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Outcomes Research:
Measurement, Valuation & Application

Research

One and the Same or Different? An Empirical Comparison of Aged Care Recipient and Non-Aged Care Recipient Preferences for Quality of Aged Care amongst Older Australians

Song J, Chen G, Khadka J, Milte R & Ratcliffe J. Social Science & Medicine, 2024, 353: 117054. DOI: 10.1016/j.socscimed.2024.117054.

QCE-ACC has been adopted by the Australian government as a new quality indicator for aged care. This study used DCE to develop an aged care user-specific value set for the QCE-ACC.

The Relative Importance and Performance of Key Life Domains on Global Life Satisfaction in Early Adolescents

Woode ME & Chen G. Value in Health, 2024, 27 (6): 767-775. DOI: https://doi.org/10.1016/j.jval.2024.02.010.

This study adopts a partial least squares structural equation modelling (PLS-SEM) approach to investigate the relative importance and performance of 14 key life domains of early adolescents across age cohorts and 10 countries at different levels of economic development. 

A Happiness Approach to Valuing Health State for Children

Huang L, Devlin N, Chen G & Dalziel K. Social Science & Medicine, 2024, 348: 116802. DOI: 10.1016/j.socscimed.2024.116802.

To date, health state utilities are predominantly derived using stated preference methods based on decision utility. This study contribute to the literature by showing that using experienced utility methods to generate preference weights for health states is possible, and we discuss some important methodological challenges for future studies such as the impracticability of anchoring to ‘dead’ when utilizing experienced utility.

The Influence of Parents’ and Partner’s Education on Own Health Behaviours

Chen G, Olsen JA & Lamu AN. Social Science & Medicine, 2024, 343: 116581. DOI: 10.1016/j.socscimed.2024.116581.

This study facilitates a better understanding of education-health behaviours nexus from a life course perspective. Results support the hypothesis that own health behaviour is affected by the educational attainments of our ‘nearest and dearest’ (i.e. spouse, mother, and father), net of own education. In particular, partners' education attainments are relatively more important for avoiding unhealthy behaviour than choosing healthy behaviour; on the contrary, parents' education is more important for healthy behaviour.

Exploring the Use of Pictorial Approaches in the Development of Paediatric Patient-Reported Outcome Instruments: A Systematic Review

Mpundu-Kaambwa C, Bulamu NB, Lines L, Chen G, Whitehurst DGT, Dalziel K, Devlin K & Ratcliffe J, on behalf of the QUality Of life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team. PharmacoEconomics, 2024, 42 (Supp 1): 9-37. DOI: 10.1007/s40273-024-01357-z.

A total of 22 paediatric pictorial PROMs, comprising 28 unique versions, were identified. Likert scales with pictorial anchors, particularly happy–sad faces, were commonly used for response options. Various graphic methods, such as happy–sad faces, cartoons, and thermometers, were adapted to specific content domains. There is some evidence that pictorial PROMs facilitate self-report in this population and improve measurement properties compared to text-only PROMs. 

Comparing the Psychometric Performance of Generic Paediatric Health-Related Quality of Life Instruments in Children and Adolescents with ADHD, Anxiety and/or Depression

O’Loughlin R, Jones R, Chen G, Mulhern B, Hiscock H, Devlin N & Dalziel K, in collaboration with the QUality Of life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team. PharmacoEconomics, 2024, 42 (Supp 1): 57-77. DOI: 10.1007/s40273-024-01354-2.

Our results indicate that the CHU9D, PedsQL, EQ-5D-Y-3L and EQ-5D-Y-5L perform equally well in children and adolescents with ADHD or anxiety and/or depression, regarding acceptability/feasibility, known-group and convergent validity. However, relative strengths of the CHU9D and PedsQL were observed regarding their lack of ceiling effects, greater test–retest reliability, and consistently good performance across all psychometric properties. The CHU9D and EQ-5D-Y-3L were the most responsive to improvements in health status.

An Investigation of Inter-Rater and Intra-Proxy Agreement in Measuring Quality of Life of Children in the Community using the EQ-5D-Y-3L

Khanna D, Khadka J, Mpundu-Kaambwa C, Chen G, Dalziel K, Devlin N & Ratcliffe J, in collobration with the QUality Of life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team. PharmacoEconomics, 2024, 42 (Supp 1): 113-128. DOI: 10.1007/s40273-024-01356-0.

There are two ways to complete a proxy report—from the proxy’s own perspective (proxy-proxy, Proxy 1) or answer as the child would (proxy-child, Proxy 2). Proxy-child perspective showed a stronger agreement at the dimension level for the psychosocial dimension compared with the traditional proxy-proxy perspective. While no statistically significant difference was observed for the preference-weighted HRQoL across the two proxy perspectives, the child- and parent-reported EQ-VAS scores differed significantly when the proxy-child perspective was adopted, indicating that perspective may influence this aspect of HRQoL measurement.

Psychometric Properties of Child Health Utility 9D (CHU9D) Proxy Version Administered to Parents and Caregivers of Children Aged 2-4 Years Compared with Pediatric Quality of Life Inventory™ (PedsQL)

Xiong X, Carvalho N, Huang L, Chen G, Jones R, Devlin N, Mulhern B & Dalziel K. PharmacoEconomics, 2024, 42 (Supp 1): 147-161. DOI: 10.1007/s40273-024-01355-1.

The CHU9D was found to be valid and reliable to measure health-related quality-of-life in children aged 2–4 years, although with relatively low test–retest reliability in some dimensions. Further development and validation work is warranted.

Comparative Psychometric Performance of Common Generic Paediatric Health Related Quality of Life Instrument Descriptive Systems: Results from the Australian Paediatric Multi-Instrument Comparison Study

Jones R, O’Loughlin R, Xiong X, Bahrampour M, Devlin N, Hiscock H, Chen G, Mulhern B & Dalziel K, on behalf of the QUality Of life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA) project team. PharmacoEconomics, 2024, 42 (Supp 1): 39-55. DOI: 10.1007/s40273-023-01330-2

In the total sample, the EQ-5D-Y-5L and CHU9D descriptive systems demonstrated evidence of good performance (i.e., meeting prespecified criteria) across all psychometric attributes tested. Considering results for ceiling effects, test–retest reliability, and responsiveness varied by child age and report type, future instrument users should consider the decision-making context, target population, and study design when deciding which instrument will be most appropriate.

Systematic Review of the Relative Social Value of Child and Adult Health

Peasgood T, Howell M, Raghunandan R, Salisbury A, Sellars M, Chen G, Coast J, Craig JC, Devlin NJ, Howard K, Lancsar E, Petrou S, Ratcliffe J, Viney R, Wong G, Norman R & Donaldson C, on behalf of the Quality of Life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA), Tools for Outcomes Research to measure, value Child Health (TORCH) project teams. PharmacoEconomics, 2024, 42 (2): 199-217. DOI: 10.1007/s40273-023-01327-x

The balance of evidence suggests the general public favours prioritising children over adults, but this view was not found across all studies. There are research gaps in understanding the public’s views on the value of health gains to very young children and the motivation behind the public’s views on the value of child relative to adult health gains.

Associations of Compositional Time Use with Self-Reported Health, Depression, and Cognitive Outcomes among Chinese Adolescents

Ren Y, Liu Y & Chen G. Children and Youth Services Review, 2024, 158: 107488. DOI: 10.1016/j.childyouth.2024.107488.

Using two waves of nationally representative data, this study examined the evolving time-use patterns of Chinese junior high school students and their associations with self-reported health, depressive symptoms, and cognitive abilities. Four stable time-use clusters were identified from the latent class analysis. 

Comparative Performance and Mapping Algorithms between EQ-5D-5L and SF-6Dv2 among the Chinese General Population

Xie S, Wu J & Chen G. European Journal of Health Economics, 2024, 25 (1): 7-19. DOI: 10.1007/s10198-023-01566-x.

 

Both EQ-5D-5L and SF-6Dv2 showed comparable discriminative validity. Systematic differences in utilities were found, and on average, the EQ-5D-5L generates higher values than the SF-6Dv2. Good test-retest reliability was found for both EQ-5D-5L (ICC=0.86) and SF-Dv2 (ICC=0.83). Mapping algorithms between the EQ-5D-5L and SF-6Dv2 are reported to enable transformations between these two measures in China.

Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Malay Version of the Assessment of Quality of Life—6 Dimensions (Malay-AQoL-6D) Instrument among Malaysians Living with Chronic Heart Failure

Tan YJ, Ong SC, Goh SP, Chen G, Yong VS, Khor WW, Kan YM, Choong YY, Zameram AM, Tan LY, Voo JYH, Lam KK, Yen CH, Abdul Wahab MJ & Abdulla ZB. Journal of Patient-Reported Outcomes, 2024, 8: 79. DOI: 10.1186/s41687-024-00763-3.

This study translated and culturally adapted the Assessment of Quality of Life (AQoL)-6D into Malay (Malay-AQoL-6D), and assessed its acceptability, reliability, and validity among Malaysians living with chronic heart failure (HF).

Mapping the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) onto the Assessment of Quality of Life (AQoL)-4D Utilities

Ma BH, Chen G, Badji S & Petrie D. Quality of Life Research, 2024, 33 (2): 411-422. DOI: 10.1007/s11136-023-03532-9.

The developed mapping algorithm enables cost-utility analyses of interventions for people with disability where the WHODAS 2.0 has been collected.

Development of Algorithms for Estimating the Child Health Utility 9D from Caregiver Priorities and Child Health Index of Life with Disability

Tonmukayakul U, Willoughby K, Mihalopoulos C, Reddihough D, Mulhern B, Carter R, Robinson S & Chen G. Quality of Life Research, 2024, 33 (7): 1881-1891. DOI: 10.1007/s11136-024-03661-9.

The developed mapping algorithm enables cost-utility analyses of interventions for non-ambulatory children with cerebral palsy (CP) where the CPCHILD has been collected.

The Subjective Wellbeing of People Living with Multiple Sclerosis in Australia: Insights from the Personal Wellbeing Index

Henson GJ, Van der Mei I, Taylor BV, Claflin SB, Campbell J, Chen G. Health and Quality of Life Outcomes, 2024, 22: 83. DOI: 10.1186/s12955-024-02278-3.

For people living with MS the most important life domains were standard of living and achieving in life. The domain of personal health was more influential for people living with MS than the general population. The life domains most susceptible to MS-related disability were personal health, achieving in life, and community connectedness.

Health-Related Quality of Life and Subjective Well-being among Children Aged 9-12 Years in Shandong Province, China

Shi Z, Cao A, Li S, Wang J, Zhang J, Ratcliffe J & Chen G. Health and Quality of Life Outcomes, 2024, 41: 22. DOI: 10.1186/s12955-024-02258-7.

Concordance of child self-reported and parent proxy-assessed was poor. Overall, mother-child concordance was higher than father-child concordance.

Assessing Health State Utilities for People with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome in Australia using the EQ-5D-5L, AQoL-8D and EQ-5D-5L-Psychosocial Instruments

Orji NC, Cox IA, Jason LA, Chen G, Zhao T, Rogerson MJ, Kelly RM, Wills K, Hensher M, Palmer AJ, de Graaff B & Campbell JA. Quality of Life Research, 2024, 33 (1): 45-57. DOI: 10.1007/s11136-023-03498-8.

 

ME/CFS has a profound impact on HRQoL. The AQoL-8D and EQ-5D-5L-Psychosocial can be used interchangeably.

Health Utility Assessments in Individuals Undergoing Diagnostic and Surveillance Colonoscopy: Improved Discrimination with a Cancer-Specific Scale

Bulamu NB, Chen G, McGrane E, Cock C, Young GP & Symonds EL. Cancer Causes & Control, 2024, 35 (2): 347-357. DOI: 10.1007/s10552-023-01789-6.

HRQoL does not change one year following a diagnosis of the bowel at colonoscopy and it does not differentiate between different colonoscopy diagnoses including cancer. However, patients undergoing colonoscopy because of symptoms have poorer HRQoL compared to those undergoing surveillance colonoscopy for cancer. Participants reporting full health with EQ-5D-5L still had problems on the QLU-C10D, with fatigue and sleep at baseline and with role function and fatigue at follow-up. 

Health State Utility Values in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

Feng J, Zhang K, Dou L, Shi Z, Chen G & Li S. Quality of Life Research, 2024, 33 (9): 2321-2334. DOI: 10.1007/s11136-024-03670-8.

 

Ankylosing spondylitis (AS) is a chronic condition that requires lifelong treatment and results in a serious disease burden. We conducted a systematic review and meta-analysis to obtain estimates of HSUVs in patients with AS, explored potential sources of heterogeneity, and compared pooled patient HSUVs with population norms.

Amplified Disparities: The Association between Spousal Education and Own Health

Lamu AN, Chen G & Olsen JA. Social Science & Medicine, 2023, 323: 115832. DOI: 10.1016/j.socscimed.2023.115832.

 

This study has provided empirical evidence that spousal education contributes to explaining the amplified health gradient in an egalitarian country like Norway.

Developing An Australian Utility Value Set for MacNew-7D Health States

Kularatna S, Chen G, Norman R, Mukuria C, Rowen D, Senanayake S, Hettiarachchi R, Mulhern B, Fozzard K, Parsonage W & McPhail SM. Quality of Life Research, 2023, 32 (4): 1151-1163. DOI: 10.1007/s11136-022-03325-6

 

The MacNew-7D Australian utility value set ranged from −0.4456 to 1 for health states defined by the classification system.

Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents with Mental Health Problems: Are Multi-Attribute Utility Instruments Fit for Purpose?

Mihalopoulos C, Chen G, Scott JG, Bucholc JB, Allen C, Coghill D, Jenkins P, Norman R, Ratcliffe J, Richardson J, Stathis S & Viney R. Value in Health, 2023, 26 (5): 733-741. DOI: 10.1016/j.jval.2022.12.007.

 

Multi-attribute utility instruments (MAUIs), such as the EQ-5D-Y, CHU9D, HUI-2&3 & the AQoL-6D, were found to have good concurrent and construct validity when compared to self-report outcome measures but poor validity when compared to clinician or parent/guardian reported measures in children/adolescents with mental disorders.

Extending the EQ-5D: The Case for A Complementary Set of 4 Psycho-Social Dimensions

Chen G & Olsen JA. Quality of Life Research, 2023, 32 (2): 495-505. DOI: 10.1007/s11136-022-03243-7.

 

This study empirically explored the performance of a coherent set of four psycho-social bolt-ons for EQ-5D: Vitality; Sleep; Personal relationships; & Social isolation. It also investigated the relative importance of nine dimensions for explaining variations in health vs subjective wellbeing.

Measuring the Wellbeing of Cancer Patients with Generic and Disease-Specific Instruments

Chen G, Bulamu NB, McGrane E & Richardson J. Cancers, 2023, 15 (4): 1351. DOI: 10.3390/cancers15041351.

 

This study investigated the extent to which patients’ SWB and generic and cancer‐specific health utility instruments are sensitive to the functional and symptom subscales employed by the QLQ‐C30 cancer‐specific instrument. The QLU‐C10D was the most sensitive instrument to most patient problems; the 15D was the most successful generic health utility instrument. This study also shows that to improve the overall life satisfaction of cancer patients, life domains, such as achievement in life, relationships, the standard of living, and future security, all play an important role in addition to health.

Valuing the Dental Caries Utility Index in Australia

Hettiarachchi RM, Kularatna S, Byrnes J, Mulhern B, Chen G & Scuffham PA. Medical Decision Making, 2023, 43(7-8): 901-913. DOI: 10.1007/s11136-023-03498-8.

 

This study developed an Australian-specific value set for the DCUI using DCE and VAS. The DCUI consists of five domains: pain/discomfort, difficulty eating food/drinking, worried, ability to participate in activities, and appearance (PMID: 34859442). 

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, 2023, 45 (3): 534-541. DOI: 10.1080/09638288.2022.2029958.

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

Validation of the EQ-5D-5L and Psychosocial Bolt-ons in a Large Cohort of People Living with Multiple Sclerosis in Australia

Campbell JA, Ahmad H, Chen G, van der Mei I, Taylor BV, Claflin S, Henson GJ, Simpson-Yap S, Laslett LL, Hawkes K, Hurst C, Waugh H & Palmer AJ. Quality of Life Research, 2023, 32 (2): 553-568. DOI: 10.1007/s11136-022-03214-y.

 

The empirical results demonstrate that the EQ-5D-5L-Psychosocial & AQoL-8D utilities are interchangeable. Additionally, when the respondent burden is taken into account and given the interchangeability of the two instruments, the EQ-5D-5L-Psychosocial is preferential to the AQoL-8D in people with multiple sclerosis. 

Evaluating Health-Related Quality of Life and Subject Wellbeing among Infertility Patients: A Cross-Sectional Study in Mainland China

Shi Z, Nie H, Geng L, Wang X, Chen G & Li S. Quality of Life Research, 2023, 32 (5): 1469-1480. DOI: 10.1007/s11136-022-03330-9

 

Patients diagnosed with primary infertility had significantly lower HRQoL and SWB than those with secondary infertility. There exists a poor agreement between EQ-5D-5L and AQoL-8D and the difference in the psychosocial components may explain the difference.

What Is the Relationship between Health-related Quality of Life among Scoliosis Patients and Their Caregiver Burden? A Cross-sectional Study in China

Shi Z, Mao Z, Xue S, Chen G & Li S. BMC Psychology, 2023, 11: 346. DOI: 10.1186/s40359-023-01375-0

This study explored the HRQoL of scoliosis patients and their caregivers, and identified the factors influencing caregiver burden. Overall, the caregiver burden of adolescent patients was higher than that of adult patients. 

Psychometric Properties and Comparison of Four Health Utility Approaches among Myopia Patients in China

Dou L, Xu Y, Chen G & Li S. Health and Quality of Life Outcomes, 2023, 21: 66. DOI: 10.1186/s12955-023-02150-w.

 

This study compared the psychometric properties (concurrent validity, known-group validity, sensitivity, & agreement) of 4 approaches to elicit health state utility among myopia patients, including TTO, SG, AQoL-7D, and the Visual Function Questionnaire–Utility Index (VFQ-UI). Moderate to high correlations have been observed between disease-specific measures and the AQoL-7D and the VFQ-UI, while weak correlations were observed with TTO and SG. Among 4 approaches, significant differences among known groups were found in the severity of myopia and duration of myopia for VFQ-UI. Overall, the VFQ-UI had the best performance based on the psychometric analysis.

Olsen JA, Chen G & Lamu AN. BMC Public Health, 2023, 23: 1981. DOI: 10.1186/s12889-023-16943-7.

Indicators of socioeconomic position and health behaviours are widely used predictors of health variations. In the institutional context of a rich egalitarian country, variations in health and wellbeing are to a larger extent explained by health behaviours than educational attainment. 

Are Relative Educational Inequalities in Multiple Health Behaviors Widening? A Longitudinal Study of Middle-Aged Adults in Northern Norway

Ibarra-Sanchez AS, Chen G & Wisløff T. Frontiers in Public Health, 2023, 11: 1190087. DOI: 10.3389/fpubh.2023.1190087.

This study explored changes in relative educational inequality in multiple variables related to health behavior (smoking, physical activity, alcohol intake, and body mass index), separately and collectively (healthy lifestyle), among middle-aged adults living in Northern Norway. Persistent and increasing relative disparities in health behavior between the highest and lower education levels were found.

Educational Patterns of Health Behaviors and Body Mass Index: A Longitudinal Multiple Correspondence Analysis of A Middle-Aged General Population, 2007-2016

Ibarra-Sanchez AS, Abelsen B, Chen G & Wisløff T. PLoS ONE, 2023, 18 (12): e0295302. DOI: 10.1371/journal.pone.0295302.

This study presents findings from a longitudinal multiple correspondence analysis on patterns of BMI & multiple health behaviors (smoking, physical activity and alcohol consumption) over time. The findings suggest that most in the study population remained in the same categories of body mass index and the three health behaviors at the follow-up, with a clear educational gradient in healthy patterns. 

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, 2022, 31 (8): 2281-2293. 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.

Discrete Choice Experiment with Duration versus Time Trade-off: A Comparison of Test-Retest Reliability of Health Utility Elicitation Approaches in SF-6Dv2 Valuation

Xie S, Wu JChen G. Quality of Life Research, 2022, 31 (9): 2791-2803. DOI: 10.1007/s11136-022-03159-2.

 

This is the first study to compare the test-retest reliability of TTO and DCETTO approaches. Results indicate that individual responses to both approaches are relatively stable over time (with a mean interval of 16 days).

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.

Preference Elicitation Techniques Used in Valuing Children’s Health-Related Quality-of-Life: A Systematic Review

Bailey C, Howell M, Raghunandan R, Salisbury A, Chen G, Coast J, Craig JC, Devlin NJ, Huynh E, Lancsar E, Mulhern BJ, Norman R, Petrou S, Ratcliffe J, Street DJ, Howard K & Viney R, on behalf of the Quality Of Life in Kids: Key evidence to strengthen decisions in Australia (QUOKKA), Tools for Outcomes Research to Measure, Value Child Health (TORCH) Project Teams. PharmacoEconomics, 2022, 40 (7): 663-698. DOI: 10.1007/s40273-022-01149-3.

 

Studies included in this review used a range of preference elicitation methods such as standard gamble, time-trade off, discrete choice modelling, best-worst scaling and visual analogue scales, with and without modification, for different sources of values (who was asked, children or adults or both) and perspectives (point of view that participants were asked to consider). Differences in reporting limited the conclusions that can be formed about which methods are most suitable for eliciting preferences for children’s health and the influence of differing perspectives and values.

A Systematic Review of International Guidance for Self-Report and Proxy Completion of Child-Specific Utility Instruments

Mpundu-Kaambwa C, Bulamu N, Lines L, Chen G, Dalziel K, Devlin N & Ratcliffe J, on behalf of the Quality Of Life in Kids: Key Evidence for Decision Makers in Australia (QUOKKA) Project Team. Value in Health, 2022, 25 (10): 1791-1804. DOI: 10.1016/j.jval.2022.04.1723.

 

The review has identified and summarized published guidance and recommendations for child self- and proxy assessment of existing child-specific instruments of HRQoL that are accompanied by utilities. The findings suggest a lack of guidance and an urgent need to fill evidence gaps to inform the generation of guidance. 

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.

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, 2022, 82 (3): 253-261. 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.

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.

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, 2022, 77 (9): 2770-2777. 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.

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

This study adopts 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.

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.

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, 2022, 33 (2): 1029-1036. DOI: 10.1080/09546634.2020.1800571.

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.

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

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.

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. 

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.

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.

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.

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.

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’.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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. 

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. 

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.

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.

NOTE: Both KS_I3 ("Have you felf sad") & KS_I4 ("Have you felt lonely") were firstly reverse coded, before including into the analyses. In this case, the response level of "never" should be coded as "5" and "always" should be coded as "1". 

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.

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.

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