Validation Evidence of Self-Reported Measures for Healthcare Resource Utilization in Adult Populations: A Systematic Review
Author(s)
Zhaohua Huo, PhD1, Xuechen Xiong, PhD2, Allen TC Lee, MD1, Benjamin H. K. Yip, PhD3, Linda CW Lam, MD1;
1The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong SAR, China, 2The University of Hong Kong, School of Public Health, Hong Kong SAR, China, 3The Chinese University of Hong Kong, JC School of Public Health and Primary Care, Hong Kong SAR, China
1The Chinese University of Hong Kong, Department of Psychiatry, Hong Kong SAR, China, 2The University of Hong Kong, School of Public Health, Hong Kong SAR, China, 3The Chinese University of Hong Kong, JC School of Public Health and Primary Care, Hong Kong SAR, China
Presentation Documents
OBJECTIVES: Despite a variety of instruments and scales, measuring healthcare utilisation in health economics studies remains challenging due to the high heterogeneities in design and validity. This study aims to synthesise the validation evidence of existing scales and questionnaires on healthcare resource utilisation.
METHODS: A systematic review was conducted. Validation studies on self- or proxy-reported healthcare utilisation scales (HUS) in adults were identified by May 2024 from multiple databases (Medline, EMBASE, PsycINFO, CINAHL, DIRUM). Search strategies included terms like “healthcare”, “utilisation”, “questionnaire” and “validation”. Study information and instrument features were extracted independently by two investigators. Study quality and measurement properties were assessed using COSMIN checklists.
RESULTS: Of 5626 identified records, 114 articles were included, mostly from European or north American countries (85.1%), non-institution settings (98.2%) and non-trial designs (78.9%). Of the 87 HUS, 80.5% were reported by patients, while 22.8% involved carers. Over half (51.7%) of scales targeted specific conditions (e.g., neurocognitive, psychiatric, musculoskeletal diseases and cancer). Beside medical services (87.4%), these HSU also evaluated social care (44.8%), caregiving time (25.3%) and productivity loss (35.6%). Criterion validity (59.8%) was the most investigated among HUSs, followed by content (41.4%), cross-cultural (40.2%) and construct (31.0%) validity. Thirty-two (36.8%) scales demonstrated sufficient criterion validity with quality evidence, while the figures were 17 (19.5%), 14 (16.1%) and 6 (6.9%) for construct, content and cross-cultural validity, respectively. The validity of one scale could vary across user demographics, service types, application settings, and recall periods.
CONCLUSIONS: Numerous HUS with potential for satisfactory validity (e.g., CSSRI, FIMA, iPCQ, ModRUM) are available for resource use measurement in clinical and health economic studies. However, researchers should consider the constructs, target population and condition, and application contexts of HUS in practice, as subtle variations may lead to considerable heterogeneity in scale performance.
METHODS: A systematic review was conducted. Validation studies on self- or proxy-reported healthcare utilisation scales (HUS) in adults were identified by May 2024 from multiple databases (Medline, EMBASE, PsycINFO, CINAHL, DIRUM). Search strategies included terms like “healthcare”, “utilisation”, “questionnaire” and “validation”. Study information and instrument features were extracted independently by two investigators. Study quality and measurement properties were assessed using COSMIN checklists.
RESULTS: Of 5626 identified records, 114 articles were included, mostly from European or north American countries (85.1%), non-institution settings (98.2%) and non-trial designs (78.9%). Of the 87 HUS, 80.5% were reported by patients, while 22.8% involved carers. Over half (51.7%) of scales targeted specific conditions (e.g., neurocognitive, psychiatric, musculoskeletal diseases and cancer). Beside medical services (87.4%), these HSU also evaluated social care (44.8%), caregiving time (25.3%) and productivity loss (35.6%). Criterion validity (59.8%) was the most investigated among HUSs, followed by content (41.4%), cross-cultural (40.2%) and construct (31.0%) validity. Thirty-two (36.8%) scales demonstrated sufficient criterion validity with quality evidence, while the figures were 17 (19.5%), 14 (16.1%) and 6 (6.9%) for construct, content and cross-cultural validity, respectively. The validity of one scale could vary across user demographics, service types, application settings, and recall periods.
CONCLUSIONS: Numerous HUS with potential for satisfactory validity (e.g., CSSRI, FIMA, iPCQ, ModRUM) are available for resource use measurement in clinical and health economic studies. However, researchers should consider the constructs, target population and condition, and application contexts of HUS in practice, as subtle variations may lead to considerable heterogeneity in scale performance.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
MSR102
Topic
Methodological & Statistical Research
Topic Subcategory
PRO & Related Methods, Survey Methods
Disease
No Additional Disease & Conditions/Specialized Treatment Areas