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Societal Utilities for Cognitive Impairment in Schizophrenia: Developing a Preference-Based Scoring Algorithm Based
Irene Santi1, Andrew J Lloyd2, Claudia E Hastedt3
1Institute for Medical Technology Assessment, Erasmus University, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands. santi@eshpm.eur.nl.
Advances in Therapy
|July 13, 2023
Summary
This study valued the Schizophrenia Cognition Rating Scale (SCoRS) to measure cognitive impairment in schizophrenia. SCoRS-based utilities effectively capture quality of life changes related to cognitive function, unlike generic measures.
Area of Science:
- Psychiatry
- Health Economics
- Psychometrics
Background:
- Cognitive dysfunction is a core symptom in schizophrenia, significantly impacting quality of life.
- Existing generic health-related quality of life measures, such as the EQ-5D, are insufficient for detecting cognitive changes in schizophrenia.
- There is a need for a schizophrenia-specific measure to assess cognitive impairment and its impact on quality of life.
Purpose of the Study:
- To value the Schizophrenia Cognition Rating Scale (SCoRS), a tool designed to measure cognitive impairment in schizophrenia.
- To develop health-state vignettes based on key SCoRS items for utility valuation.
- To compare the performance of SCoRS-based utilities with EQ-5D utilities in capturing quality of life changes.
Main Methods:
- Expert opinion and psychometric analysis were used to select 5 key SCoRS items (attention, learning, processing speed, social cognition, memory).
- Health-state vignettes were created from these items and valued using the composite time trade-off (cTTO) method with 400 respondents.
- Econometric models were employed to estimate disutilities, and SCoRS-based utilities were compared against EQ-5D utilities.
Main Results:
- The valuation study yielded utility values for health states, with the best state at 0.855 and the worst at 0.152.
- Severe impairments in social cognition, learning, and memory resulted in the largest disutilities.
- SCoRS-based utilities demonstrated sensitivity to changes in cognitive function, whereas EQ-5D utilities did not.
Conclusions:
- It is feasible to separately value different cognitive dimensions using a validated proxy assessment instrument like SCoRS.
- The derived SCoRS-based utilities reflect the loss in quality of life associated with reduced cognitive functioning in schizophrenia.
- SCoRS offers a valuable tool for assessing cognition-related quality of life in schizophrenia research and clinical practice.
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