Psychometric Testing of the ICECAP-A in Patients With Coeliac Disease: A Comparative Analysis With EQ-5D-5L
Author(s)
Mária M. Angyal, MSc1, Peter L Lakatos, MD, PhD2, Valentin Brodszky, MSc, PhD, MD3, Fanni Rencz, Msc, MD, PhD3;
1Semmelweis University, Student, Budapest, Hungary, 2McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada, 3Corvinus University of Budapest, Budapest, Hungary
1Semmelweis University, Student, Budapest, Hungary, 2McGill University Health Centre, Montreal General Hospital, Montreal, QC, Canada, 3Corvinus University of Budapest, Budapest, Hungary
Presentation Documents
OBJECTIVES: This study aims to assess the psychometric properties of the ICEpop CAPability measure for Adults (ICECAP-A) in patients with celiac disease (CD) and compare its performance with the EQ-5D-5L.
METHODS: An online cross-sectional survey was conducted among 312 adult CD patients in Hungary, who completed both the ICECAP-A and EQ-5D-5L. The following psychometric properties were assessed: ceiling, convergent validity with the Gastrointestinal Symptom Rating Scale (GSRS) and Satisfaction with Life Scale (SWLS) and known-group validity. The index values were compared with the Hungarian ICECAP-A population norms.
RESULTS: Mean age was 36 years (range 18-80), and 70.2% were female. On the ICECAP-A, 51.3% (attachment) to 81.1% (stability) reported limitations in their capabilities. In comparison, 7.5% (self-care) to 43.8% (pain/discomfort) of patients reported problems on the EQ-5D-5L. No ceiling effect was observed on the ICECAP-A (6.7%), in contrast with a high ceiling effect on the EQ-5D-5L (38.8%). Mean index values of ICECAP-A were lower than the EQ-5D-5L (0.85 vs. 0.92). ICECAP-A correlated strongly with SWLS (rs=0.685), moderately with EQ-5D-5L (rs=0.485) and weakly with GSRS (rs=0.314). The ICECAP-A differentiated between known groups by general health status, symptoms and GSRS tertiles with large effect sizes (0.156-0.455), and comorbidities with moderate effect size (0.061). The EQ-5D-5L showed larger effect sizes for health-related and clinical variables, as well as age and gender. More limitations were reported among CD patients in multiple ICECAP-A items than the general population, particularly in stability (81.1% vs. 48.2%) and achievement (77.9% vs. 56.6%). Patients reported worse capability well-being across almost all age groups compared to the general population (mean ICECAP-A index: 0.76-0.86 vs. 0.84-0.92).
CONCLUSIONS: This is the first study to validate the ICECAP-A in patients with CD. ICECAP-A is a valid measure in this population, sensitive to specific symptoms and health status, effectively capturing the well-being impact of CD.
METHODS: An online cross-sectional survey was conducted among 312 adult CD patients in Hungary, who completed both the ICECAP-A and EQ-5D-5L. The following psychometric properties were assessed: ceiling, convergent validity with the Gastrointestinal Symptom Rating Scale (GSRS) and Satisfaction with Life Scale (SWLS) and known-group validity. The index values were compared with the Hungarian ICECAP-A population norms.
RESULTS: Mean age was 36 years (range 18-80), and 70.2% were female. On the ICECAP-A, 51.3% (attachment) to 81.1% (stability) reported limitations in their capabilities. In comparison, 7.5% (self-care) to 43.8% (pain/discomfort) of patients reported problems on the EQ-5D-5L. No ceiling effect was observed on the ICECAP-A (6.7%), in contrast with a high ceiling effect on the EQ-5D-5L (38.8%). Mean index values of ICECAP-A were lower than the EQ-5D-5L (0.85 vs. 0.92). ICECAP-A correlated strongly with SWLS (rs=0.685), moderately with EQ-5D-5L (rs=0.485) and weakly with GSRS (rs=0.314). The ICECAP-A differentiated between known groups by general health status, symptoms and GSRS tertiles with large effect sizes (0.156-0.455), and comorbidities with moderate effect size (0.061). The EQ-5D-5L showed larger effect sizes for health-related and clinical variables, as well as age and gender. More limitations were reported among CD patients in multiple ICECAP-A items than the general population, particularly in stability (81.1% vs. 48.2%) and achievement (77.9% vs. 56.6%). Patients reported worse capability well-being across almost all age groups compared to the general population (mean ICECAP-A index: 0.76-0.86 vs. 0.84-0.92).
CONCLUSIONS: This is the first study to validate the ICECAP-A in patients with CD. ICECAP-A is a valid measure in this population, sensitive to specific symptoms and health status, effectively capturing the well-being impact of CD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PT31
Topic
Patient-Centered Research
Topic Subcategory
Health State Utilities, Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
SDC: Gastrointestinal Disorders, SDC: Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)