The Multi Instrument Comparison (MIC) project

 

Formal title: A cross-national comparison of 8 generic quality of life (QoL) instruments: 

NHMRC ID: 1006334

Chief Investigators: Richardson J (Monash University, Australia)
Cummins, R (Deakin University, Australia)
Olsen, J (University of Tromso, Norway)
Kaplan, R (UCLA, USA)
Coast, J (University of Birmingham, UK)
Schlander, M (Institute for Innovation and Valuation in Health Care, Germany)

 

Objective: To compare instruments purporting to measure quality of life; to use survey results to discriminate between the 6 multi attribute utility (MAU) instruments which are most commonly used for the economic evaluation of health programs and the allocation of health budgets

 

Scope:

The instruments, respondents and countries included in the study are summarised in Tables 1-3.

Table 1 Countries and disease areas included in the study

 Countries

 Disease area

 Australia

 Arthritis

 Canada

 Asthma

 Norway

 Cancer

 UK

 Depression

 USA

 Diabetes

 Germany

 Hearing Loss

 

 Heart problems

 

Table 2 General questionnaires

 

 

Items

 Subjective Wellbeing (SWB)

 Personal Wellbeing Index (PWI)

9

 Integrated Household Survey (IHS)

5

 Satisfaction with Life Survey (SWLS)

4

       subtotal

18

 Multi Attribute Utility (MAU) Instruments

 EQ-5D-5L

5

 AQoL-8D and AQoL-4D

44

 HUI3

8

 15D

15

 QWB-SA

77

 MA Non-Utility Instrument

 SF-36

36

 

       subtotal

185

 Capabilities

 ICECAP-A

5

 Demographics

 

23

 

       Total items in composite instrument

231

 

Table 2a Disease Specific Questionnaires

 Health Condition 

 Disease Specific Instruments

 Number of items 

 Depression

 DASS21 and K10

31

 Hearing Loss

 Abbreviated Profile of Hearing Aid Benefit (APHAB)

24

 Asthma

 Asthma Quality of Life Questionnaire (AQLQ-Sydney)

20

 Diabetes

 Diabetes-39

39

 Arthritis

 Arthritis Impact Measurement Scales 2 (AIMS2-SF)

26

 Heart

 Macnew Heart QoL

27

 Cancer

 Cancer QLQ C-30

30

 

Table 3 Respondents and sample size

Australia

USA

UK

Canada

Norway

Germany

 Disease free  

265

321

298

328

288

260

 Disease Sample  

Depression 

146

168

158

145

140

160

Hearing Loss 

155

156

126

144

115

136

Asthma 

141

150

150

138

130

147

Diabetes 

168

168

161

144

143

140

Arthritis 

163

179

159

139

130

159

Heart 

149

170

167

154

151

152

Cancer 

154

148

137

138

80

115

 

Project Rationale

(i) Budgets are increasingly guided by economic evaluations which increasingly employ CUA. This technique relies upon multi attribute utility (MAU) instruments to include the quality of life. These instruments produce very different results and the allocation of a budget may depend upon the choice of MAU instrument. (ii) MAU and SWB (happiness) instruments have followed different theoretical and measurement traditions. The fields need integration. As a preliminary step towards determining the most appropriate instrument for measuring the value of health states, the relationship between SWB and MAU instruments should be understood. This project seeks to achieve this.