Over the last two decades preference-based measures of health have been increasingly used in economic evaluation to inform health policy, such as submissions to agencies like the National Institute for Health and Care Excellence in England and Wales (NICE, 2013). Preference-based measures are typically used to generate a value of health-related quality of life that can be used to generate a quality adjusted life year (QALY). A QALY combines the value of health-related quality-of-life (HRQoL) with the value of length of life into a single index number, and can be used to capture changes in both mortality and morbidity of patients. The QALY provides a measure of the benefit of an intervention which can be compared to its incremental cost. Interventions can then be compared in terms of their incremental cost per QALY ratio.
NICE requires one measure to be used as the reference case in adult populations i.e. the EQ-5D (NICE, 2013). By contrast, NICE prefers a standardised outcome measure for children and adolescents, but no single one due to a lack of evidence. The most widely used measures include a youth version of the EQ-5D (EQ-5D-Y) and the CHU9D, the latter a measure developed by an MRC Fellow in Sheffield more than 10 years ago (Stevens, 2009). CHU9D licenses are distributed by TUoS with nearly 100 since 2013.
Concerns exist around the appropriateness of measures like CHUI-9D in capturing the health status of across different groups of children and adolescents (i.e. content validity). Furthermore, the methods used to derive the utility weights were taken from an adult perspective. NICE and similar agencies around the world will be looking to adopt a single measure in this population and will be looking for evidence to support their decision.
This PhD aims to address key gaps in the evidence-base, which will better inform the use in clinical research and to inform decision-making for cost-effectiveness of interventions moving forward. This will be achieved applying a combination of qualitative and quantitative techniques covering three broad components.
1.Critical evaluation of the content validity of existing preference-based measures used to determine HRQoL in children and adolescents. This stage will determine whether current instruments, particularly the CHU9D, require further evidence to support its use for measuring and valuing HRQoL in children and adolescents.
2. Design and conduct of qualitative studies with child and adolescent populations to improve understanding of CHU-9D against competitor measures and address gaps identified in Stage 1.
3. Design and conduct studies to provide a new dataset for UK utility weights for CHU-9D based on the latest methods.
Entry Requirements:
Candidates must have a first or upper second class honors degree or significant research experience, and in addition a Masters degree in a relevant area, such as Economics, Psychology, Health Research.
How to apply:
Please complete a University Postgraduate Research Application form available here: www.shef.ac.uk/postgraduate/research/apply
Please clearly state the prospective main supervisor in the respective box and select 'School of Health & Related Research' as the department. Please also state your first and second choice project by entering the project tiles in the 'Research Topic' box on your application.
Enquiries:
Interested candidates should in the first instance contact Dr Jill Carlton - [Email Address Removed]
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