Abstract
PurposeA desire to incorporate broader aspects of well-being in health economic evaluations has led to the development of the ICEpop CAPability measure for Adults (ICECAP-A). The ICECAP-A draws upon Amartya Sen’s capability approach and conceptualises well-being as the capability to achieve Stability, Attachment, Autonomy, Achievement, and Enjoyment. The aim of this study was to assess the psychometric performance of the ICECAP-A in a context where patient outcomes can extend beyond health-related quality of life.Methods Longitudinal data were collected for 478 women with symptoms of urinary frequency and urgency, with or without incontinence. Women were recruited across 22 hospitals in the UK and had a mean age of 55 (SD 14). The psychometric performance of the measure was evaluated in relation to the EuroQol Five-Dimension Questionnaire (EQ-5D-3L) and the International Consultation on Incontinence Questionnaire for Overactive Bladder (ICIQ-OAB) and involved an assessment of acceptability, construct validity, and responsiveness using parametric and nonparametric methods.ResultsICECAP-A showed good convergence with the ICIQ-OAB with 20 out of 22 expected patterns of relationship confirmed. Findings suggested that the ICECAP-A has better discriminative properties than EQ-5D-3L and as good as those of the ICIQ-OAB, confirming expected associations with clinical and demographic factors. The ICECAP-A was more responsive than EQ-5D-3L and ICIQ-OAB to deteriorations of clinical symptoms. Improvements in symptoms were not valued as highly as deteriorations by either ICECAP-A or EQ-5D-3L.ConclusionsThe ICECAP-A is a valid and responsive measure capturing broad emotional and practical impacts of urinary symptoms on women’s well-being and could be considered for use in economic evaluations in this context.
Highlights
Consideration of health-related quality of life (HrQoL) is an integral component of healthcare decision-making in many systems of the developed world
Findings suggested that the ICEpop1 CAPability (ICECAP)-A has better discriminative properties than EQ-5D-3L and as good as those of the ICIQ-OAB, confirming expected associations with clinical and demographic factors
The ICECAP-A was more responsive than EQ-5D-3L and ICIQ-OAB to deteriorations of clinical symptoms
Summary
Consideration of health-related quality of life (HrQoL) is an integral component of healthcare decision-making in many systems of the developed world. Qual Life Res (2016) 25:2063–2075 developed [10,11,12,13,14], the ICEpop CAPability (ICECAP) measures are distinct as they provide a generic measure of capability-well-being for use in the economic evaluation of health and social care interventions. The ICECAP measure for the general adult population (ICECAP-A) has recently been developed [12] and conceptualises well-being as the capability of an individual to achieve the valuable functionings of Stability, Attachment, Autonomy, Achievement, and Enjoyment, with health potentially being a direct determinant of functioning. Previous validation work on the ICECAP-A has suggested that the attributes of the measure can comprehensively capture quality of life [15] and that the measure is able to identify expected differences in capability-well-being in a general population sample [16]. Small changes in capability-well-being were evident as a result of changes in physical and psychological health after a knee pain intervention [17]
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