A Systematic Review of the Feasibility and Psychometric Properties of the ICECAP-A Capability Instrument and Its Use So Far in Economic Evaluation

Research output: Contribution to journalArticlepeer-review

Colleges, School and Institutes


Objectives: Development of the ICECAP-A capability instrument was reported in 2012; use of certain capability measures was suggested in the context of social/long-term care soon afterwards by decision-making organisations in the UK and Netherlands. Despite enthusiasm for ICECAP-A this study represents the first attempt to collate evidence on its psychometric properties, and its use in economic analysis.
Methods: A systematic review of studies published between January 2012 and February 2019 which have either explored the psychometric properties of ICECAP-A (validity, reliability and responsiveness), or report its use in economic analysis.
Results: 27 studies were identified, 11 undertaking some form of economic analysis (including pilot and feasibility studies) and 16 assessing psychometric properties (seven assessing construct validity). ICECAP-A has mainly been used in the UK, but also in other English speaking countries and in Europe, across a wide range of healthcare contexts. There is promising evidence on content validity, construct validity and responsiveness. Whilst there was consistently strong association between ICECAP-A and AQoL-8D, associations with EQ-5D-3L and 5L were inconsistent. In some cases it was found that a switch in evaluative space from health to capability wellbeing would alter resource allocation decisions.
Discussion: ICECAP-A is correlated with health related quality of life (HRQoL), but is most appropriately regarded as a complement for and not a substitute to EQ-5D in particular. Positive evidence of the measure’s content and construct validity is beginning to accumulate, but further conceptual and policy debate is needed regarding the equity implications of switching between evaluative spaces.


Original languageEnglish
JournalValue in Health
Publication statusAccepted/In press - 22 Jan 2020


  • Systematic Review; ICECAP-A; Capability; Economic Evaluation; Psychometric Properties