Measuring the value of health-related quality of life

  • Graeme Hawthorne


Health-related quality of life is concerned with the relationship between the effect of treatment on the patient’s life with society’s value for this effect. It is only through balancing these two concerns that transparent decisions concerning the best choice of treatment at the intervention level and, at the policy level, the allocation of scarce health resources can incorporate both the patient’s and society’s views. Where these decisions are important, the appropriate form of evaluation is cost-utility analysis (CUA). With rising health care costs, the ageing of populations and the determination of governments to cap health care expenditure, the mental health field will increasingly be asked for evidence of its cost-effectiveness. In the absence of such evidence, patients access to mental health services in the future may be hindered and the choice of treatment restricted as decision-makers may be disinclined to increase or even maintain funding.

This paper reviews the axioms of cost-utility analysis and the role of multi-attribute (MAU) utility instruments. Seven leading instruments are reviewed, and examples of their use in cost-utility analysis in the mental health field are presented. It is concluded that none of the existing instruments fully meet the axioms of either utility or measurement theory, and that the instruments provide HRQoL estimates that are so different that study outcomes are likely to be as much a function of the instrument chosen for a particular study as the effectiveness of the intervention itself.

It is recommended that mental health professionals undertaking CUAs review available instruments carefully, use two MAU-instruments in any particular study, and report both sets of results. The shortcomings of existing MAU-instruments should not be taken as a reason to avoid economic evaluation; at the moment they are the only practical way of capturing the balance described above. Few CUA studies have been carried out in the mental health field, there is thus an opportunity to undertake studies providing the evidence needed by clinicians and decision-makers for transparent decisions regarding treatment options and the future funding of mental health care

Key words

AQoL Burden of disease Cost-effectiveness Cost-utility analysis CUA Economic evaluation EQ5D Health-related quality of life HUI3 15D Multi-attribute utility instrument Quality-adjusted life years QALY QWB Rosser Index SF6D 


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  1. 1.
    Ostenfeld E. Aristotle on the good life and quality of life. In: Nordenfelt L, editor. Concepts and Measurement of Quality of Life in Health Care. Dordrecht: Kluwer Academic Publishers; 1994. p. 19–34.Google Scholar
  2. 2.
    Long PH. On the quantity and quality of life. Med. Times 1960;88:613–9.PubMedGoogle Scholar
  3. 3.
    Elkinton JR. Medicine and the quality of life. Ann. Intern. Med. 1966;64(3):711–4.PubMedGoogle Scholar
  4. 4.
    Imhof A. The implications of increased life expectancy for family and social life. In: Wear A, editor. Medicine in Society: Historical Essays. Cambridge: Cambridge University Press; 1992.Google Scholar
  5. 5.
    Nordenfelt L, editor. Concepts and Measurement of Quality of Life in Health Care. Dordrecht: Kluwer Academic; 1994.Google Scholar
  6. 6.
    Walker S, Rosser R. Quality of life assessment: key issues in the 1990s. Dordrecht: Kluwer Academic Publishers; 1993.Google Scholar
  7. 7.
    Williams B. Patient satisfaction: a valid concept? Soc. Sci. Med. 1994;38(4):509–516.PubMedCrossRefGoogle Scholar
  8. 8.
    Sitzia J, Wood N. Patient satisfaction: a review of issues and concepts. Soc. Sci. Med. 1997;45(12):1829–1843.PubMedCrossRefGoogle Scholar
  9. 9.
    Bowling A. Measuring Health: A Review of Quality of Life Measurement Scales. Milton Keynes: Open University; 1991.Google Scholar
  10. 10.
    Drummond M, O’Brien B, Stoddart G, et al. Methods for the Economic Evaluation of Health Care Programmes. 2nd ed. Oxford: Oxford University Press; 1998.Google Scholar
  11. 11.
    Productivity Commission. Economic Implications of an Ageing Australia. Canberra: Commonwealth of Australia; 2005.Google Scholar
  12. 12.
    Productivity Commission. Impacts of Medical Technology in Australia. Melbourne: Productivity Commission; 2005.Google Scholar
  13. 13.
    Mathers C, Vos T, Stevenson C. The Burden of Disease and Injury in Australia. Canberra: Australian Institute of Health and Welfare; 1999.Google Scholar
  14. 14.
    Suchman EA. Evaluative Research: Principles and Practice in Public Service & Social Action Programs. New York: Russell Sage Foundation; 1967.Google Scholar
  15. 15.
    Foucault M. Madness and civilization; a history of insanity in the Age of Reason. New York: Vintage Books; 1965.Google Scholar
  16. 16.
    WHOQoL Group. Study protocol for the World Health Organization project to develop a quality of life assessment instrument (WHOQOL). Qual. Life Res. 1993;2:153–159.CrossRefGoogle Scholar
  17. 17.
    Atkinson M, Zibin S, Chuang H. Characterizing quality of life among patients with chronic mental illness: a critical examination of the self-report methodology. Am. J. Psychiatry 1997;154:99–105.PubMedGoogle Scholar
  18. 18.
    Awad G, Voruganti P. Cost-utility analysis in schizophrenia. J. Clin. Psychiatry 1999;60(Suppl 3): 22–28.PubMedGoogle Scholar
  19. 19.
    Voruganti L, Heslegrave R, Awad A, et al. Quality of life measurement in schizophrenia: reconciling the quest for subjectivity with the question of reliability. Psychol. Med. 1998;28:165–172.PubMedCrossRefGoogle Scholar
  20. 20.
    Herrman H, Hawthorne G, Thomas R. Quality of life assessment in people living with psychosis. Soc. Psychiatry Psychiatr. Epidemiol. 2002;37(11):510–518.PubMedCrossRefGoogle Scholar
  21. 21.
    Sackett D, Torrance G. The utility of different health states as perceived by the general public. J. Chronic Dis. 1978;31:697–704.PubMedCrossRefGoogle Scholar
  22. 22.
    Torrance G, Boyle M, Horwood S. Application of multi-attribute theory to measure social preferences for health states. Oper. Res. 1982;30:1043–1069.PubMedGoogle Scholar
  23. 23.
    Patrick DL, Bush JW, Chen MM. Toward an operational definition of health. J. Health Soc. Behav. 1973;14(1):6–23.PubMedCrossRefGoogle Scholar
  24. 24.
    Rosser R, Kind P. A scale of valuations of states of illness: is there a social consensus. Int. J. Epidemiol. 1978;7(4):347–58.PubMedCrossRefGoogle Scholar
  25. 25.
    Ubel PA, Richardson J, Menzel P. Societal value, the person trade-off, and the dilemma of whose values to measure for cost-effectiveness analysis. Health Econ. 2000;9(2):127–36.PubMedCrossRefGoogle Scholar
  26. 26.
    Ubel PA, Loewenstein G, Jepson C. Whose quality of life? A commentary exploring discrepancies between health state evaluations of patients and the general public. Qual. Life Res. 2003;12:599–607.PubMedCrossRefGoogle Scholar
  27. 27.
    Shortell R, Richardson W. Health Program Evaluation. St Louis: Mosby; 1978.Google Scholar
  28. 28.
    Ovretveit J. Evaluating Health Interventions. Buckingham: Open University Press; 1998.Google Scholar
  29. 29.
    Singh B, Hawthorne G, Vos T. The role of economic evaluation in mental health care. Aust. N. Z. J. Psychiatry 2001;35:104–117.PubMedCrossRefGoogle Scholar
  30. 30.
    Torrance G. Measurement of health state utilities for economic appraisal: a review. J. Health Econ. 1986;5:1–30.PubMedCrossRefGoogle Scholar
  31. 31.
    Hawthorne G, Richardson J, Day N, et al. Life and Death: Theoretical and Practical Issues in Utility Measurement. Melbourne: Centre for Health Program Evaluation; 2000. Working Paper 102.Google Scholar
  32. 32.
    Richardson J, Hawthorne G. Negative Utilities and the Evaluation of Complex Health States: Issues Arising from the Scaling of a Multiattribute Utility Instrument. Melbourne: Centre for Health Program Evaluation; 2000. Working Paper 113.Google Scholar
  33. 33.
    Richardson J. Cost utility analysis: what should be measured? Soc. Sci. Med. 1994;39(1):7–21.PubMedCrossRefGoogle Scholar
  34. 34.
    Brazier J, Deverill M, Green C, et al. A review of the use of health status measures in economic evaluation. Health Technol. Assess. 1999;3(9):1–165.Google Scholar
  35. 35.
    Bennett K, Torrance G. Measuring health state preferences and utilities: rating scale, time trade-off, and standard gamble techniques. In: Spilker B, editor. Quality of Life and Pharmacoeconomics in Clinical Trials. Philadelphia: Lippincott-Raven Publishers; 1996. p. 253–265.Google Scholar
  36. 36.
    Robinson A, Dolan P, Williams A. Valuing health states using VAS and TTO: what lies behind the numbers? Soc. Sci. Med. 1997;45(8):1289–1297.CrossRefGoogle Scholar
  37. 37.
    Gudex C, Kind P, van Dalen H, et al. Comparing Scaling Methods for Health State Valuations - Rosser Revisited. Discussion Paper. York: Centre for Health Economics, University of York; 1993. Report No.: 107.Google Scholar
  38. 38.
    Rosser R. A health index and output measure. In: Walker S, Rosser R, editors. Quality of Life Assessment: Key Issues in the 1990s. Dordrecht: Kluwer Academic Publishers; 1993.Google Scholar
  39. 39.
    von Winterfeldt D, Edwards W. Decision Analysis and Behavioural Research. Cambridge: Cambridge University Press; 1986.Google Scholar
  40. 40.
    Hawthorne G, Richardson J, Osborne R. The Assessment of Quality of Life (AQoL) instrument: a psychometric measure of health related quality of life. Qual. Life Res. 1999;8:209–224.PubMedCrossRefGoogle Scholar
  41. 41.
    Hawthorne G, Richardson J, Day N. A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments. Ann. Med. 2001;33(5):358–370.PubMedGoogle Scholar
  42. 42.
    Hawthorne G, Richardson J, Day N, et al. Construction and Utility Scaling of the Assessment of Quality of Life (AQoL) Instrument. Melbourne: Centre for Health Program Evaluation; 2000. Working Paper 101.Google Scholar
  43. 43.
    EuroQol Group. EuroQol: a new facility for measurement of health-related quality of life. Health Policy 1990;16:199–208.CrossRefGoogle Scholar
  44. 44.
    Kind P. The EuroQoL instrument: an index of health-related quality of life. In: Spilker B, editor. Quality of Life and Pharmacoeconomics in Clinical Trials. 2nd ed. Philadelpha: Lippincott-Raven Publishers; 1996. p. 191–201.Google Scholar
  45. 45.
    Feeny D, Furlong W, Torrance G. Health Utilities Index Mark 2 and Mark 3 (HUI2/3) 15-item questionnaire for self-administered, self-assessed usual health status. Hamilton: Centre for Health Economics and Policy Analysis, McMaster University; 1996.Google Scholar
  46. 46.
    Feeny D, Torrance G, Furlong W. Health utilities index. In: Spilker B, editor. Quality of Life and Pharmacoeconomics in Clinical Trials. 2nd ed. Philadelpha: Lippincott-Raven Publishers; 1996.Google Scholar
  47. 47.
    Torrance GW, Furlong W, Feeny D, et al. Multi-attribute preference functions. Health Utilities Index. Pharmacoeconomics 1995;7(6):503–20.Google Scholar
  48. 48.
    Sintonen H, Pekurinen M. A fifteen-dimensional measure of health-related quality of life (15D) and its applications. In: Walker S, Rosser R, editors. Quality of Life Assessment. Dordrecht: Kluwer Academic Publishers; 1993.Google Scholar
  49. 49.
    Sintonen H. The 15D measure of health-related quality of life: feasibility, reliability and validity of its valuation system. Melbourne: National Centre for Health Program Evaluation; 1995. Working Paper 42.Google Scholar
  50. 50.
    Sintonen H. The 15D measure of health-related quality of life: reliability, validity and sensitivity of its health state descriptive system. Melbourne: National Centre for Health Program Evaluation; 1994. Working Paper 41.Google Scholar
  51. 51.
    Kaplan R, Anderson J, Ganiats T. The Quality of Well-Being Scale: rationale for a single quality of life index. In: Walker S, Rosser R, editors. Quality of Life Assessment: Key Issues in the 1990s. Dordrecht: Kluwer Academic Publishers; 1993.Google Scholar
  52. 52.
    Kaplan RM, Alcaraz JE, Anderson JP, et al. Quality-adjusted life years lost to arthritis: effects of gender, race,and social class. Arthritis Care Res. 1996;9(6):473–82.PubMedCrossRefGoogle Scholar
  53. 53.
    Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J. Health Econ. 2002;21:271–292.PubMedCrossRefGoogle Scholar
  54. 54.
    Brazier J, Usherwood T, Harper R, et al. Deriving a preference-based single index from the UK SF-36 Health Survey. J. Clin. Epidemiol. 1998;51(11):1115–1128.PubMedCrossRefGoogle Scholar
  55. 55.
    Hawthorne G, Richardson J. An Australian MAU/QALY Instrument: Rationale and Preliminary Results. In: Sansoni J, editor. Proceedings Health Outcomes and Quality of Life Measurement Conference; 1995; Canberra: The Australian Health Outcomes Collaboration. The University of Wollongong; 1995.Google Scholar
  56. 56.
    Nord E. A Review of Synthetic Health Indicators. Oslo: National Institute of Public Health for the OECD Directorate for Education, Employment, Labour and Social Affairs; 1997.Google Scholar
  57. 57.
    Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann. Med. 2001;33:337–343.PubMedGoogle Scholar
  58. 58.
    Kaplan RM, Anderson JP. A general health policy model: update and applications. Health Serv. Res. 1988;23(2):203–35.PubMedGoogle Scholar
  59. 59.
    Bergner M, Bobbitt RA, Carter WB, et al. The Sickness Impact Profile: development and final revision of a health status measure. Med. Care 1981;19(8):787–805.PubMedCrossRefGoogle Scholar
  60. 60.
    Hunt S, McKenna S, McEwen J, et al. The Nottingham Health Profile: subjective health status and medical consultations. Soc. Sci. Med. 1981;15A:221–229.Google Scholar
  61. 61.
    Dolan P. Modeling valuations for EuroQol health states. Med. Care 1997;35(11):1095–1108.PubMedCrossRefGoogle Scholar
  62. 62.
    Shaw JW, Johnson JA, Coons SJ. US valuation of the EQ-5D health states: development and testing of the D1 valuation model. Med. Care 2005;43(3):203–20.PubMedCrossRefGoogle Scholar
  63. 63.
    Havranek EP, Steiner JF. Valuation of health states in the US versus the UK: two measures divided by a common language? Med. Care 2005;43(3):201–2.PubMedCrossRefGoogle Scholar
  64. 64.
    Johnson JA, Luo N, Shaw JW, et al. Valuations of EQ-5D health states: are the United States and United Kingdom different? Med. Care 2005;43(3):221–8.PubMedCrossRefGoogle Scholar
  65. 65.
    Fryback DG. A US valuation of the EQ-5D. Med. Care 2005;43(3):199–200.PubMedCrossRefGoogle Scholar
  66. 66.
    MVHGroup. The Measurement and Valuation of Health: Final Modelling of Valuation Tariffs. York: Centre for Health Economics; 1995.Google Scholar
  67. 67.
    Dolan P, Gudex C, Kind P, et al. Valuing health states: a comparison of methods. J. Health Econ. 1996;15:209–231.PubMedCrossRefGoogle Scholar
  68. 68.
    Furlong WJ, Feeny DH, Torrance GW, et al. The Health Utilities Index (HUI) system for assessing health-related quality of life in clinical studies. Ann. Med. 2001;33:375–384.PubMedGoogle Scholar
  69. 69.
    Furlong W, Feeny D, Torrance G, et al. Multiplicative Multi-attribute Utility Function for the Health Utilities Index Mark 3 (HUI3) System: A Technical Report. Working Paper. Hamilton: McMaster University, Centre for Health Economics and Policy Analysis; 1998. Report No.: 98–11.Google Scholar
  70. 70.
    Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann. Med. 2001;33:328–336.PubMedGoogle Scholar
  71. 71.
    McDowell I, Newell C, editors. Measuring health: a guide to rating scales and questionnaires. New York: Oxford University Press; 1987.Google Scholar
  72. 72.
    Cadet B. History of the construction of a health indicator integrating social preference: the Quality of Well-Being Scale. In: 7th Meeting, International Network on Health Expectancy (REVES); 1994 23–25 February; Canberra; 1994.Google Scholar
  73. 73.
    Kaplan R, Bush J, Berry C. Health status: types of validity and the Index of Well-being. Health Serv. Res. 1976;11(4):478–507.PubMedGoogle Scholar
  74. 74.
    Anderson J, Kaplan R, Berry C, et al. Interday reliability of function assessment for a health status measure: The Quality of Well-Being scale. Med. Care 1989;27(11):1076–1084.PubMedCrossRefGoogle Scholar
  75. 75.
    Kaplan R, Ganiats T, Sieber W, et al. The Quality of Well-being Scale. Medical Outcomes Trust Bulletin 1996:2–3.Google Scholar
  76. 76.
    Bombardier C, Raboud J. A comparison of health-related quality-of-life measures for rheumatoid arthritis research. The Auranofin Cooperating Group. Control. Clin. Trials 1991;12(4 Suppl): 243S-256S.PubMedCrossRefGoogle Scholar
  77. 77.
    Coons S, Kaplan R. Quality of life assessment: understanding its use as an outcome measure. Hosp. Formul. 1993;28:486–498.PubMedGoogle Scholar
  78. 78.
    Kind P, Gudex C. Measuring health status in the community: a comparison of methods. J. Epidemiol. Community Health 1994;48:86–91.PubMedCrossRefGoogle Scholar
  79. 79.
    Martin A, Glasziou P, Simes R. A Utility-Based Quality of Life Questionnaire for Cardiovascular Patients: Reliability and Validity of the UBQ-H(eart) Items. Sydney: NHMRC Clinical Trials Centre, University of Sydney; 1996.Google Scholar
  80. 80.
    Hawthorne G, Richardson J. Measuring the value of program outcomes: a review of utility measures. Exp. Rev. Pharm. Outcomes Res. 2001;1(2):215–228.Google Scholar
  81. 81.
    Barton GR, Bankart J, Davis AC, et al. Comparing utility scores before and after hearing-aid provision: results according to the EQ-5D, HUI3 and SF-6D. Appl. Health Econ. Health Policy 2004;3(2):103–5.PubMedCrossRefGoogle Scholar
  82. 82.
    Barton GR, Bankart J, Davis AC. A comparison of the quality of life of hearing-impaired people as estimated by three different utility measures. Int. J. Audiol. 2005;44(3):157–63.PubMedCrossRefGoogle Scholar
  83. 83.
    Conner-Spady B, Suarez-Almazor ME. Variation in the estimation of quality-adjusted life-years by different preference-based instruments. Med. Care 2003;41(7):791–801.PubMedCrossRefGoogle Scholar
  84. 84.
    Hawthorne G, Richardson J, Day N. A comparison of five multi-attribute utility instruments.Aust. Stud. Health Serv Admin 2001;89: 151–179.Google Scholar
  85. 85.
    Kopec JA, Willison KD. A comparative review of four preference-weighted measures of health- related quality of life. J. Clin. Epidemiol. 2003;56(4):317–25.PubMedCrossRefGoogle Scholar
  86. 86.
    Marra CA, Woolcott JC, Kopec JA, et al. A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc. Sci. Med. 2005;60(7):1571–82.PubMedCrossRefGoogle Scholar
  87. 87.
    Pickard AS, Johnson JA, Feeny DH. Responsiveness of generic health-related quality of life measures in stroke. Qual. Life Res. 2005;14(1):207–19.PubMedCrossRefGoogle Scholar
  88. 88.
    Robinson A, Loomes G, Jones-Lee M. Visual analog scales, standard gambles and relative risk aversion. Med. Decis. Making 2001;21(1):17–27.PubMedGoogle Scholar
  89. 89.
    Torrance GW, Feeny D, Furlong W. Visual analog scales: do they have a role in the measurement of preferences for health states? Med. Decis. Making 2001;21(4):329–34.CrossRefGoogle Scholar
  90. 90.
    Dolan P, Gudex C, Kind P, et al. Social tariff for EUROQoL: results from a UK general population survey. York: Centre for Health Economics, University of York; 1995. Discussion Paper 138.Google Scholar
  91. 91.
    Bleichrodt H, Johannesson M. An experimental test of a theoretical foundation for rating-scale valuations. Med. Decis. Making 1997;17(2):208–16.PubMedCrossRefGoogle Scholar
  92. 92.
    Nord E. Unjustified use of the Quality of Well-Being Scale in priority setting in Oregon. Health Policy 1993;24(1):45–53.PubMedCrossRefGoogle Scholar
  93. 93.
    Hollingworth W, Mackenzie R, Todd CJ, et al. Measuring changes in quality of life following magnetic resonance imaging of the knee: SF-36, EuroQol or Rosser index? Qual. Life Res. 1995;4(4):325–34.CrossRefGoogle Scholar
  94. 94.
    Nord E, Richardson J, Macarounas-Kirchmann K. Social evaluation of health care versus personal evaluation of health states. Evidence on the validity of four health-state scaling instruments using Norwegian and Australian surveys. Int. J. Technol. Assess. Health Care 1993;9(4):463–78.PubMedGoogle Scholar
  95. 95.
    Mulkay M, Ashmore M, Pinch T. Measuring the quality of life: a sociological intervention concerning the application of economics to health care. Sociology 1987;21:541–564.CrossRefGoogle Scholar
  96. 96.
    Elvik R. The validity of using health state indexes in measuring the consequences of traffic injury for public health. Soc. Sci. Med. 1995;40(10):1385–98.PubMedCrossRefGoogle Scholar
  97. 97.
    DeptHealth. Research Group on the measurement and valuation of health. In: Methodology Workshop, EUROQoL Conference; 1995; London: Economics & Operational Research Division, Department of Health; 1995.Google Scholar
  98. 98.
    Richardson C, Zumbo B. A statistical examination of the Health Utility Index-Mark III as a summary measure of health status for a general population survey. Soc. Ind. Res. 2000;51(2):171–191.CrossRefGoogle Scholar
  99. 99.
    Cattell R. Factor Analysis: an Introduction and Manual for the Psychologist and Social Scientist. New York: Harper & Row; 1952.Google Scholar
  100. 100.
    Cook K, Ashton C, Byrne M, et al. A psychometric analysis of the measurement level of the rating scale, time trade-off, and standard gamble. Soc. Sci. Med. 2001;53:1275–1285.PubMedCrossRefGoogle Scholar
  101. 101.
    Hawthorne G, Richardson J, Day N. A comparison of five %multi-attribute utility instruments. Aust. Stud. Health Serv. Admin. 2001;89:151–179.Google Scholar
  102. 102.
    Brazier J, Roberts J, Tsuchiya A, et al. A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ. 2004;13(9):873–84.PubMedCrossRefGoogle Scholar
  103. 103.
    Kaplan R, Bush J, Berry C. The reliability, stability and generalizability of a health status index. In: Proceedings of the Social Statistics Section; 1978: American Statistical Association; 1978. p. 704–709.Google Scholar
  104. 104.
    Kaplan RM. Quality of life assessment for cost/utility studies in cancer. Cancer Treat. Rev. 1993;19 Suppl A:85–96.PubMedCrossRefGoogle Scholar
  105. 105.
    Kaplan RM, Anderson JP, Patterson TL, et al. Validity of the Quality of Well-Being Scale for persons with human immunodeficiency virus infection. HNRC Group. HIV Neurobehavioral Research Center. Psychosom. Med. 1995;57(2):138–47.Google Scholar
  106. 106.
    Bradlyn AS, Harris CV, Warner JE, et al. An investigation of the validity of the quality of Well-Being Scale with pediatric oncology patients. Health Psychol. 1993;12(3):246–50.PubMedCrossRefGoogle Scholar
  107. 107.
    O’Connor R. Issues in the Measurement of Health-Related Quality of Life. Melbourne: National Centre for Health Program Evaluation; 1993. Working Paper 30.Google Scholar
  108. 108.
    Visser M, Fletcher A, Parr G, et al. A comparison of three quality of life instruments in subjects with angina pectoris: the Sickness Impact Profile, the Nottingham Health Profile, and the Quality of Well Being Scale. J. Clin. Epidemiol. 1994;47(2):157–163.PubMedCrossRefGoogle Scholar
  109. 109.
    Brazier J, Jones N, Kind P. Testing the validity of the EuroQoL and comparing it with the SF-36 health survey questionnaire. Qual. Life Res. 1993;2:169–180.PubMedCrossRefGoogle Scholar
  110. 110.
    Andersen L, Kristiansen I, Falch J, et al. Cost-effectiveness of Alendronate for the prevention of osteoporotic fractures in Norwegian women. Working Paper. Oslo: Folkehelsa; Statens Institutt for Folkehelsa; 1995. Report No.: 11/1995.Google Scholar
  111. 111.
    Wlodarczyk JH, Brodaty H, Hawthorne G. The relationship between quality of life, Mini-Mental State Examination, and the Instrumental Activities of Daily Living in patients with Alzheimer’s Disease. Arch. Gerontol. Geriatr. 2004;39(1):25–33.PubMedCrossRefGoogle Scholar
  112. 112.
    Hogan A, Hawthorne G, Kethel L, et al. Health-related quality-of-life outcomes from adult cochlear implantation: a cross-sectional study. Cochlear Imp. Int. 2001;2(2):115–128.CrossRefGoogle Scholar
  113. 113.
    Hawthorne G, Cheok F, Goldney R, et al. The excess cost of depression in South Australia: a comparative study of two methods of calculating burden. Aust. N. Z. J. Psychiatry 2003;37(3):362–373.PubMedCrossRefGoogle Scholar
  114. 114.
    Goldney RD, Fisher LJ, Wilson DH, et al. Suicidal ideation and health-related quality of life in the community. Med. J. Aust. 2001;175(10):546–549.PubMedGoogle Scholar
  115. 115.
    Sturm JW, Osborne RH, Dewey HM, et al. Brief comprehensive quality of life assessment after stroke: the Assessment of Quality of Life instrument in the North East Melbourne Stroke Incidence study (NEMESIS). Stroke 2002;33(12):2888–94.PubMedCrossRefGoogle Scholar
  116. 116.
    Stavem K. Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease. Qual. Life Res. 1999;8(1–2):45–54.PubMedCrossRefGoogle Scholar
  117. 117.
    Dorman P, Slattery J, Farrell B, et al. Qualitative comparison of the reliability of health status assessments with the EuroQol and SF-36 questionnaires after stroke. United Kingdom Collaborators in the International Stroke Trial. Stroke 1998;29(1):63–68.Google Scholar
  118. 118.
    van Agt HM, Essink-Bot ML, Krabbe PF, et al. Test-retest reliability of health state valuations collected with the EuroQol questionnaire. Soc. Sci. Med. 1994;39(11):1537–1544.PubMedCrossRefGoogle Scholar
  119. 119.
    Boyle MH, Furlong W, Feeny D, et al. Reliability of the Health Utilities Index – Mark III used in the 1991 cycle 6 Canadian General Social Survey Health Questionnaire. Qual. Life Res. 1995;4:249–257.PubMedCrossRefGoogle Scholar
  120. 120.
    Hawthorne G. The effect of different methods of collecting data: mail, telephone and filter data collection issues in utility measurement. Qual. Life Res. 2003;12:1081–1088.PubMedCrossRefGoogle Scholar
  121. 121.
    Hawthorne G, Osborne R, McNeil H, et al. The Australian Multi-attribute Utility (AMAU): Construction and Initial Validation. Melbourne: Centre for Health Program Evaluation; 1996. Working Paper 56.Google Scholar
  122. 122.
    Hawthorne G, Richardson J, Osborne R, et al. The Assessment of Quality of Life (AQoL) Instrument: Construction, Initial Validation and Utility Scaling. Melbourne: Centre for Health Program Evaluation; 1997. Working Paper 76.Google Scholar
  123. 123.
    Araya R, Flynn T, Rojas G, et al. Cost-effectiveness of a primary care treatment program for depression in low-income women in Santiago, Chile. Am. J. Psychiatry 2006;163(8):1379–87.PubMedCrossRefGoogle Scholar
  124. 124.
    Adams M, Kutcher S, Antoniw E, et al. Diagnostic utility of endocrine and neuroimaging screening tests in first-onset adolescent psychosis. J. Am. Acad. Child Adolesc. Psychiatry 1996;35(1):67–73.PubMedCrossRefGoogle Scholar
  125. 125.
    Pinkerton SD, Johnson-Masotti AP, Otto-Salaj LL, et al. Cost-effectiveness of an HIV prevention intervention for mentally ill adults. Ment Health Serv Res 2001;3(1):45–55.PubMedCrossRefGoogle Scholar
  126. 126.
    Manning W. Panel on cost-effectiveness in health and medicine recommendations: identifying costs. J. Clin. Psychiatry 1999;60(Suppl 3):54–58.PubMedGoogle Scholar
  127. 127.
    Noyes K, Dick AW, Holloway RG. Pramipexole v. levodopa as initial treatment for Parkinson’s disease: a randomized clinical-economic trial. Med. Decis. Making 2004;24(5):472–85.PubMedCrossRefGoogle Scholar
  128. 128.
    Fernandez JL, Montgomery S, Francois C. Evaluation of the cost effectiveness of escitalopram versus venlafaxine XR in major depressive disorder. Pharmacoeconomics 2005;23(2):155–67.PubMedCrossRefGoogle Scholar
  129. 129.
    Jones PB, Barnes TR, Davies L, et al. Randomized controlled trial of the effect on Quality of Life of second- vs first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Arch. Gen. Psychiatry 2006;63(10):1079–87.PubMedCrossRefGoogle Scholar
  130. 130.
    Holland R, Smith R, Harvey I, et al. Assessing quality of life in the elderly: a direct comparison of the EQ-5D and AQoL. Health Econ. 2004;13(8):793–805.PubMedCrossRefGoogle Scholar
  131. 131.
    Hawthorne G. Measuring incontinence in Australia. Melbourne: Department of Psychiatry, The University of Melbourne for the Department of Health and Ageing, Australian Government, Canberra. May 2006.Google Scholar
  132. 132.
    Spitzer RL, Williams JB, Kroenke K, et al. Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA 1994;272(22):1749–56.Google Scholar
  133. 133.
    Spitzer RL, Kroenke K, Linzer M, et al. Health-related quality of life in primary care patients with mental disorders. Results from the PRIME-MD 1000 Study. JAMA 1995;274(19):1511–7.Google Scholar
  134. 134.
    Fayers P, Machin D. Quality of Life: Assessment, Analysis and Interpretation. Chichester: Wiley; 2000.Google Scholar
  135. 135.
    Wood J, Taylor S, Lichtman R. Social comparison in adjustment to breast cancer. J. Pers. Soc. Psychol. 1985;49:1169–1183.PubMedCrossRefGoogle Scholar
  136. 136.
    Diener E, Suh E, Lucas R, et al. Subjective well-being: three decades of progress. Psychol. Bull. 1999;125:276–302.CrossRefGoogle Scholar
  137. 137.
    Kring A, Kerr S, Smith D, et al. Flat affect in schizophrenia does not reflect diminished subjective experience of emotion. J. Abnorm. Psychol. 1993;102:507–517.PubMedCrossRefGoogle Scholar
  138. 138.
    Jenkins C. Assessment of outcomes of health intervention. Soc. Sci. Med. 1992;35:367–375.PubMedCrossRefGoogle Scholar
  139. 139.
    Awad G, Hogan T, Voruganti L, et al. Patients’ subjective experiences on antipsychotic medications: implications for outcome and quality of life. Int. Clin. Psychopharmacol. 1995;10S:123–132.CrossRefGoogle Scholar
  140. 140.
    Coucill W, Bryan S, Bentham P, et al. EQ-5D in patients with dementia: an investigation of interrater agreement. Med. Care 2001;39(8):760–71.PubMedCrossRefGoogle Scholar
  141. 141.
    Becchi A, Rucci P, Placentino A, et al. Quality of life in patients with schizophrenia—comparison of self-report and proxy assessments. Soc. Psychiatry Psychiatr. Epidemiol. 2004;39(5):397–401.PubMedCrossRefGoogle Scholar
  142. 142.
    Ankri J, Beaufils B, Novella JL, et al. Use of the EQ-5D among patients suffering from dementia. J. Clin. Epidemiol. 2003;56(11):1055–63.PubMedCrossRefGoogle Scholar
  143. 143.
    Bullinger M, Azouvi P, Brooks N, et al. Quality of life in patients with traumatic brain injury-basic issues, assessment and recommendations. Restor Neurol Neurosci 2002;20(3–4):111–24.PubMedGoogle Scholar
  144. 144.
    Tamim H, McCusker J, Dendukuri N. Proxy reporting of quality of life using the EQ-5D. Med. Care 2002;40(12):1186–95.PubMedCrossRefGoogle Scholar
  145. 145.
    Naglie G, Tomlinson G, Tansey C, et al. Utility-based Quality of Life measures in Alzheimer’s disease. Qual. Life Res. 2006;15(4):631–43.PubMedCrossRefGoogle Scholar
  146. 146.
    Scocco P, Fantoni G, Caon F. Role of depressive and cognitive status in self-reported evaluation of quality of life in older people: comparing proxy and physician perspectives. Age Ageing 2005;35(2):166–71.PubMedCrossRefGoogle Scholar
  147. 147.
    Sainfort F, Becker M, Diamond R. Judgements of quality of life of individuals with severe mental disorders: patient self-report versus provider perspectives. Am. J. Psychiatry 1996;153:497–502.PubMedGoogle Scholar
  148. 148.
    Hawthorne G, Osborne R. Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure. Aust. N. Z. J. Public Health 2005;29(2):136–142.PubMedGoogle Scholar
  149. 149.
    Patterson TL, Shaw W, Semple SJ, et al. Health-related quality of life in older patients with schizophrenia and other psychoses: relationships among psychosocial and psychiatric factors. Int. J. Geriatr. Psychiatry 1997;12(4):452–61.PubMedCrossRefGoogle Scholar
  150. 150.
    Depp CA, Davis CE, Mittal D, et al. Health-related quality of life and functioning of middle-aged and elderly adults with bipolar disorder. J. Clin. Psychiatry 2006;67(2):215–21.PubMedCrossRefGoogle Scholar
  151. 151.
    Lonnqvist J, Sintonen H, Syvalahti E, et al. Antidepressant efficacy and quality of life in depression: a double-blind study with moclobemide and fluoxetine. Acta Psychiatr. Scand. 1994;89(6):363–369.PubMedGoogle Scholar
  152. 152.
    Sapin C, Fantino B, Nowicki ML, et al. Usefulness of EQ-5D in assessing health status in primary care patients with major depressive disorder. Health Qual Life Outcomes 2004;2:20.PubMedCrossRefGoogle Scholar
  153. 153.
    Pyne JM, Patterson TL, Kaplan RM, et al. Assessment of the quality of life of patients with major depression. Psychiatr. Serv. 1997;48(2):224–30.PubMedGoogle Scholar
  154. 154.
    Kasckow JW, Twamley E, Mulchahey JJ, et al. Health-related quality of well-being in chronically hospitalized patients with schizophrenia: comparison with matched outpatients. Psychiatry Res. 2001;103(1):69–78.PubMedCrossRefGoogle Scholar
  155. 155.
    Saarni SI, Harkanen T, Sintonen H, et al. The Impact of 29 Chronic Conditions on Healthrelated Quality of Life: A General Population Survey in Finland Using 15D and EQ-5D. Qual. Life Res. 2006; 15(9):1403–1414. 2006.CrossRefGoogle Scholar
  156. 156.
    Goldney RD, Fisher LJ. Double depression in an Australian population. Soc. Psychiatry Psychiatr. Epidemiol. 2004;39(11):921–6.PubMedCrossRefGoogle Scholar
  157. 157.
    Manuel DG, Schultz SE, Kopec JA. Measuring the health burden of chronic disease and injury using health adjusted life expectancy and the Health Utilities Index. J. Epidemiol. Community Health 2002;56(11):843–50.PubMedCrossRefGoogle Scholar
  158. 158.
    Goldney R, Fisher LJ, Dal Grande E, et al. Have education and publicity about depression made a difference? A comparison of prevalence, service use and excess costs in South Australia: 1998 and 2004. Aust. N. Z. J. Psychiatry 2007:41(1);38–53.PubMedCrossRefGoogle Scholar
  159. 159.
    Rasanen P, Roine E, Sintonen H, et al. Use of quality-adjusted life years for the estimation of effectiveness of health care: A systematic literature review. Int. J. Technol. Assess. Health Care 2006;22(2):235–41.PubMedGoogle Scholar
  160. 160.
    PBAC. Background Document on the use of economic analysis as a basis for inclusion of pharmaceutical products on the Pharmaceutical Benefits Scheme. Canberra: Australian Government Publishing Service; 1993.Google Scholar
  161. 161.
    PBAC. Guidelines for the Pharmaceutical Industry on Preparation of Submissions to the Pharmaceutical Benefits Advisory Committee. 2nd draft. Canberra: Pharmaceutical Benefits Advisory Committee, Commonwealth of Australia; 1995.Google Scholar
  162. 162.
    Thomas S, Nay R, Moore K, et al. Continence Outcomes Measurement Suite Project (Final Report). Canberra: Australian Government, Department of Health and Ageing; 2006 April.Google Scholar

Copyright information

© springer 2007

Authors and Affiliations

  • Graeme Hawthorne
    • 1
  1. 1.Department of PsychiatryThe University of MelbourneAustralia

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