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Randomized Controlled Trial
. 2015 Jan;18(1):35-43.
doi: 10.1016/j.jval.2014.09.006. Epub 2014 Nov 11.

Comparing measurement properties of the EQ-5D-3L, ICECAP-O, and ASCOT in frail older adults

Karen M van Leeuwen  1 , Judith E Bosmans  2 , Aaltje P D Jansen  3 , Emiel O Hoogendijk  3 , Maurits W van Tulder  2 , Henriette E van der Horst  3 , Raymond W Ostelo  4
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Free article
Randomized Controlled Trial

Comparing measurement properties of the EQ-5D-3L, ICECAP-O, and ASCOT in frail older adults

Karen M van Leeuwen et al. Value Health. 2015 Jan.
Free article

Abstract

Background: The ICEpop CAPability measure for Older people (ICECAP-O) and the Adult Social Care Outcomes Toolkit (ASCOT) are preference-based measures for assessing quality of life (QOL) from a broader perspective than do traditional health-related QOL measures such as the EuroQol five-dimensional questionnaire (EQ-5D). Measurement properties of these instruments have not yet been directly compared.

Objective: The purpose of this study was to compare the test-retest reliability, construct validity, and responsiveness of the three-level EQ-5D (EQ-5D-3L), ICECAP-O, and ASCOT in frail older adults living at home.

Methods: Cross-sectional data and longitudinal data were used. Parameters for reliability (the intraclass correlation coefficient) and agreement (standard error of measurement) were used to assess test-retest reliability after 1 week. We formulated hypotheses about correlations with other measures and tested these to assess construct validity and responsiveness (longitudinal validity).

Results: The reliability parameters for all three scales were considered good (intraclass correlation coefficient values above 0.70). Standard error of measurement values were less than 10% of the scale. Hypotheses regarding construct validity were in general accepted; the EQ-5D-3L was more strongly associated with physical limitations than were ICECAP-O and ASCOT and less strongly with instruments measuring aspects beyond health. Longitudinally, as hypothesized, mental health was most strongly associated with ICECAP-O, and self-perceived QOL, mastery, and client-centeredness of home care most strongly with ASCOT.

Conclusions: Our findings support the adoption of ICECAP-O and ASCOT as outcome measures in economic evaluations of care interventions for older adults that have a broader aim than health-related QOL because they are at least as reliable as the EQ-5D-3L and are associated with aspects of QOL broader than health.

Keywords: measurement properties; older adults; preference-based measures; quality of life.

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