Portal de Periódicos da CAPES

POSB424 Valuation of Cognitive Impairment in Schizophrenia

2022; Elsevier BV; Volume: 25; Issue: 1 Linguagem: Inglês

10.1016/j.jval.2021.11.1335

1524-4733

I Santi, Andrew Lloyd, Claudia Hastedt, Matthijs Versteegh,

Mental Health and Psychiatry

Preference-based measures of health are used in economic evaluation as a measure of health benefit. The commonly used EQ-5D may not be very sensitive to cognitive impairment in schizophrenia compared to interview-based cognitive functioning measures such as the Schizophrenia Cognition Rating Scale (SCoRS). The purpose of this study was to select and value key dimensions of cognitive impairment described by the SCoRS to estimate utilities. A health state classification system was derived from the SCoRS based on factor analysis, principal component analysis, item response theory analysis, correlation with cognitive performance, and expert opinion. Health states based on selected SCoRS items and their response levels were rated in an online time trade-off (TTO) exercise. Data were modeled using random effects (RE) and Tobit models. Model performance was evaluated based on goodness of fit. The five SCoRS items identified as most relevant assessed attention, learning, language, social cognition, and memory. A UK general public sample (n=400) completed the TTO survey. RE regression model showed the best fit. Regression coefficients were ordered and were significant, except for the mild levels of language and memory. Mild to moderate levels of attention were combined and the corresponding coefficient was significant. Small but significant utility decrements were found for other dimensions, with the severe level showing the larger effect. The results obtained in terms of utility decrement were in the range of 0.01–0.24 per SCoRS item. In the trial data larger changes on MCCB were associated with larger changes in utility. The results of this study show that it is possible to identify and value dimensions of cognitive functioning separately. The developed scoring algorithm showed discriminative validity and sensitivity to change when applied to clinical trial data and can be used as an instrument to derive health utility for health economic evaluation of treatments for schizophrenia.