Assessing outcomes for cost-utility analysis in depression: comparison of five multi-attribute utility instruments with two depression-specific outcome measures

Br J Psychiatry. 2014 Nov;205(5):390-7. doi: 10.1192/bjp.bp.113.136036. Epub 2014 Sep 25.


Background: Many mental health surveys and clinical studies do not include a multi-attribute utility instrument (MAUI) that produces quality-adjusted life-years (QALYs). There is also some question about the sensitivity of the existing utility instruments to mental health.

Aims: To compare the sensitivity of five commonly used MAUIs (Assessment of Quality of Life - Eight Dimension Scale (AQoL-8D), EuroQoL-five dimension (EQ-5D-5L), Short Form 6D (SF-6D), Health Utilities Index Mark 3 (HUI3), 15D) with that of disease-specific depression outcome measures (Depression Anxiety Stress Scales (DASS-21) and the Kessler Psychological Distress Scale (K10)) and develop 'crosswalk' transformation algorithms between the measures.

Method: Individual data from 917 people with self-report depression collected as part of the International Multi-Instrument Comparison Survey.

Results: All the MAUIs discriminated between the levels of severity measured by the K10 and the DASS-21. The AQoL-8D had the highest correlation with the disease-specific measures and the best goodness-of-fit transformation properties.

Conclusions: The algorithms developed in this study can be used to determine cost-effectiveness of services or interventions where utility measures are not collected.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Depression / diagnosis*
  • Depression / therapy*
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Quality of Life*
  • Quality-Adjusted Life Years
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Young Adult