatological Treatment, 2020, DOI: 10.1080/09546634.2020.1800571.

The Construct Validity of the Child Health Utility 9D-DK Instrument

Petersen KD, Ratcliffe J, Chen G, Serles D, Frøsig CS & Olesen AV. Health and Quality of Life Outcomes, 2019, 17: 187. DOI: 10.1186/s12955-019-1256-0.

Changes in Weight Status, Quality of Life and Behaviours of South Australian Primary School Children: Results from the Obesity Prevention and Lifestyle (OPAL) Community Intervention Program

Bell L, Ullah S, Leslie E, Magarey A, Olds T, Ratcliffe J, Chen G, Miller M, Jones M & Cobiac L. BMC Public Health, 2019, 19: 1338. DOI: 10.1186/s12889-019-7710-4.

This study demonstrates the complexity of evaluating complex, multi-component, community-based interventions under real-world conditions.

Mapping the PedsQL™ onto the CHU9D: An Assessment of External Validity in A Large Community-Based Sample

Mpundu-Kaambwa C, Chen G, Huynh E, Russo R & Ratcliffe J. PharmacoEconomics, 2019, 37 (9); 1139-1153. DOI: 10.1007/s40273-019-00808-2.

The published mapping algorithms have acceptable predictive accuracy. The findings of this study indicate that the choice of the most appropriate mapping algorithm to apply may vary according to the population under consideration.

Health-Related Quality of Life associated with Barrett’s Esophagus and Cancer

Bulamu NB, Chen G, Ratcliffe J, Schloithe A, Bright T & Watson DI. World Journal of Surgery, 2019, 43 (6): 1554-1562. DOI: 10.1007/s00268-019-04936-w.

Measuring Subjective Wellbeing in Patients with Heart Disease: Relationship and Comparison between Health-Related Quality of Life Instruments

Gao L, Moodie M & Chen G. Quality of Life Research, 2019, 28 (4): 1017-1028. DOI: 10.1007/s11136-018-2094-y.

Assessing SWB provides complementary information on understanding heart patients’ subjective outcome over the use of quality of life instruments alone. The life domains that were significantly important to patients with heart disease were standard of living, followed by achieving in life, personal relationships, personal health, and future security. Compared to the healthy public, personal health and future security were significantly more important life domains among patients with heart disease.

Which Approach Is Better in Eliciting Health State Utilities from Breast Cancer Patients? Evidence from Mainland China

Li S, Wang M, Liu L & Chen G. European Journal of Cancer Care, 2019, 28 (2): e12965. DOI: 10.1111/ecc.12965.

This study empirically investigated both indirect approaches (including EQ-5D-5L & SF-6D), as well as a direct approach (the TTO) for eliciting utilities in breast cancer patients. Results suggested that the EQ-5D-5L is currently the optimal approach (followed by the SF-6D) to elicit health state utilities from breast cancer patients in mainland China.

A Systematic Review of Randomised Controlled Trials Evaluating the Use of Patient-Reported Outcome Measures (PROMs)

Ishaque S, Karnon J, Chen G, Nair R & Salter AB. Quality of Life Research, 2019, 28 (3): 567-592. DOI: 10.1007/s11136-018-2016-z.

While combined evidence supports the use of PROMs in clinical practice, standards of reporting remain inadequate with many published RCTs failing to pre-specify primary outcomes and/or adequately powering their comparisons for clinically meaningful differences.

Scoring the Child Health Utility 9D Instrument: Estimation of a Chinese Child and Adolescent-Specific Tariff

Chen G, Xu F, Huynh E, Wang Z, Li C, Stevens K & Ratcliffe J. Quality of Life Research, 2019, 28 (1): 163-176. DOI: 10.1007/s11136-018-2032-z.

This study used the best-worst scaling (BWS) method and time trade-off (TTO) method to derive Chinese-specific tariff for the CHU9D instrument. The value set reported in this study can be used to estimate quality-adjusted life years (QALYs) for economic evaluation in China.

Systemic Treatments for Alopecia Areata: A Systematic Review

Lai VWY, Chen G, Gin D & Sinclair R. Australasian Journal of Dermatology, 2019, 60 (1): e1-e13. DOI: 10.1111/ajd.12913.

Alopecia areata is associated with a marked burden on utility; however, so far no study evaluated the impact of pharmacotherapy on QoL using complete quantitative QoL instruments.

Health-Related Quality of Life of Esophageal Cancer Patients in Daily Life after Treatment: A Multicentre Cross-Sectional Study in China

Liu Q, Zeng H, Xia R, Chen G, Liu S, Zhang Z, Liu Y, Guo G, Song G, Zhu Y, Wu X, Song B, Liao X, Chen Y, Wei W, Chen W & Zhuang G. Cancer Medicine, 2018, 7 (11): 5803-5811. DOI: 10.1002/cam4.1817.

Compared to the healthy controls, the mean EQ-5D-3L index values of the esophageal cancer patients were significantly lower, with decrements of 0.158 (severe dysplasia/CIS), 0.289 (Stage I), 0.303 (Stage II), 0.296 (Stage III) and 0.505 (Stage IV), respectively. In addition, among these clinical stages, the magnitudes of decrement on the EQ-5D-3L index values were not significantly different among stages I to III.

Converting Parkinson-Specific Scores into Health States Utilities to Assess Cost-Utility Analysis

Chen G, Garcia-Gordillo MA, Collado-Mateo D, del Pozo-Cruz B, Adsuar JC, Cordero-Ferrera JM, Abellán-Perpiñán JM & Sánchez-Martínez FI. Patient, 2018, 11 (6): 665-675. DOI: 10.1007/s40271-018-0317-5.

Mapping algorithms reported from Parkinson’s Disease Questionnaire-8 (PDQ-8) onto EQ-5D-3L, EQ-5D-5L, and 15D.

The Impact of Depression on Health-Related Quality of Life and Wellbeing: Identifying Important Dimensions and Assessing Their Inclusion in Multi-Attribute Utility Instruments

Engel L, Chen G, Richardson J, Mihalopoulos C. Quality of Life Research, 2018, 27 (11): 2873-2884. DOI: 10.1007/s11136-018-1936-y.

This study identified important dimensions of HRQoL and wellbeing (PWI, SWLS, IHS, and ICECAP-A) that are most affected by depression and examined the extent to which these are captured by MAUIs (15D, AQoL-8D, EQ-5D-5L, HUI-3, and SF-6D).

Empirical Comparison between Capability and Two Health-Related Quality of Life Measures

Chen G, Ratcliffe J, Kaambwa B, McCaffrey N & Richardson J. Social Indicators Research, 2018, 140 (1): 175-190. DOI: 10.1007/s11205-017-1788-9.

Conceptually, the ICECAP differs from HRQoL as the focus is upon the ability or capacity to achieve as distinct from the current experience of the attributes. Empirical results suggest that ICECAP-A should be included in evaluation studies along with a HRQoL instrument is more persuasive when the instrument is the EQ-5D. The case for its inclusion with other HRQoL instruments (e.g. AQoL-8D) requires further research and evaluation.

Urban-Rural Difference in the Associations between Living Arrangements and the Health-Related Quality of Life (HRQOL) of the Elderly in China—Evidence from Shaanxi Province

Zhou Z, Zhou Z, Gao J, Lai S & Chen G. PLoS ONE, 2018, 13 (9): e0204118. DOI: 10.1371/journal.pone.0204118.

HRQoL of the single elderly either living alone or living with adult children were lower than the elderly living with a spouse in urban areas. In rural areas only the single elderly living with adult children were more disadvantaged. Additionally, living-alone elderly had worse psychological health and the single elderly living with adult children had worse physical health.

What Characteristics of Nursing Homes Are Most Valued by Consumers? A Discrete Choice Experiment with Residents and Family Members

Milte R, Ratcliffe J, Chen G & Crotty M. Value in Health, 2018, 21 (7): 843-849. DOI: 10.1016/j.jval.2017.11.004.

The Consumer Choice Index – Six Dimension (CCI-6D) instrument was designed to fill this gap in measuring and valuing the quality of nursing home care from the perspective of consumers. This study elicited preference weights for the CCI-6D in Australia.

Health-Related Quality of Life among Women Breast Cancer Patients in Eastern China

Chen Q, Li S, Wang M, Liu L & Chen G. BioMed Research International, 2018, 1452635. DOI: 10.1155/2018/1452635.

This study explored which dimensions of HRQOL played important roles in breast cancer patients’ overall quality of life, and explored the latent factor structure and the potential complementary relationship between these two EORTC questionnaires (QLQ-C30 & QLQ-BR23) in breast cancer patients.

Assessment of Outcome Measures for Cost-Utility Analysis in Depression: Mapping Depression Scales onto the EQ-5D-5L

Gamst-Klaussen T, Lamu AN, Chen G & Olsen JA. BJPsych Open, 2018, 4 (4): 160-166. DOI: 10.1192/bjo.2018.21.

Mapping algorithms reported from Depression Anxiety Stress Scales (DASS-21) and Kessler Psychological Distress Scale (K-10) onto EQ-5D-5L.

Psychometric Evaluation of the Chinese Version of the Child Health Utility 9D (CHU9D-CHN): A School-Based Study in China

Yang P, Chen G, Wang P, Zhang K, Deng F, Yang H & Zhuang G. Quality of Life Research, 2018, 27 (7): 1921-1931. DOI: 10.1007/s11136-018-1864-x.

Do Country-Specific Preference Weights Matter in the Choice of Mapping Algorithms? The Case of Mapping the Diabetes-39 onto Eight Country-Specific EQ-5D-5L Value Sets

Lamu AN, Chen G, Gamst-Klaussen T & Olsen JA. Quality of Life Research, 2018, 27 (7): 1801-1814. DOI: 10.1007/s11136-018-1840-5.

Mapping algorithms reported from Diabetes-39 onto EQ-5D-5L. The fractional regression model, which is appropriate for handling bounded outcomes, outperformed other candidate methods in this mapping study.

A Review of Preference-Based Measures for the Assessment of Quality of Life in Children and Adolescents with Cerebral Palsy

Mpundu-Kaambwa C, Chen G, Huynh E, Russo R & Ratcliffe J. Quality of Life Research, 2018, 27 (7): 1781-1799. DOI: 10.1007/s11136-018-1837-0.

This review examined the psychometric properties and suitability for use within the context of cerebral palsy research in children and adolescents of generic preference-based health-related quality of life (HRQoL) instruments. Four preference-based HRQoL instruments were identified from eight studies: HUI-2, HUI-3, AQoL-4D, & EQ-5D-3L.

Health State Utilities and Subjective Well-Being among Psoriasis Vulgaris Patients in Mainland China

Liu L, Li S, Zhao Y, Zhang J & Chen G. Quality of Life Research, 2018, 27 (5): 1323-1333. DOI: 10.1007/s11136-018-1819-2.

There is a poor agreement between direct (TTO & SG) and indirect (EQ-5D-5L) methods on measuring health state utility. Exploratory factor analysis further suggests a complementary relationship between the EQ-5D-5L and WHO-5 wellbeing index.

Comparing the Effects of China’s Three Basic Medical Insurance Schemes on the Equity of Health-Related Quality of Life: Using the Method of Coarsened Exact Matching

Su Min, Zhou Z, Si Y, Wei X, Xu Y, Fan X & Chen G. Health and Quality of Life Outcomes, 2018, 16: 41. DOI: 10.1186/s12955-018-0868-0.

This study compared the equity of health-related quality of life (HRQoL) of residents under any two of three basic health insurance schemes in China. Findings demonstrated the pro-rich health inequity was much higher for the rural scheme than that for the urban ones.

Measuring Health Related Quality of Life in Adolescent Populations: An Empirical Comparison of the CHU9D and the PedsQL™ 4.0 Short Form 15

Petersen KD, Chen G, Mpundu-Kaambwa C, Stevens K, Brazier J & Ratcliffe J. Patient, 2018, 11 (1): 29-37. DOI: 10.1007/s40271-017-0265-5.

Protocol for a Systematic Review of Instruments for the Assessment of Quality of Life and Well-Being in Children and Adolescents with Cerebral Palsy

Mpundu-Kaambwa C, Chen G, Huynh E, Russo R & Ratcliffe J. BMJ Open, 2017, 7: e015924. DOI: 10.1136/bmjopen-2017-015924.

Does the Choice of Tariff Matter? A Comparison of EQ-5D-5L Utility Scores using Chinese, UK and Japanese Tariffs on Patients with Psoriasis Vulgaris in Central South China

Zhao Y, Li S-P, Liu L, Zhang J-L & Chen G. Medicine, 2017, 96 (34): e7840. DOI: 10.1097/MD.0000000000007840.

The evidence from this study supports the choice of the country-specific tariff to be used in clinical research.

Comparison of EQ-5D-5L Health State Utilities using 4 Country-Specific Tariffs on a Breast Cancer Patient Sample in Mainland China

Liu L, Li S, Wang M & Chen G. Patient Preference and Adherence, 2017, 11: 1049-1056. DOI: 10.2147/PPA.S138028.

Although 4 country-specific EQ-5D-5L tariffs have shown an overall high level of correlation and agreement, none of them could be regarded as interchangeable. The higher correlation and agreement between Chinese and UK tariffs may be due to the similar functions that were used in the tariff development.

Fibromyalgia and Quality of Life: Mapping the Revised Fibromyalgia Impact Questionnaire to the Preference-Based Instruments

Collado-Mateo D, Chen G, Garcia-Gordillo MA, Iezzi A, Adsuar JC, Olivares PR & Gusi N. F. Health and Quality of Life Outcomes, 2017, 15: 114. DOI: 10.1186/s12955-017-0690-0.

Mapping algorithms reported from Revised Fibromyalgia Impact Questionnaire (FIQR) onto 15D, AQoL-8D, EQ-5D-5L, or SF-6D.

Assessing Income-Related Health Inequality and Horizontal Inequity in China

Zhou Z, Fang Y, Zhou Z, Li D, Wang D, Li Y, Lu L, Gao J & Chen G. Social Indicators Research, 2017, 132 (1): 241-256. DOI: 10.1007/s11205-015-1221-1.

The study investigates both income-related health inequality and horizontal equity in urban and rural China (2008 & 2013). Results suggested that there was a pro-rich inequality of HRQoL in both urban and rural China. Comparing the CIs of HRQoL between 2008 and 2013, an increasing trend could be observed, especially in the urban sample. Results from the decomposition exercises suggest that economic and education status were two key factors of the pro-rich inequity.

Mapping Sri Lankan EQ-5D-3L to EQ-5D-5L Value Sets

Kularatna S, Chen G, Byrnes J & Scuffham PA. Value in Health Regional Issues, 2017, 12 C: 20-23. DOI: 10.1016/j.vhri.2017.01.001.

This study produced the Sri Lankan EQ-5D-5L interim value set from EQ-5D-3L value set using a mapping approach.

Mapping CHU9D Utility Scores from the PedsQL™ 4.0 SF-15

Mpundu-Kaambwa C, Chen G, Russo R, Stevens K, Petersen KD & Ratcliffe J. PharmacoEconomics, 2017, 35 (4): 453-467. DOI: 10.1007/s40273-016-0476-y.

Mapping between the Sydney Asthma Quality of Life Questionnaire (AQLQ-S) and Five Multi-Attribute Utility Instruments (MAUIs)

Kaambwa B, Chen G, Ratcliffe J, Iezzi A, Maxwell A & Richardson J. PharmacoEconomics, 2017, 35 (1): 111-124. DOI: 10.1007/s40273-016-0446-4.

Mapping algorithms reported from Sydney Asthma Quality of Life Questionnaire (AQLQ-S) onto 15D, AQoL-8D, EQ-5D-5L, HUI3, or SF-6D.

Estimating Utility Weights for the Vision Related Quality of Life Index

Chen G, Finger R, Holloway EE, Iezzi A & Richardson J. Optometry and Vision Science, 2016, 93 (12): 1495-1501. DOI: 10.1097/OPX.0000000000000966.

Mapping algorithms reported from Vision Related Quality of Life (VisQoL) onto AQoL-7D. 

Decomposing Socioeconomics Inequalities in Depressive Symptoms among the Elderly in China

Xu Y, Yang J, Gao J, Zhou Z, Zhang T, Ren J, Li Y, Qian Y, Lai S & Chen G. BMC Public Health, 2016, 16: 1214. DOI: 10.1186/s12889-016-3876-1.

Results from 2nd wave of the China Health and Retirement Longitudinal Study (CHARLS) indicate a pro-rich inequality in depressive symptoms amongst elderly Chinese with the overall concentration index of depressive symptoms was -0.0645 among the elderly.

Health-Related Quality of Life and Associated Factors of Frontline Railway Workers: A Cross-Sectional Survey in the Ankang Area, Shaanxi Province, China 

Zhang X, Chen G, Xu F, Zhou K & Zhuang G. International Journal of Environmental Research and Public Health, 2016, 13, 1192. DOI: 10.3390/ijerph13121192.

Long or irregular working schedules were the most important factors that were negatively associated with HRQOL of railway workers in China.

Health State Utility Instruments Compared: Inquiring into Nonlinearity across EQ-5D-5L, SF-6D, HUI-3, and 15D

Gamst-Klaussen T, Chen G, Lamu AN & Olsen JA. Quality of Life Research, 2016, 25 (7): 1667-1678. DOI: 10.1007/s11136-015-1212-3.

This paper inquires into the degree of nonlinearity across the 4 health state utility instruments (EQ-5D-5L, SF-6D, HUI-3, and 15D) & proposes exchange rates that differ depending on the severity levels of the utility scale. Accounting for nonlinearities will increase the validity of the comparison for decision makers when faced with a choice between interventions whose calculations of QALY gains have been based on different HSU-instruments.

Valuing the Child Health Utility 9D: Using Profile Case Best Worst Scaling Methods to Develop a New Adolescent Specific Scoring Algorithm

Ratcliffe J, Huynh E, Chen G, Stevens K, Swait J, Brazier J, Sawyer M, Roberts R, Flynn T. Social Science and Medicine, 2016, 157: 48-59. DOI: 10.1016/j.socscimed.2016.03.042.

This paper reports upon a study to apply profile case best worst scaling (BWS) and time trade-off (TTO) methods to derive a new adolescent-specific scoring algorithm for the Child Health Utility 9D (CHU9D), a generic preference-based instrument that has been specifically designed for the estimation of quality-adjusted life years for the economic evaluation of health care treatment and preventive programs targeted at young people. 

Mapping between 6 Multiattribute Utility Instruments

Chen G, Khan MA, Iezzi A, Ratcliffe J & Richardson J. Medical Decision Making, 2016, 36 (2): 160-175. DOI: 10.1177/0272989X15578127.

Different multiattribute utility (MAU) instruments predict significantly different utilities, which makes the comparison of results from different evaluation studies problematical. This article presents mapping functions (“crosswalks”) from 6 MAU instruments (15D, AQoL-8D, EQ-5D-5L, HUI 3, QWB, SF-6D) to each of the other 5 instruments in the study: a total of 30 mapping functions.

Measuring the Sensitivity and Construct Validity of 6 Utility Instruments in 7 Disease Areas

Richardson J, Khan MA, Iezzi A, Chen G, Maxwell A. Medical Decision Making, 2016, 36 (2): 147-159. DOI: 10.1177/0272989X15613522.

The present article has 2 objectives: 1) to compare the results of 3 measures of the sensitivity of 6 multiattribute utility (MAU) instruments and the results of 6 tests of construct validity in 7 disease areas, and 2) to rank the MAU instruments by each of the test results in each disease area and by an overall composite index constructed from the tests. The apparent sensitivity of instruments varied significantly with the measurement method and by disease area. Validation test results varied with the comparator instruments. Notwithstanding this variability, 15D, AQoL-8D, & SF-6D generally achieved better test results than QWB & EQ-5D-5L.

Exploring the Nonlinear Relationship between Body Mass Index and Health-Related Quality of Life among Adults: A Cross-Sectional Study in Shaanxi Province, China

Xu Y, Zhou Z, Li Y, Yang J, Guo X, Gao J, Yan J & Chen G. Health and Quality of Life Outcomes, 2015, 13: 153. DOI: 10.1186/s12955-015-0347-9.

There were statistically significant nonlinear relationships between BMI and HRQOL, with optimal HRQOL achieved at a BMI of near 23 kg/m2 for men and 24 kg/m2 for women. Before BMI reached optimal HRQOL, the EQ-5D utility scores were increasing faster among men than the women, whilst after the BMI value reached the optimal utility scores, women showed a faster decline in utility scores than men. 

Valuing Child Health Utility 9D Health States with Young Adults: Insights from A Time Trade Off Study

Ratcliffe J, Chen G, Stevens K, Bradley S, Couzner L, Brazier J, Sawyer M, Roberts R, Huynh E & Flynn T. Applied Health Economics and Health Policy, 2015, 13 (5): 485-492. DOI: 10.1007/s40258-015-0184-3.

A Review of the Development and Application of Generic Multi-Attribute Utility Instruments for Paediatric Populations

Chen G & Ratcliffe J. PharmacoEconomics, 2015, 33 (10): 1013-1028. DOI: 10.1007/s40273-015-0286-7.

T​his paper critically reviews the development and application of nine multiattribute utility (MAU) instruments (QWB, HUI2, HUI3, 16D, 17D, AQoL-6D, CHU9D, EQ-5D-Y, AHUM) that have been used in paediatric populations internationally. Areas for further research relating to the development and application of generic MAU instruments in paediatric populations are highlighted.

Deriving Health Utilities from the MacNew Heart Disease Quality of Life Questionnaire

Chen G, McKie J, Khan MA & Richardson JR. European Journal of Cardiovascular Nursing, 2015, 14 (5): 405-415. DOI: 10.1177/1474515114536096.

Mapping algorithms reported from MacNew Heart Disease Quality of Life Questionnaire onto 15D, AQoL-8D, EQ-5D-5L, HUI3, QWB, or SF-6D. 

Diabetes and Quality of Life: Comparing Results from Utility Instruments and Diabetes-39

Chen G, Iezzi A, McKie J, Khan M & Richardson J. Diabetes Research and Clinical Practice, 2015, 109 (2): 326-333. DOI: 10.1016/j.diabres.2015.05.011.

Mapping algorithms reported from Diabetes-39 onto 15D, AQoL-8D, EQ-5D-5L, HUI3, QWB, or SF-6D. 

Assessing the Health-Related Quality of Life of Australian Adolescents: Comparison of the CHU9D and EQ-5D-Y based on Adult Values

Chen G, Flynn T, Stevens K, Brazier J, Huynh E, Sawyer M, Roberts R & Ratcliffe J. Value in Health, 2015, 18 (4): 432-438. DOI: 10.1016/j.jval.2015.02.014.

Can Multi-Attribute Utility Instruments Adequately Account for Subjective Well-Being? 

Richardson J, Chen G, Khan MA & Iezzi A. Medical Decision Making, 2015, 35 (3): 292-304. DOI: 10.1177/0272989X14567354.

This article explores a hypothesis that a failure of an multiattribute utility (MAU) instrument to account for variation in subjective wellbeing (SWB) is primarily a result of the failure of its descriptive system to include the elements of health that determine SWB and that cannot therefore be included in assessment of the health state utility. Results suggest that, to a large extent, utility can account for variation in SWB.

Assessing Outcomes for Cost-Utility Analysis in Depression: Comparison of Five Multi-Attribute Utility Instruments with Two Depression-Specific Outcome Measures

Mihalopoulos C, Chen G, Iezzi A, Khan MA & Richardson J. British Journal of Psychiatry, 2014, 205 (5): 390-397. DOI: 10.1192/bjp.bp.113.136036.

This paper firstly investigated the sensitivity of 5 commonly used health utility instruments in depression. Next, mapping algorithms were developed from Depression Anxiety Stress Scales (DASS-21) and/or Kessler Psychological Distress Scale (K10) onto 15D, AQoL-8D, EQ-5D-5L, HUI3 or SF-6D. 

From KIDSCREEN-10 to CHU9D: Creating a Unique Mapping Algorithm for Application in Economic Evaluation

Chen G, Stevens K, Rowen D & Ratcliffe J. Health and Quality of Life Outcomes, 2014, 12: 134. DOI: 10.1186/s12955-014-0134-z.

Mapping of Incontinence Quality of Life (I-QOL) Scores to Assessment of Quality of Life 8D (AQoL-8D) Utilities in Patients with Idiopathic Overactive Bladder

Chen G, Tan JT, Ng K, Iezzi A & Richardson J. Health and Quality of Life Outcomes, 2014, 12: 133. DOI: 10.1186/s12955-014-0133-0.

Utility Values among Myopic Patients in Mainland China

Li S, Wang G, Xu Y, Gray A & Chen G. Optometry and Vision Science, 2014, 91 (7): 723-729. DOI: 10.1097/OPX.0000000000000299.

This study elicited utility values of adult myopic patients in mainland China using both TTO and SG methods. Although they produced similar mean utility values, a poor agreement on individuals utility values were found from these two methods.

BMI, Health Behaviors, and Quality of Life in Children and Adolescents: A School-Based Study

Chen G, Ratcliffe J, Olds T, Magarey A, Jones M & Leslie E. Pediatrics, 2014, 133 (4): e868-e874. DOI: 10.1542/peds.2013-0622.

Irrespective of BMI, young people engaging in more physical activities or less sedentary behavior, and having healthier sleep patterns or eating behavior exhibited higher utilities. Associations between utilities and sleep patterns or eating behavior were stronger than the associations with BMI.

Measuring and Valuing Health-Related Quality of Life among Children and Adolescents in Mainland China – A Pilot Study

Xu F§†, Chen G§, Stevens K, Zhou H, Qi S, Wang Z, Hong X, Chen X, Yang H, Wang C & Ratcliffe J. PLoS ONE, 2014, 9 (2): e89222. DOI: 10.1371/journal.pone.0089222.