A systematic review, psychometric analysis and qualitative assessment of Generic Preference-Based Measures of Health in Mental Health Populations and the estimation of mapping functions from widely used specific measures

Background Generic preference-based measures of health like the EQ-5D and SF-6D® are increasingly being used in economic evaluation and outcome assessment. However, there are concerns as to whether or not these generic measures are appropriate for use in people with mental health problems. Objectives The EQ-5D and SF-36® (including its derivatives the SF-12® and SF-6D) were assessed using the psychometric criteria of validity and responsiveness using quantitative and qualitative methods. Another aim was to estimate mapping functions between the EQ-5D and SF-6D and condition-specific measures, where appropriate. Design Four studies were undertaken to examine the appropriateness of the measures: (1) a systematic review of quantitative evidence on validity and responsiveness; (2) a further quantitative assessment of these criteria using existing data sets; (3) a review of qualitative research on the quality of life of people with mental health problems; and (4) qualitative semistructured interviews of people with a full range of problems. A fifth study estimated mapping functions between mental health-specific measures and the EQ-5D and SF-6D. Setting A choice of venue was offered for the interviews including the participant’s own home, a room at the university or a centre frequently used by mental health services. Participants The interviews were undertaken with 19 people with a broad range of mental health problems at varying levels of severity. Main outcome measures The reviews included the EQ-5D and SF-36 (and the SF-12 and SF-6D). The psychometric analysis included the Hospital Anxiety and Depression Scale (HADS), Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), Generalised Anxiety Disorder Assessment (GAD-7), General Health Questionnaire (GHQ-12) and Patient Health Questionnaire (PHQ-9). Results (1) and (2) The EQ-5D and SF-36 achieved an adequate level of performance in depression, and to some extent in anxiety and personality disorder. Results from the psychometric analyses in schizophrenia and bipolar disorder have been more mixed. (3) A framework analysis of 13 studies identified six major themes. (4) The interview data fitted the themes from the review well and resulted in minor modifications to the themes. The final set of themes comprised: well-being and ill-being; control, autonomy and choice; self-perception; belonging; activity; hope and hopelessness; and physical health. Conclusions The EQ-5D and SF-36 achieved mixed results in the quantitative testing against psychometric criteria. The qualitative analysis suggests this is because they provide a very limited coverage of themes identified by people with mental health problems. Recommendations for future work include the development of new preference-based measures in mental health that are based on, or substantially revise, an existing measure. Funding The Medical Research Council

Prevalence and risk factors associated with bovine viral diarrhea virus infection in dairy herds in Jordan

A cross-sectional study was carried out to determine the seroprevalence and to identify risk factors associated with bovine viral diarrhea virus (BVDV) infection in 62 non-vaccinated dairy herds (671 cows) in Jordan between January and June 2007. Information regarding herd management was recorded through a personal interview with farmers. Antibodies against BVDV were detected using an indirect ELISA test. Chi-square analysis and multivariable logistic regression model were used to identify risk factors for BVDV seropositivity. The true prevalence of antibodies against BVDV in individual cows and cattle herds was 31.6% and 80.7%, respectively. The seroprevalence of BVDV in medium and large size herds was significantly higher than that in smaller herds. There was no significant difference in BVD seroprevalence between different age groups. Random-effects logistic regression model revealed two major factors associated with seropositivity to BVDV; exchange of visits between adjacent farm workers and not isolating newly purchased animals before addition to the herd. The seroprevalence of BVDV in cows located in the northern Jordanian governorates was significantly higher than that in other studied governorates. Results of this study indicated that BVDV is highly prevalent in Jordan and BVDV infection could be controlled by livestock-trade control, and applying strict biosecurity measures in the dairy farms.A. Q. Talafha, S. M. Hirche, M. M. Ababneh, A. M. Al-Majali and M. M. Ababne