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. 2025 Oct;34(10):2821-2833.
doi: 10.1007/s11136-025-04032-8. Epub 2025 Jul 23.

Psychometric properties of the ICECAP-SCM capability-wellbeing measure in specialist palliative care units in Austria

Elisabeth Saly  1 , Judit Simon  2 , Karin Brenner  3 , Bert Engelhardt  4 , Gudrun Kreye  5   6 , Rudolf Likar  7 , Eva Katharina Masel  8 , Veronika Mosich  9 , Mario Molnar  7 , Andrea Passini  10 , Claudia Fischer  2
Affiliations

Psychometric properties of the ICECAP-SCM capability-wellbeing measure in specialist palliative care units in Austria

Elisabeth Saly et al. Qual Life Res. 2025 Oct.

Abstract

Purpose: Patient-reported outcome measures (PROMs) with robust psychometric properties are key for healthcare and resource allocation decisions. Palliative Care (PC) presents challenges for PROM assessment including its holistic scope, patients’ poor health and uncertainty about suitable PROMs to capture the value of PC. The ICECAP-SCM capability-wellbeing questionnaire was developed for economic evaluations in PC but its psychometric information is limited. This study assessed the comparative validity of ICECAP-SCM in Austrian specialist PC settings.

Methods: The PallPROMs cohort study collected PROM data for quality-of-life or symptom and concern burden (ICECAP-SCM, EQ-5D-5L, IPOS) alongside clinician ratings at specialist PC units in 12 Austrian hospitals. We assessed the convergent validity and responsiveness based on pre-developed hypotheses, the known-groups validity of ICECAP-SCM and conducted exploratory factor analysis according to COSMIN guidelines.

Results: Of the 293 participating patients, 228 patients had complete PROM data (58% female, 90% cancer-diagnosis). ICECAP-SCM showed ceiling effects (67–85%) in all domains except physical and emotional suffering. As hypothesized, it had moderate correlations with IPOS (r=-0.35) and EQ-5D-5L (r = 0.35), though the correlation with IPOS was weaker than with EQ-5D-5L. ICECAP-SCM effectively discriminated between patients with different symptom severity levels, and showed responsiveness to improvements. A four-factor structure was identified, with EQ-5D-5L loading on three factors and ICECAP-SCM and IPOS on all four factors.

Conclusion: This study provides evidence of the validity of ICECAP-SCM in specialist PC units. It confirms its ability to provide a broader, more holistic wellbeing information than EQ-5D-5L. However, observed ceiling effects may limit its applicability.

Supplementary Information: The online version contains supplementary material available at 10.1007/s11136-025-04032-8.

Keywords: EQ-5D-5L; ICECAP-SCM; IPOS; Palliative care; Patient reported outcome measures; Psychometrics.

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Conflict of interest statement

Declarations. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the Medical University of Vienna (1043/2021) and the respective ethics committees of the participating palliative care units: Ethikkommission der Wiener Krankenhäuser der Vinzenz Gruppe (23/2021), Ethikkommission der Stadt Wien (21-166-VK), Kommission für Scientific Integrity und Ethik der Karl Landsteiner Privatuniversität (1097/2021), Ethics Committee of the Medical University of Graz (33–472 ex 20/21), Ethikkommission des Landes Kärnten (M2021-25), Ethikkommission der Medizinischen Fakultät der JKU (1168/2021), Ethikkommission des Landes Vorarlberg (EK-0.04-351/ EK-0.04-382), Ethics Committee of the Medical University of Innsbruck (1099/2022). Consent to participate: All the participating patients provided written informed consent. Consent for publication: Not applicable. Competing interests: The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Histogram of ICECAP-SCM index values (0–1) at baseline (n = 228)
Fig. 2
Fig. 2
ICECAP-SCM change scores from baseline to one-week follow-up assessment
See this image and copyright information in PMC

References

    1. Luta, X., Diernberger, K., Bowden, J., Droney, J., Howdon, D., Schmidlin, K., Rodwin, V., Hall, P., & Marti, J. (2020). Healthcare trajectories and costs in the last year of life: A retrospective primary care and hospital analysis. BMJ Supportive & Palliative Care. - PubMed
    1. Round, J., Jones, L., & Morris, S. (2015). Estimating the cost of caring for people with cancer at the end of life: A modelling study. Palliative Medicine, 29(10), 899–907. - PMC - PubMed
    1. Zweifel, P., Felder, S., & Meiers, M. (1999). Ageing of population and health care expenditure: A red herring? Health Economics, 8(6), 485–496. - PubMed
    1. Yi, D., Johnston, B. M., Ryan, K., Daveson, B. A., Meier, D. E., Smith, M., McQuillan, R., Selman, L., Pantilat, S. Z., Normand, C., Morrison, R. S., & Higginson, I. J. (2020). Drivers of care costs and quality in the last 3 months of life among older people receiving palliative care: A multinational mortality follow-back survey across England, Ireland and the United States. Palliative Medicine, 34(4), 513–523. - PubMed
    1. Cardona-Morrell, M., Kim, J., Turner, R., Anstey, M., Mitchell, I., & Hillman, K. (2016). Non-beneficial treatments in hospital at the end of life: A systematic review on extent of the problem. International Journal for Quality in Health Care, 28(4), 456–469. - PubMed

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