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Published on: August 29, 2025
Estimation of a multiattribute utility function for the Spanish version of the TooL questionnaire
Angel Luis Montejo1, Javier Correas-Lauffer, Jorge Mauriño
1Department of Psychiatry, Hospital Universitario de Salamanca, Salamanca, Spain.
Summary
The Spanish Tolerability and Quality of Life (TooL) questionnaire
Area of Science:
- Psychometric evaluation
- Health economics
- Quality of Life research
Background:
- Assessing health-related quality of life (HRQoL) in patients with schizophrenia and bipolar disorder is crucial for treatment evaluation.
- Generic HRQoL instruments may not fully capture the nuances of treatment tolerability.
- A validated multiattribute utility function (MAUF) specific to the Spanish population is needed.
Purpose of the Study:
- To estimate and validate the psychometric properties of the Spanish version of the Tolerability and Quality of Life (TooL) questionnaire's MAUF.
- To assess its utility in patients with schizophrenia and bipolar disorder.
Main Methods:
- A balanced sample of 243 patients with schizophrenia or bipolar disorder was initially recruited.
- Data included clinical scales (PANSS, YMRS, MADRS, UKU, CGIS) and generic HRQoL measures (EQ-5D, SF-6D).
- A multiplicative-form MAUF was estimated using visual analogue scale (VAS) and time trade-off (TTO) ratings from a subsample of 70 patients.
Main Results:
- The MAUF demonstrated good convergent validity, with strong correlations between its utility estimates and those from SF-6D (0.66) and EQ-5D (0.69).
- Moderate correlations were observed with other clinical measures, and criterion validity was met through significant differences in utilities by clinical severity.
- The MAUF covered a broader range of health states (0.04-1.00) compared to generic instruments.
Conclusions:
- The MAUF derived from the Spanish TooL questionnaire exhibits favorable psychometric properties.
- It serves as a valuable complement to generic health utilities for assessing HRQoL in Spanish-speaking populations.
- Caution is advised to prevent potential bias towards treatments with fewer side effects when interpreting MAUF utilities.
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