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Optimising the cost effectiveness of repeated FIT screening and screening strategies combining bowel scope and FIT screening
A ScHARR report commissioned by the UK National Screening Committee (NSC) to consider the cost-effectiveness and endoscopy capacity requirements of a variety of different screening options incorporating faecal immunochemical testing (FIT) and bowel scope (BS) within the Bowel Cancer Screening Programme (BCSP).
S Whyte, C Thomas, B Kearns, M Webster, J Chilcott
Rapid reviews are of increasing importance within health technology assessment (HTA) due to the need for timely evidence to underpin the assessment of new technologies. A team in ScHARR have developed a decision tool for reviewers to use to select the most appropriate rapid review approaches for HTA. This paper presents the protocol for a Delphi study to validate the decision tool.
Eva Kaltenthaler, Katy Cooper, Marrissa Martyn St James, Abdullah Pandor, Ruth Wong
Recovering Quality of Life (ReQoL): assessment of the factor structure of a generic self-reported outcome measure for use with people experiencing mental health difficulties
This paper reports the factorial structure of the Recovering Quality of Life (ReQoL). Both confirmatory and exploratory factor analyses were conducted and there is sufficient evidence to suggest that the ReQoL is sufficiently unidimensional given the acceptable fit of a bi-factor model.
A Keetharuth, M Barkham, J B Bjorner, J Browne, T Croudace, and J Brazier
Towards a more inclusive approach to measure development in mental health populations: integrating qualitative and quantitative data in the Recovering Quality of Life (ReQoL) measure
This paper reports in detail a novel approach of combining qualitative and quantitative evidence that was used in the development of the Recovering Quality of Life (ReQoL) measures.
A Keetharuth, E Taylor Buck, C Acquadro, K Conway, J Connell, M Barkham, J Carlton, T Ricketts, R Barber and J Brazier
The importance of content and face validity in instrument development: Lessons learnt from service users when developing the Recovering Quality of Life Measure (ReQoL)
This paper emphasises the importance of conducting face validity interviews with service users and reports the key themes of what should be considered in measure development using the development of the Recovering Quality of Life (ReQoL) measures as an example. This is often a stage in measure development that is not reported in detail.
J Connell, J Carlton, A Grundy, E Taylor Buck, A Keetharuth, T Ricketts, M Barkham, D Robotham, D Rose, and J Brazier
The "Reappraisal of the options for colorectal cancer screening report" is a substantial update to the "Option appraisal of population-based colorectal cancer screening programmes in England" (Tappenden et al. 2007). It includes a significant development in modelling methodology, and incorporation of data from (1)the first two rounds of the England gFOBT BCSP, (2) a large randomized UK trial of FS for ages 55 to 64 years, and (3) further data on the immunochemical FOBT (iFOBT).
S Whyte, J Chilcott, K Cooper, M Essat, J Stevens, R Wong, N Kalita
Causal inference for long-term survival in randomised trials with treatment switching: Should re-censoring be applied when estimating counterfactual survival times?
In this paper we present a simulation study designed to investigate applications of statistical methods used to adjust for treatment switching with and without re-censoring, to determine whether re-censoring should always be recommended within adjustment analyses. This investigates the context typically seen in health technology assessment, where estimates of long-term treatment effects are required.
N Latimer, I White, K Abrams, U Siebert
Estimating a Dutch value set for the paediatric preference-based CHU-9D using a discrete choice experiment with duration
This paper presents the development of the Dutch value set for the CHU-9D, a paediatric preference-based measure of quality of life that can be used to generate quality adjusted life years (QALYs). A large online survey was conducted using a discrete choice experiment (DCE) including a duration attribute with adult members of the Netherlands general population (n=1,276). Normative questions are raised around the valuation of paediatric preference-based measures including the appropriate perspective for imagining hypothetical paediatric health states.
D Rowen, B Mulhern, K Stevens, E Vermaire
The prevalence of diabetes mellitus (DM) is increasing dramatically and patient self-management is crucial for the control of blood glucose levels. Self-management interventions vary widely, and a method is required for assessing the impact of self-management. This paper describes the development of a questionnaire intended for use to measure the impact of self-management in diabetes.
J Carlton, J Elliott, D Rowen, K Stevens, H Basarir, K Meadows, J Brazier
This paper generates health state utility values for a novel classification system measuring the quality of life impact of self-management for diabetes, that can be used to generate Quality Adjusted Life Years (QALYs). A large online survey was conducted using a discrete choice experiment (DCE) with duration as an additional attribute on members of the UK general population (n=1,493) to elicit values for health (social limitations, mood, vitality, hypoglycaemia) and non-health (stress, hassle, control, support) aspects of self-management in diabetes. The results presented in the paper can be used in economic models of the cost-effectiveness of new interventions to value the day to day impact of the interventions for health and self-management of diabetes.
D Rowen, A Labeit, K Stevens, J Elliott, B Mulhern, J Carlton, H Basarir, J Brazier
This paper describes the use of a novel approach in health valuation of a discrete choice experiment (DCE) including a cost attribute to value a recently developed classification system for measuring the quality of life impact (both health and treatment experience) of self-management for diabetes. A large online survey was conducted using DCE with cost on UK respondents from the general population (n=1,497) and individuals with diabetes (n=405). The approach shows promise, but found large willingness to pay estimates exceeding the cost levels used in the survey.
D Rowen, A Labeit, K Stevens, J Elliott, B Mulhern, J Carlton, H Basarir, J Brazier
In the estimation of population value sets for measures such as the EQ-5D, there is increasing interest in asking respondents to value their own health state, sometimes referred to as “experience-based utility values”, rather than hypothetical health states. Evidence shows that these experience-based utility values differ to hypothetical health state values. This paper first critically examines these differences. Second, the paper reviews some of the normative arguments for and against using own health state valuation. Finally, the paper also examines other ways own health state values can be taken into account.
J Brazier, D Rowen, M Karimi, T Peasgood, A Tsuchiya, J Ratcliffe
This article develops and compares methods for mapping to preference-based measures using mixture model approaches. We use data from 856 patients with asthma collected as part of the Multi-Instrument Comparison (MIC) international project to map from the Asthma Quality of Life Questionnaire (AQLQ) to both EQ5D-5L and HUI-3. We estimate adjusted limited dependent variable mixture models (ALDVMMs) and beta-regression based mixture models and explore the optional inclusion of the gap between full health and the next value, and a mass point at the next feasible value.
Both model types are able to closely fit the data without biased characteristic of many mapping approaches. Skilled judgement is critical in determining the optimal model. Caution is required in ensuring a truly global maximum likelihood has been identified.
L A Gray, M Hernández Alava, A J Wailoo
EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version. We model the relationship between EQ-5D-3L and EQ-5D-5L using two different reference datasets and examine how differences impact on cost-effectiveness in nine case studies.
M Hernandez Alava, A Wailoo, S Grimm, S Pudney, M Gomes, Z Sadique, D Meads, J O’Dwyer , G Barton, L Irvine.
Using data from the Millennium Cohort Study, we investigate the dynamic relationship between underlying family lifestyle and childhood obesity during early childhood. We use a dynamic latent factor model, an approach that allows us to identify family lifestyle, its evolution over time and its influence on childhood obesity and other observable outcomes. We find that family lifestyle is persistent and has a significant influence on childhood weight status as well as other outcomes for all family members. Interventions should therefore be prolonged and persuasive and target the underlying lifestyle of a family as early as possible during childhood in order to have the greatest cumulative influence.
L A Gray, M Hernandez Alava, M P Kelly, M J Campbell