PMID- 36535579 OWN - NLM STAT- MEDLINE DCOM- 20230502 LR - 20230505 IS - 1524-4733 (Electronic) IS - 1098-3015 (Linking) VI - 26 IP - 5 DP - 2023 May TI - Assessing Outcomes for Cost-Utility Analysis in Children and Adolescents With Mental Health Problems: Are Multiattribute Utility Instruments Fit for Purpose? PG - 733-741 LID - S1098-3015(22)04781-7 [pii] LID - 10.1016/j.jval.2022.12.007 [doi] AB - OBJECTIVES: The objective of this study was to compare the concurrent and construct validity, as well as the sensitivity of 5 multiattribute utility instruments (MAUIs), including the Assessment of Quality of Life-6D (AQoL-6D), EQ-5D-Y, Health Utilities Index (HUI)-2 and HUI-3, and the Child Health Utility 9D, 1 generic pediatric quality of life instrument, with 3 routinely collected outcome measures in Australian mental health services (Strengths and Difficulties Questionnaire, Clinical Global Assessment Scale [CGAS] and the Health of the Nation Outcome Scale for Children and Adolescents) in children and adolescents diagnosed of internalizing (eg, anxiety/depression), externalizing (eg, attention deficit hyperactivity disorder/conduct disorders), and trauma/stress related mental disorders. METHODS: A cross-sectional survey of measures, including demographic and basic treatment information, in children/adolescents recruited via 5 child and youth mental health services in Queensland and Victoria, Australia. Measures were either proxy or self-report completed, the CGAS and the Health of the Nation Outcome Scale for Children and Adolescents were clinician completed. RESULTS: The sample included 426 participants and had a mean age of 13.7 years (range 7-18 years). Utilities (as calculated from MAUIs) were generally lower in older adolescents and those with internalizing disorders. All MAUIs and self-reported clinical measures significantly correlated with each other (absolute correlation range 0.40-0.90), with the AQoL-6D showing generally higher levels of correlations. Correlations between the MAUIs and clinician/proxy-reported measures were weak, regardless of diagnosis (absolute correlation range 0.09-0.47). Generally, EQ-5D-Y, HUI-2, and AQoL-6D were more sensitive than Child Health Utility 9D and HUI-3 when distinguishing between different severities according to clinician-assessed CGAS (effect size range 0.17-0.84). CONCLUSIONS: The study showed that the commonly used MAUIs had good concurrent and construct validity compared with routinely used self-complete measures but poor validity when compared with clinician/proxy-completed measures. These findings generally held across different diagnoses. CI - Copyright (c) 2023. Published by Elsevier Inc. FAU - Mihalopoulos, Cathrine AU - Mihalopoulos C AD - Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia; School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University. Electronic address: cathy.mihalopoulos@monash.edu. FAU - Chen, Gang AU - Chen G AD - Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia. FAU - Scott, James G AU - Scott JG AD - QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Metro North Mental Health Service, Herston, QLD, Australia. FAU - Bucholc, Jessica AU - Bucholc J AD - Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia. FAU - Allen, Cassandra AU - Allen C AD - Child and Adolescent Mental Health Services Barwon Health, Geelong, VIC, Australia. FAU - Coghill, David AU - Coghill D AD - Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia. FAU - Jenkins, Peter AU - Jenkins P AD - Child and Youth Mental Health Service, Eastern Health, Melbourne, VIC, Australia. FAU - Norman, Richard AU - Norman R AD - School of Population Health, Curtin University, Perth, WA, Australia. FAU - Ratcliffe, Julie AU - Ratcliffe J AD - Caring Futures Institute, Flinders University, Adelaide, SA, Australia. FAU - Richardson, Jeffrey AU - Richardson J AD - Centre for Health Economics, Monash Business School, Monash University, Melbourne, VIC, Australia. FAU - Stathis, Stephen AU - Stathis S AD - Children's Health, Queensland Hospital and Health Service, University of Queensland, Herston, QLD, Australia. FAU - Viney, Rosalie AU - Viney R AD - Centre for Health Economics Research and Evaluation, Faculty of Health, University of Technology, Sydney, NSW, Australia. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20221216 PL - United States TA - Value Health JT - Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research JID - 100883818 RN - EC 2.7.7.- (Nucleotidyltransferases) SB - IM MH - Humans MH - Adolescent MH - Child MH - *Mental Health MH - *Quality of Life/psychology MH - Health Status MH - Surveys and Questionnaires MH - Cost-Benefit Analysis MH - Cross-Sectional Studies MH - Australia MH - Nucleotidyltransferases MH - Reproducibility of Results OTO - NOTNLM OT - child and adolescent mental health OT - cost-utility analysis OT - economic evaluation OT - multiattribute utility instruments OT - outcome measures OT - quality-adjusted life-years (QALYs) OT - utility weights OT - young people's mental health EDAT- 2022/12/20 06:00 MHDA- 2023/05/02 06:42 CRDT- 2022/12/19 19:26 PHST- 2021/12/16 00:00 [received] PHST- 2022/10/18 00:00 [revised] PHST- 2022/12/05 00:00 [accepted] PHST- 2023/05/02 06:42 [medline] PHST- 2022/12/20 06:00 [pubmed] PHST- 2022/12/19 19:26 [entrez] AID - S1098-3015(22)04781-7 [pii] AID - 10.1016/j.jval.2022.12.007 [doi] PST - ppublish SO - Value Health. 2023 May;26(5):733-741. doi: 10.1016/j.jval.2022.12.007. Epub 2022 Dec 16.