workshop: introduction & icecap measures · 2014. 11. 4. · joanna coast: 3rd icecap users’...

3rd ICECAP Users’

Workshop: Introduction

& ICECAP measures

Joanna Coast

3rd ICECAP Users’ Workshop

University of Birmingham, February 2014

Joanna Coast: 3rd ICECAP users’ workshop: introduction

WELCOME!


Introductory sessions: others!

Capability approach & health

– Proochista Ariana, University of Oxford

A health service perspective

– Vikki Entwistle, University of Aberdeen

A health economics perspective

– Paula Lorgelly, Monash University


So, I will restrict myself…

…the ICECAP measures


ICECAP


ICECAP

ICECAP-O

– Older people

ICECAP-A

– Adult population

ICECAP-SCM

– End of life


The ICECAP story (1)

Initial project to develop a measure that would cross

health & social care for older people

Early qualitative work found that people appeared to

be concerned about their (lack of) ability to meet

particular functionings

– Major theme arising from findings (Grewal et al, SSM, 2006)

Loss of capability was clearly important to informants

Decision to take forward the development of the

measure in line with Sen’s capability approach


The ICECAP story (2)

Initial development through MRC-funded programme

(ICEPOP) looking at measuring outcomes for older

people for use in economic evaluation (2005-09)

– Development of ICECAP-O

– Early development of ICECAP-SCM

Further work through an MRC-funded project (2008-10)

– Development of ICECAP-A

Further work through ERC-funded project (2011-15)

– Further development of ICECAP-SCM


ICECAP development – all versions

Phase 1: in-depth interviews to generate conceptual

attributes for measures, constant comparative analysis

Phase 2: semi-structured interviews to check attributes &

develop meaningful wording for measures

Phase 3: valuation using best-worst scaling amongst

general population; anchoring on philosophical basis

between full capability and no capability

Phase 4: assessment of feasibility, validity, reliability,

sensitivity to change


5 questions, each with

4 response categories.

1024 possible

‘capability

wellbeing’ states.

ICECAP-O


ICECAP-O index values

-0.1 0 0.1 0.2 0.3

Attachment

Security

Role

Enjoyment

Control

Values rescaled such that 11111 equals zero and

44444 equals one

4

3

2

1

No capability on all attributes: value 0

A little capability on all attributes: value 0.556

A lot of capability on all attributes: value 0.868

Full capability on all attributes: value 1


Aims to tap into what is

important to the general

adult population.

ICECAP-A

5 questions, each with

4 possible responses


UK values

-0.05

0

0.05

0.1

0.15

0.2

0.25

L1 L2 L3 L4 L1 L2 L3 L4 L1 L2 L3 L4 L1 L2 L3 L4 L1 L2 L3 L1

Stability Attachment Autonomy Achievement Enjoyment

ind

ex

va

lue

Attribute

UK index values for ICECAP-A

No capability on all attributes: value 0

A little capability on all attributes: value 0.43

A lot of capability on all attributes: value 0.86

Full capability on all attributes: value 1


ICECAP-SCM

1) Having a say (Your ability to influence where you would like to live or be cared for, the kind of treatment you receive, the people who care for you)

2) Being with people who care about you (Being with family, friends or caring professionals

3) Physical suffering (Experiencing pain or physical discomfort which interferes with your daily activities)

4) Emotional suffering (Experiencing worry or distress, feeling like a burden)

5) Dignity (Being yourself, being clean, having privacy, being treated with respect, being spoken to with respect, having your religious or spiritual beliefs respected)

6) Being supported (Having help and support)

7) Being prepared (Having financial affairs in order, having your funeral planned, saying goodbye to family and friends, resolving things that are important to you, having treatment preferences in writing or making a living will)


Use of ICECAP-O

57 studies

Countries (of PI): UK, Australia, Canada, Netherlands, USA

Translations: Dutch, Welsh, Spanish, Chinese, (French), (German)

Topics include: frailty, orthopaedic, pulmonary, telehealth, chronic pain, Parkinsons, MS, speech & language, renal


Use of ICECAP-A

28 studies

Countries (of PI): UK, Australia, Netherlands,

USA, Canada, New Zealand

Translations: Welsh, (German), (Dutch)

Topics include: musculoskeletal,

resuscitation, pulmonary, cancer, hearing,

housing, overseas development, workplace


Use of ICECAP-SCM

2 studies

Countries: UK

Translations: n/a

Topics include: day hospice, advanced cancer patients


ICECAP dissemination

http://www.birmingham.ac.uk/icecap

– Visits to the ICECAP website Oct 2013: 379 unique pageviews

Nov 2013: 394 unique pageviews

Dec 2013: 284 unique pageviews

Jan 2014: 767 unique pageviews

@ICECAPm on twitter

– Since 16 Jan 2014

– 37 tweets

– 51 followers

http://www.birmingham.ac.uk/icecap


Overview of the workshop


Participants

Health care settings

– UK

– Netherlands

– France

– Australia

– Italy

– Austria

Experience

– Health economists

– Trialists

– Decision-makers

– Capability researchers

– Health researchers

– Policy makers


Workshop aims – Thursday large

group 1. Locate measures within capability, health, economics

2. Discuss new developments

● Better understanding of capability concept

● New measures

● New valuations

● New information on validity

● New methods for use in decision making

3. Share experience of use of the measures

● Posters on a variety of topics

● Panel discussion


Workshop aims – Friday small group

1. Generate further research

● ICECAP & Children

● Use in other settings & cultures

2. Develop collaboration

● Generate and establish national and international collaborations


Thoughts to leave you with…


The measurement challenge: ICECAP

Capabilities or functionings?

Participatory methods or capabilities based on overall

standard (e.g. Nussbaum list)?

Truly ‘objective’ or perceived capabilities?

Inclusion of ‘capabilities’ that influence other

‘capabilities’ or fundamental end-point capabilities?


The valuation challenge: ICECAP

Valuation choices

– Individual preferences (rejected by Sen)

– Deliberation & debate

– Value judgements elicited from population as ‘evidence’ for

values (‘Cookson’s compromise’)

Anchoring of values

– No anchoring

– Anchor based on choice task with equivalent ‘preference’ to

death

– Anchor on ‘full capability’ and ‘no capability’: those who have

died have no capability on any attribute


Inevitably ICECAP represents

compromises between the philosophy

and the practical requirements

CAN WE DO BETTER?

SHOULD WE MAKE DIFFERENT

CHOICES?


Acknowledgements

MRC Hubs for Trials Methodology Research

– Workshop funding (2nd & 3rd Workshops)

MRC

– Funding of ICEPOP HSRC programme

– Funding of ICECAP-A development project

ERC

– Funding of EconEndLife (ICECAP-SCM work)

Advisory Groups for ICEPOP, ICECAP-A, EconEndLife

– Helpful & constructive advice from both economics & other perspectives

workshop: introduction & icecap measures · 2014. 11. 4. · joanna coast: 3rd icecap users’...

Documents