What is the best approach to adopt for identifying the domains for a new measure of health, social care and carer-related quality of life to measure quality-adjusted life years? Application to the development of the EQ-HWB?
What is the best approach to adopt for identifying the domains for a new measure of health, social care and carer-related quality of life to measure quality-adjusted life years? Application to the development of the EQ-HWB?
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DOI：
10.1007/s10198-021-01306-z
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Brazier J
中科院分区：
文献类型：
--
作者：
Peasgood T;Mukuria C;Carlton J;Connell J;Devlin N;Jones K;Lovett R;Naidoo B;Rand S;Rejon-Parrilla JC;Rowen D;Tsuchiya A;Brazier J
在评估新的干预措施时，经济评价将成本和效益结合起来，以支持决策，使用基于偏好的措施来衡量和评估健康或与健康有关的生活质量方面的效益。这些以健康为重点的工具在反映对非正规护理人员的更广泛影响或社会护理等其他部门的成果方面能力有限。可以使用针对具体部门的手段，但当干预措施的影响跨越不同部门时，这就成了问题。另一种办法是制定一个通用的基于优惠的衡量标准，其范围足以反映重要的跨部门成果。我们认为选择域的跨部门的通用措施，包括如何识别域，谁应该提供信息的域，以及如何这应该是框架的选项。除了领域识别之外，还确定了标准和利益相关者需求的考虑因素。本文阐述了一种依赖患者、社会护理使用者和非正式护理人员的声音作为领域主要来源的方法的案例，并描述了该方法如何在开发新措施的“扩展QALY”项目中实施EQ-HWB（情商健康和福祉工具）。最后，我们讨论这种方法的优势和局限性。新的衡量标准应该足够通用，以用于持续评估健康和社会护理干预措施，但也足够敏感，以了解患者，社会护理使用者和护理人员生活质量的重要变化。
Economic evaluation combines costs and benefits to support decision-making when assessing new interventions using preference-based measures to measure and value benefits in health or health-related quality of life. These health-focused instruments have limited ability to capture wider impacts on informal carers or outcomes in other sectors such as social care. Sector-specific instruments can be used but this is problematic when the impact of an intervention straddles different sectors. An alternative approach is to develop a generic preference-based measure that is sufficiently broad to capture important cross-sector outcomes. We consider the options for the selection of domains for a cross-sector generic measure including how to identify domains, who should provide information on the domains and how this should be framed. Beyond domain identification, considerations of criteria and stakeholder needs are also identified. This paper sets out the case for an approach that relies on the voice of patients, social care users and informal carers as the main source of domains and describes how the approach was operationalised in the ‘Extending the QALY’ project which developed the new measure, the EQ-HWB (EQ health and wellbeing instrument). We conclude by discussing the strengths and limitations of this approach. The new measure should be sufficiently generic to be used to consistently evaluate health and social care interventions, yet also sensitive enough to pick up important changes in quality of life in patients, social care users and carers.
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影响因子：
4.4
作者：
Karimi, Milad;Brazier, John
通讯作者：
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影响因子：
3.5
作者：
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影响因子：
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通讯作者：
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影响因子：
3.5
作者：
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通讯作者：
Coast, Joanna