Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Feb 18:13:22.
doi: 10.1186/s12955-015-0218-4.

The validity of the Child Health Utility instrument (CHU9D) as a routine outcome measure for use in child and adolescent mental health services

Gareth Furber  1 , Leonie Segal  2
Affiliations

The validity of the Child Health Utility instrument (CHU9D) as a routine outcome measure for use in child and adolescent mental health services

Gareth Furber et al. Health Qual Life Outcomes. .

Abstract

Background: Few cost-utility studies of child and adolescent mental health services (CAMHS) use quality adjusted life years (a combination of utility weights and time in health state) as the outcome to enable comparison across disparate programs and modalities. Part of the solution to this problem involves embedding preference-based health-related quality of life (PBHRQOL) utility instruments, which generate utility weights, in clinical practice and research. The Child Health Utility (CHU9D) is a generic PBHRQOL instrument developed specifically for use in young people. The purpose of this study was to assess the suitability of the CHU9D as a routine outcome measure in CAMHS clinical practice.

Methods: Two hundred caregivers of children receiving community mental health services completed the CHU9D alongside a standardised child and adolescent mental health measure (the Strengths and Difficulties Questionnaire - SDQ) during a telephone interview. We investigated face validity, practicality, internal consistency, and convergent validity of the CHU9D. In addition, we compared the utility weights obtained in this group with utility weights from other studies of child and adolescent mental health populations.

Results: Participants found the CHU9D easy and quick to complete. It demonstrated acceptable internal consistency, and correlated moderately with the SDQ. It was able to discriminate between children in the abnormal range and those in the non-clinical/borderline range as measured by the SDQ. Three CHU9D items without corollaries in the SDQ (sleep, schoolwork, daily routine) were found to be significant predictors of the SDQ total score and may be useful clinical metrics. The mean utility weight of this sample was comparable with clinical subsamples from other CHU9D studies, but was significantly higher than mean utility weights noted in other child and adolescent mental health samples.

Conclusions: Initial validation suggests further investigation of the CHU9D as a routine outcome measure in CAMHS is warranted. Further investigation should explore test-retest reliability, sensitivity to change, concordance between caregiver and child-completed forms, and the calibration of the utility weights. Differences between utility weights generated by the CHU9D and other utility instruments in this population should be further examined by administering a range of PBHRQOL instruments concurrently in a mental health group.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of CHU9D utility weights for UK and Adolescent Tariffs.
Figure 2
Figure 2
Scatterplot of CHU9D utility weights and SDQ scores by Tariff.
See this image and copyright information in PMC

References

    1. Hall CL, Moldavsky M, Taylor J, Sayal K, Marriott M, Batty MJ, et al. Implementation of routine outcome measurement in child and adolescent mental health services in the United Kingdom: a critical perspective. Eur Child Adolesc Psychiatry. 2013;23:239–42. doi: 10.1007/s00787-013-0454-2. - DOI - PMC - PubMed
    1. Duncan EAS, Murray J. The barriers and facilitators to routine outcome measurement by allied health professionals in practice: A systematic review. BMC Health Serv Res. 2012;12:96. doi: 10.1186/1472-6963-12-96. - DOI - PMC - PubMed
    1. McKay R, Coombs T. An exploration of the ability of routine outcome measurement to represent clinically meaningful information regarding individual consumers. Australas Psychiatry. 2012;20:433–7. doi: 10.1177/1039856212458813. - DOI - PubMed
    1. Coombs T, Stapley K, Pirkis J. The multiple uses of routine mental health outcome measures in Australia and New Zealand: Experiences from the field. Australas Psychiatry. 2011;19:247–53. doi: 10.3109/10398562.2011.562507. - DOI - PubMed
    1. Gowers SG, Harrington RC, Whitton A, Lelliott P, Beevor A, Wing J, et al. Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) Br J Psychiatry. 1999;174(MAY):413–6. doi: 10.1192/bjp.174.5.413. - DOI - PubMed

Publication types