Psychometric Performance of Preference-Weighted Instruments in Older Adults: A Systematic Review.
Lidia Engel, Valeriia Sokolova, Jan Faller et al.
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In 30 seconds
This systematic review assessed the psychometric properties of preference-weighted health-related quality-of-life instruments in adults aged ≥60. It included 106 studies evaluating 14 measures. EQ-5D versions performed acceptably on some criteria but showed ceiling effects, limited interrater reliability, and inconsistent responsiveness. ICECAP-O and ASCOT had more consistent supporting evidence, although responsiveness remains insufficiently tested. Evidence for other instruments was limited or mixed; early findings for QOL-ACC and WOOP were promising but incomplete. Overall, the review found that evidence remains incomplete across measures.
Key findings
- The review included 106 studies covering 14 preference-weighted measures in adults aged ≥60.
- EQ-5D versions showed acceptable performance on some criteria, but ceiling effects, limited interrater reliability, and inconsistent responsiveness were reported.
- ICECAP-O and ASCOT had more consistent evidence, but both require further assessment of responsiveness.
- Interrater reliability and responsiveness evidence remained limited across all measures; specific measures generally performed better than generic measures but had fewer studies.
Why it matters
Instrument choice can affect how health-related quality of life is measured and how cost-effectiveness is assessed in older populations. This review indicates that performance varies across measures and psychometric evidence is uneven, particularly for responsiveness and reliability. Clinicians and evaluators should therefore interpret results in light of the measure used and the remaining evidence gaps.
What to keep in mind
The review identified limited assessment of responsiveness, few head-to-head comparisons, and a lack of age-group-specific analyses in the underlying evidence.