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Using mixed methods research to explore the effect of an adaptation exercise on general population valuations of health states

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Abstract

Purpose

To understand the effect of an adaptation exercise (AE) on general population values for rheumatoid arthritis (RA) states.

Methods

A sequential mixed methods design was employed: an analysis of a dataset to develop RA states for valuing in later phases of the study; a qualitative interview study with members of the general population to identify how an AE affected valuing of the RA states and to help design a questionnaire for the final phase; and a quantitative quasi-experimental study to identify factors that influence change in values after being informed about adaptation.

Results

Three RA states were developed using Rasch and cluster analyses. Participants in the qualitative phase identified a range of ways in which information about adaptation affected their values. For example, they realized they could adapt to RA because their family and friends who had RA, or similar conditions, could cope. A 25-item questionnaire was developed and used during the final phase to identify that younger and healthier individuals were more likely to increase their values after being informed about disease adaptation. The qualitative findings were revisited and found to support the quantitative results.

Conclusions

This approach facilitated understanding of whether and how an AE affected valuing of health states. Each phase affected the next phase of the study, leading to the conclusion that general population respondents who have little experience of disease will likely increase their health state values after being informed about adaptation because they understand that they could cope with the disease.

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Abbreviations

AE:

Adaptation exercise

EQ-5D:

EuroQol-5D

HAQ:

Stanford Health Assessment Questionnaire

QOL:

Quality of life

RA:

Rheumatoid arthritis

RCQ:

Reasons to Change Questionnaire

TTO:

Time trade-off

VAS:

Visual analogue scale

References

  1. Gold, M. R., Siegal, J. E., Russell, L. B., & Weinstein, M. C. (Eds.). (1996). Cost-effectiveness in health and medicine. Oxford: Oxford University Press.

    Google Scholar 

  2. Brazier, J., Akehurst, R., Brennan, A., Dolan, P., Claxton, K., McCabe, C., et al. (2005). Should patients have a greater role in valuing health states? Applied Health Economics and Health Policy, 4(4), 201–208.

    Article  PubMed  Google Scholar 

  3. National Institute for Health and Clinical Excellence. Guide to the methods of technology appraisal. London: National Institute for Health and Clinical Excellence, 2008.

  4. Kahneman, D., & Snell, J. (2000). Predicting utility. In R. A. M. Hogarth (Ed.), Insights in decision making (pp. 673–693). Chicago: University of Chicago Press.

    Google Scholar 

  5. Nord, E., Pinto, J. L., Richardson, J., Menzel, P., & Ubel, P. (1999). Incorporating societal concerns for fairness in numerical valuations of health programs. Health Economics, 8, 25–39.

    Article  PubMed  CAS  Google Scholar 

  6. Creswell, J. W., Fetters, M. D., & Ivankova, N. V. (2004). Designing a mixed methods study in primary care. Annals of Family Medicine, 2(1), 7–12.

    Article  PubMed  Google Scholar 

  7. National Data Bank for Rheumatic Diseases [Online]. N.d. Available from: http://www.arthritis-research.org. Accessed 21 February, 2011.

  8. McTaggart-Cowan, H. M., Brazier, J. E., & Tsuchiya, A. (2010). Clustering Rasch results: A novel method for developing rheumatoid arthritis states for use in valuation studies. Value in Health, 13(6), 787–795.

    Article  PubMed  Google Scholar 

  9. McTaggart-Cowan, H. M., Tsuchiya, A., O’Cathain, A., & Brazier, J. E. (2010). The impact of disease adaptation information on general population values for rheumatoid arthritis states. Discussion paper 10/10. Sheffield: Health Economics and Decision Science.

    Google Scholar 

  10. McTaggart-Cowan, H., Tsuchiya, A., O’Cathain, A., & Brazier, J. E. (2011). Understanding the effect of disease adaptation information on general population values for hypothetical health states. Social Science and Medicine, 72(11), 1904–1912.

    Google Scholar 

  11. Deeks, A., Lombard, C., Michelmore, J., & Teede, H. (2009). The effects of gender and age on health related behaviours. BMC Public Health, 9, 213.

    Article  PubMed  Google Scholar 

  12. Gudex, C. (1994). Time trade-off user manual: Props and self-completion methods. Working Paper 020. Centre for Health Economics, University of York.

  13. DIPEx Health Experiences Research Group. Health talk online [online]. (2008). Available from http://www.healthtalkonline.org/Bones_joints/Rheumatoid_Arthritis [Accessed: 24 June 2009].

  14. Tijhuis, G. J., Jansen, S. J. T., Stiggelbout, A. M., Zwinderman, A. H., & Hazes, J. M. W. (2000). Value of the time trade off method for measuring utilities in patients with rheumatoid arthritis. Annuals of Rheumatic Diseases, 59, 892–897.

    Article  CAS  Google Scholar 

  15. Ritchie, J., & Spencer, L. (1994). Qualitative data analysis for applied policy research. In A. Bryman & R. Burgess (Eds.), Analyzing qualitative data (pp. 173–194). London: Routledge.

    Chapter  Google Scholar 

  16. O’Cathain, A. (2009). Reporting mixed methods projects. In S. Andrew & E. J. Halcomb (Eds.), Mixed methods research for nursing and the health sciences (pp. 135–158). Chicester: Wiley Blackwell.

    Chapter  Google Scholar 

  17. Moffatt, S., White, M., Mackintosh, J., & Howel, D. (2006). Using quantitative and qualitative data in health services research—What happens when mixed method findings conflict? BMC Health Services Research, 6, 28.

    Article  PubMed  Google Scholar 

  18. Ubel, P. A., Loewenstein, G., & Jepson, C. (2005). Disability and sunshine: Can hedonic predictions be improved by drawing attention to focusing illusions or emotional adaptation? Journal of Experimental Psychology: Applied, 11(2), 111–123.

    Article  PubMed  Google Scholar 

  19. Damschroder, L. J., Zikmund-Fisher, B. J., & Ubel, P. A. (2005). The impact of considering adaptation in health state valuations. Social Science and Medicine, 61, 267–277.

    Article  PubMed  Google Scholar 

  20. Damschroder, L. J., Zikmund-Fisher, B. J., & Ubel, P. A. (2008). Considering adaptation in preference elicitation. Health Psychology, 27(3), 394–399.

    Article  PubMed  Google Scholar 

  21. Dolan, P., Gudex, C., Kind, P., & Williams, A. (1996). Valuing health states: A comparison of methods. Journal of Health Economics, 15(2), 209–231.

    Article  PubMed  CAS  Google Scholar 

  22. Sprangers, M. A., & Schwartz, C. E. (1999). Integrating response shift into health-related quality of life research: A theoretical model. Social Science and Medicine, 48(11), 1507–1515.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

At the time of the study, HMC was supported by a doctoral research award from the Canadian Institutes for Health Research. The project was funded by the Arthritis Research Campaign (project grant 18289) and AstraZeneca. The authors thank the Faculty of Health and Wellbeing at Sheffield Hallam University of conducting the interviews and the study participants for their time and effort. The authors also thank DIPEx for allowing use of the patient interviews available on their website. The usual disclaimer applies.

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Authors and Affiliations

  1. Canadian Centre for Applied Research in Cancer Control, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada

    Helen M. McTaggart-Cowan

  2. British Columbia Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada

    Helen M. McTaggart-Cowan

  3. School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK

    Alicia O’Cathain, Aki Tsuchiya & John E. Brazier

  4. Department of Economics, University of Sheffield, 9 Mappin Street, Sheffield, S1 4DT, UK

    Aki Tsuchiya

Authors
  1. Helen M. McTaggart-Cowan
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  2. Alicia O’Cathain
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  3. Aki Tsuchiya
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  4. John E. Brazier
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Corresponding author

Correspondence to Helen M. McTaggart-Cowan.

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McTaggart-Cowan, H.M., O’Cathain, A., Tsuchiya, A. et al. Using mixed methods research to explore the effect of an adaptation exercise on general population valuations of health states. Qual Life Res 21, 465–473 (2012). https://doi.org/10.1007/s11136-011-9994-4

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  • DOI: https://doi.org/10.1007/s11136-011-9994-4

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