Measuring health and broader wellbeing benefits in the context of opiate dependence: the psychometric performance of ICECAP-A and EQ-5D-5L

Ilias Goranitis, Jo Coast, Ed Day, Alexandre Copello, Nick Freemantle, Jennifer Seddon, Carmel Bennett, Emma Frew

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)
181 Downloads (Pure)


Background Measuring outcomes in economic evaluations of social care interventions is challenging because both health and well-being benefits are evident. The ICEpop CAPability instrument for adults (ICECAP-A) and the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) are measures potentially suitable for the economic evaluation of treatments for substance use disorders. Evidence for their validity in this context is, however, lacking. Objectives To assess the construct validity of the ICECAP-A and the EQ-5D-5L in terms of convergent and discriminative validity and sensitivity to change on the basis of standard clinical measures (Clinical Outcomes in Routine Evaluation-Outcome Measure, Treatment Outcomes Profile, Interpersonal Support Evaluation List, Leeds Dependence Questionnaire, and Social Satisfaction Questionnaire). Methods A secondary analysis of pilot trial data for heroin users in opiate substitution treatment was conducted. Baseline convergence with clinical measures was assessed using the Pearson correlation coefficient. Discriminative validity was assessed using one-way analysis of variance and stepwise regressions. Sensitivity to changes in clinical indicators was assessed at 3 and 12 months using the standardized response mean statistic and parametric and nonparametric testing. Results Both measures had the same level of construct validity, except for clinical indicators of well-being, for which the ICECAP-A performed better. The ICECAP-A was sensitive to changes in both health and well-being indicators. The EQ-5D-5L had lower levels of sensitivity to change, and a ceiling effect (27%), particularly evident in the dimensions of self-care (89%), mobility (75%), and usual activities (72%). Conclusions The findings support the construct validity of both measures, but the ICECAP-A gives more attention to broader impacts and is more sensitive to change. The ICECAP-A shows promise in evaluating treatments for substance use disorders for which recovery is the desired outcome.

Original languageEnglish
Pages (from-to)820-828
Number of pages9
JournalValue in Health
Issue number6
Early online date9 Jun 2016
Publication statusPublished - 1 Sept 2016


  • addiction
  • construct validity
  • economic evaluation
  • EQ-5D
  • mental health
  • outcome valuation
  • sensitivity to change


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