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

Furber G, Segal L - Health Qual Life Outcomes (2015)

Bottom Line: Participants found the CHU9D easy and quick to complete.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.Initial validation suggests further investigation of the CHU9D as a routine outcome measure in CAMHS is warranted.

View Article: PubMed Central - PubMed

Affiliation: Health Economics and Social Policy Group, School of Population Health, University of South Australia, Adelaide, Australia. gareth.furber@unisa.edu.au.

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.

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Related in: MedlinePlus

Scatterplot of CHU9D utility weights and SDQ scores by Tariff.
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Related In: Results  -  Collection

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Fig2: Scatterplot of CHU9D utility weights and SDQ scores by Tariff.

Mentions: Figure 2 shows the scatterplot of CHU9D utility values (UK Adult and Australian Adolescent tariffs) and SDQ Total scores. Utility weights were moderately correlated with the SDQ total score, for both the UK Adult Tariff [r(199) = −.487 (p < .001)] and Australian Adolescent Tariff [r(199) = −.494 (p < .001)].Figure 2


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

Furber G, Segal L - Health Qual Life Outcomes (2015)

Scatterplot of CHU9D utility weights and SDQ scores by Tariff.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4340862&req=5

Fig2: Scatterplot of CHU9D utility weights and SDQ scores by Tariff.
Mentions: Figure 2 shows the scatterplot of CHU9D utility values (UK Adult and Australian Adolescent tariffs) and SDQ Total scores. Utility weights were moderately correlated with the SDQ total score, for both the UK Adult Tariff [r(199) = −.487 (p < .001)] and Australian Adolescent Tariff [r(199) = −.494 (p < .001)].Figure 2

Bottom Line: Participants found the CHU9D easy and quick to complete.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.Initial validation suggests further investigation of the CHU9D as a routine outcome measure in CAMHS is warranted.

View Article: PubMed Central - PubMed

Affiliation: Health Economics and Social Policy Group, School of Population Health, University of South Australia, Adelaide, Australia. gareth.furber@unisa.edu.au.

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.

Show MeSH
Related in: MedlinePlus