IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v18y2021i19p10314-d647204.html
   My bibliography  Save this article

Convergent and Discriminant Validity of the Barthel Index and the EQ-5D-3L When Used on Older People in a Rehabilitation Setting

Author

Listed:
  • Billingsley Kaambwa

    (Health Economics, College of Medicine and Public Health, Bedford Park Campus, Flinders University, Sturt Road, Bedford Park 5042, Australia)

  • Norma B. Bulamu

    (Health Economics, College of Medicine and Public Health, Bedford Park Campus, Flinders University, Sturt Road, Bedford Park 5042, Australia)

  • Christine Mpundu-Kaambwa

    (Health and Social Care Economics Group, College of Nursing and Health Sciences, Bedford Park Campus, Flinders University, Sturt Road, Bedford Park 5042, Australia)

  • Raymond Oppong

    (Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Birmingham B15 2TT, UK)

Abstract

This study compares the empirical performance of a commonly used functional-status measure, the Barthel Index (BI), to that of a widely used generic preference-based instrument, the EuroQoL-5-Dimensions 3 Level (EQ-5D-3L), in older people. Data from older people receiving rehabilitation services were used to test the validity of the BI and EQ-5D-3L. Convergent validity was investigated using Spearman’s correlation, exploratory factor analysis (EFA), scatter plots, Krippendorff’s alpha and modified Bland-Altman plots. Discriminant validity was examined using Kruskal Wallis tests, ceiling effects and EFA. A total of 1690 participants were included in the analysis. The BI total and EQ-5D-3L utility scores showed moderate correlation (r = 0.51; Krippendorff’s alpha = 0.52). Kendall’s Tau-B correlations between BI items and EQ-5D-3L dimensions measuring the same construct were weak to moderate (0.05 ≤ absolute r ≤ 0.54). In the EFA, some BI items cross-loaded onto the same factors as EQ-5D-3L dimensions, suggesting that the instruments were interrelated. The BI, however, focuses more on physical functioning, while the EQ-5D-3L measures broader wellbeing concepts. Both instruments showed good discriminant validity and would therefore be equally valuable for measuring subgroup differences. Researchers should consider using the BI in rehabilitation to capture more physical functioning-specific constructs not measured by the EQ-5D-3L.

Suggested Citation

  • Billingsley Kaambwa & Norma B. Bulamu & Christine Mpundu-Kaambwa & Raymond Oppong, 2021. "Convergent and Discriminant Validity of the Barthel Index and the EQ-5D-3L When Used on Older People in a Rehabilitation Setting," IJERPH, MDPI, vol. 18(19), pages 1-16, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10314-:d:647204
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/18/19/10314/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/18/19/10314/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Coast, Joanna & Flynn, Terry N. & Natarajan, Lucy & Sproston, Kerry & Lewis, Jane & Louviere, Jordan J. & Peters, Tim J., 2008. "Valuing the ICECAP capability index for older people," Social Science & Medicine, Elsevier, vol. 67(5), pages 874-882, September.
    2. Drummond, Michael F. & Sculpher, Mark J. & Torrance, George W. & O'Brien, Bernie J. & Stoddart, Greg L., 2005. "Methods for the Economic Evaluation of Health Care Programmes," OUP Catalogue, Oxford University Press, edition 3, number 9780198529453.
    3. Billingsley Kaambwa & Julie Ratcliffe, 2018. "Predicting EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) Utilities from Older People’s Quality of Life Brief Questionnaire (OPQoL-Brief) Scores," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 11(1), pages 39-54, February.
    4. Joanna Coast & Richard Smith & Paula Lorgelly, 2008. "Should the capability approach be applied in Health Economics?," Health Economics, John Wiley & Sons, Ltd., vol. 17(6), pages 667-670, June.
    5. Makai, Peter & Brouwer, Werner B.F. & Koopmanschap, Marc A. & Stolk, Elly A. & Nieboer, Anna P., 2014. "Quality of life instruments for economic evaluations in health and social care for older people: A systematic review," Social Science & Medicine, Elsevier, vol. 102(C), pages 83-93.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Fouad Sakr & Mariam Dabbous & Marwan Akel & Pascale Salameh & Hassan Hosseini, 2022. "Construction and Validation of the 17-Item Stroke-Specific Quality of Life Scale (SS-QOL-17): A Comprehensive Short Scale to Assess the Functional, Psychosocial, and Therapeutic Factors of QOL among S," IJERPH, MDPI, vol. 19(23), pages 1-16, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carmen M Sarabia-Cobo & Paula Parás-Bravo & Francisco José Amo-Setién & Ana Rosa Alconero-Camarero & María Sáenz-Jalón & Blanca Torres-Manrique & Raquel Sarabia-Lavín & Angela Fernández-Rodríguez & Ta, 2017. "Validation of the Spanish Version of the ICECAP-O for Nursing Home Residents with Dementia," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-13, January.
    2. Mitchell, Paul Mark & Roberts, Tracy E. & Barton, Pelham M. & Coast, Joanna, 2015. "Assessing sufficient capability: A new approach to economic evaluation," Social Science & Medicine, Elsevier, vol. 139(C), pages 71-79.
    3. Simon, Judit & Anand, Paul & Gray, Alastair & Rugkåsa, Jorun & Yeeles, Ksenija & Burns, Tom, 2013. "Operationalising the capability approach for outcome measurement in mental health research," Social Science & Medicine, Elsevier, vol. 98(C), pages 187-196.
    4. Ilias Goranitis & Joanna Coast & Ed Day & Alex Copello & Nick Freemantle & Emma Frew, 2017. "Maximizing Health or Sufficient Capability in Economic Evaluation? A Methodological Experiment of Treatment for Drug Addiction," Medical Decision Making, , vol. 37(5), pages 498-511, July.
    5. Wildman, John & McMeekin, Peter & Grieve, Eleanor & Briggs, Andrew, 2016. "Economic evaluation of integrated new technologies for health and social care: Suggestions for policy makers, users and evaluators," Social Science & Medicine, Elsevier, vol. 169(C), pages 141-148.
    6. Herlitz, Anders & Horan, David, 2016. "Measuring needs for priority setting in healthcare planning and policy," Social Science & Medicine, Elsevier, vol. 157(C), pages 96-102.
    7. Lorgelly, Paula K. & Lorimer, Karen & Fenwick, Elisabeth A.L. & Briggs, Andrew H. & Anand, Paul, 2015. "Operationalising the capability approach as an outcome measure in public health: The development of the OCAP-18," Social Science & Medicine, Elsevier, vol. 142(C), pages 68-81.
    8. Peter Makai & Willemijn Looman & Eddy Adang & René Melis & Elly Stolk & Isabelle Fabbricotti, 2015. "Cost-effectiveness of integrated care in frail elderly using the ICECAP-O and EQ-5D: does choice of instrument matter?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(4), pages 437-450, May.
    9. Hareth Al-Janabi & Job van Exel & Werner Brouwer & Joanna Coast, 2016. "A Framework for Including Family Health Spillovers in Economic Evaluation," Medical Decision Making, , vol. 36(2), pages 176-186, February.
    10. Kathryn Hale & Truls Østbye & Bilesha Perera & Robert Bradley & Joanna Maselko, 2019. "A Novel Adaptation of the HOME Inventory for Elders: The Importance of the Home Environment Across the Life Course," IJERPH, MDPI, vol. 16(16), pages 1-21, August.
    11. Paul Anand & Laurence S. J. Roope & Anthony J. Culyer & Ron Smith, 2020. "Disability and multidimensional quality of life: A capability approach to health status assessment," Health Economics, John Wiley & Sons, Ltd., vol. 29(7), pages 748-765, July.
    12. Hareth Al‐Janabi, 2018. "Do capability and functioning differ? A study of U.K. survey responses," Health Economics, John Wiley & Sons, Ltd., vol. 27(3), pages 465-479, March.
    13. Hareth Al‐Janabi & Terry N. Flynn & Tim J. Peters & Stirling Bryan & Joanna Coast, 2015. "Test–Retest Reliability of Capability Measurement in the UK General Population," Health Economics, John Wiley & Sons, Ltd., vol. 24(5), pages 625-630, May.
    14. Joanna Coast, 2019. "Assessing capability in economic evaluation: a life course approach?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 779-784, August.
    15. Cassandra Mah & Vanessa K. Noonan & Stirling Bryan & David G. T. Whitehurst, 2021. "Empirical Validity of a Generic, Preference-Based Capability Wellbeing Instrument (ICECAP-A) in the Context of Spinal Cord Injury," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 14(2), pages 223-240, March.
    16. Sebastian Himmler & Job Exel & Werner Brouwer, 2020. "Estimating the monetary value of health and capability well-being applying the well-being valuation approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1235-1244, November.
    17. Enrica Chiappero‐Martinetti & Paola Salardi & Francesco Scervini, 2019. "Estimating conversion rates: A new empirical strategy with an application to health care in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 28(6), pages 748-764, June.
    18. Lien Nguyen & Hanna Jokimäki & Ismo Linnosmaa & Eirini-Christina Saloniki & Laurie Batchelder & Juliette Malley & Hui Lu & Peter Burge & Birgit Trukeschitz & Julien Forder, 2022. "Valuing informal carers’ quality of life using best-worst scaling—Finnish preference weights for the Adult Social Care Outcomes Toolkit for carers (ASCOT-Carer)," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(3), pages 357-374, April.
    19. Karen M van Leeuwen & Miriam S van Loon & Fenna A van Nes & Judith E Bosmans & Henrica C W de Vet & Johannes C F Ket & Guy A M Widdershoven & Raymond W J G Ostelo, 2019. "What does quality of life mean to older adults? A thematic synthesis," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-39, March.
    20. Paula K. Lorgelly & Kenny D. Lawson & Elisabeth A.L. Fenwick & Andrew H. Briggs, 2010. "Outcome Measurement in Economic Evaluations of Public Health Interventions: a Role for the Capability Approach?," IJERPH, MDPI, vol. 7(5), pages 1-16, May.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:18:y:2021:i:19:p:10314-:d:647204. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.