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Using Rasch analysis to form plausible health states amenable to valuation: the development of CORE-6D from a measure of common mental health problems (CORE-OM)

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Abstract

Purpose

To describe a new approach for deriving a preference-based index from a condition specific measure that uses Rasch analysis to develop health states.

Methods

The CORE-OM is a 34-item instrument monitoring clinical outcomes of people with common mental health problems. The CORE-OM is characterised by high correlation across its domains. Rasch analysis was used to reduce the number of items and response levels in order to produce a unidimensional measure and to generate a credible set of health states corresponding to different levels of symptom severity using the Rasch item threshold map.

Results

The proposed methodology resulted in the development of CORE-6D, a 2-dimensional health state descriptive system consisting of a unidimensional 5-item emotional component (derived from Rasch analysis) and a physical symptom item. Inspection of the Rasch item threshold map of the emotional component helped identify a set of 11 plausible health states, which, combined with 3 physical symptom item levels, form 33 plausible health states that can be used for the valuation of the instrument, resulting in the development of a preference-based index.

Conclusions

This is a useful new approach to develop preference-based measures from existing instruments with high correlations across domains. The CORE-6D preference-based index will enable calculation of Quality-Adjusted Life Years in people with common mental health problems.

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Abbreviations

CORE-OM:

Clinical Outcomes in Routine Evaluation-Outcome Measure

CSM:

Condition-specific measure

DIF:

Differential item functioning

HRQoL:

Health-related quality of life

NHS:

National Health Service

PBM:

Preference-based measure

SRM:

Standardised response mean

QALY:

Quality-Adjusted Life Year

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Acknowledgments

Ifigeneia Mavranezouli undertook this work as a PhD student in the School of Health and Related Research at the University of Sheffield. We are grateful to the UK MRC Methodology Programme for supporting this work and to the CORE System Trustees for giving approval for the development of the CORE-6D.

Author information

Authors and Affiliations

  1. Health Economics and Decision Science, School of Health and Related Research, University of Sheffield, Sheffield, S1 4DA, UK

    Ifigeneia Mavranezouli, John E. Brazier & Tracey A. Young

  2. National Collaborating Centre for Mental Health, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, Gower Street, London, WC1E 6BT, UK

    Ifigeneia Mavranezouli

  3. Yorkshire and Humber Research Design Service, University of Sheffield, Sheffield, S1 4DA, UK

    Tracey A. Young

  4. Centre for Psychological Services Research, University of Sheffield, Sheffield, S10 2TN, UK

    Michael Barkham

Authors
  1. Ifigeneia Mavranezouli
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  2. John E. Brazier
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  3. Tracey A. Young
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  4. Michael Barkham
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Correspondence to Ifigeneia Mavranezouli.

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Mavranezouli, I., Brazier, J.E., Young, T.A. et al. Using Rasch analysis to form plausible health states amenable to valuation: the development of CORE-6D from a measure of common mental health problems (CORE-OM). Qual Life Res 20, 321–333 (2011). https://doi.org/10.1007/s11136-010-9768-4

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