Brendan joined CHERE in January 2015 - he is currently a Senior Research Fellow. Prior to that he spent over five years working at the School of Health and Related Research, University of Sheffield, UK. His research interests include the development of both generic and condition specific preference based measures for use in economic evaluation, and the development and testing of new and innovative methods for valuing health. He is currently involved in the development of the EQ-5D-5L value set for England/UK, and is leading a large international study developing version 2 of the SF-6D (SF-6D-V2). He is also interested in developing non preference based measures of health and quality of life, and testing and comparing the psychometric performance of existing instruments using Item Response Theory methods. Previously he spent a number of years working as a health psychology researcher at the University of Leeds, UK, developing online interventions for alcohol use. He has a Batchelor of Science (Honours) in Psychology from the University of Wolverhampton, UK, and a Master of Research in Psychology from the University of Birmingham, UK. Brendan is currently completing his PhD at UTS.
Tonmukayakul, U, Imms, C, Mihalopoulos, C, Reddihough, D, Carter, R, Mulhern, B & Chen, G 2020, 'Health-related quality of life and upper-limb impairment in children with cerebral palsy: developing a mapping algorithm', DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY.View/Download from: Publisher's site
Van Gelder, T, Mulhern, B, Schoormans, D, Husson, O & De Abreu Lourenco, R 2020, 'Assessing health-related quality of life in cancer survivors: Factors impacting on EORTC QLU-C10D derived utility values', Quality of Life Research, vol. 29, no. 6, pp. 1483-1494.View/Download from: Publisher's site
Brazier, J, Mulhern, B, Bjorner, JB, Gandek, B, Rowen, D, Alonso, J, Vilagut, G & Ware, J 2020, 'Developing a new version of the SF-6D health state classification system from the SF-36v2: SF-6Dv2', Medical Care.
Bull, C, Crilly, J, Chaboyer, W, Spain, D, Mulhern, B, Fitzgerald, G, Scuffham, P & Byrnes, J 2020, 'Does facility type and location impact upon patient experiences in emergency departments? Secondary analysis of a state-wide, cross-sectional survey', Emergency Medicine Australasia : EMA.View/Download from: Publisher's site
OBJECTIVE:To identify the extent to which patient experiences in the ED differ depending on facility type (based on bed numbers, services available and annual separations), and location (level of remoteness). METHODS:Data from a 2015 state-wide (Queensland, Australia) public ED patient experience survey were linked to sociodemographic and presentation-related characteristics data. Survey items were individually scored (from 0 to 100), and averaged across 13 pre-determined patient experience topic areas. Descriptive statistics were used to report on patient sociodemographic and presentation-related characteristics. One-way analysis of variance tests were used to identify associations between patient-reported experience scores, facility types and location. RESULTS:A total of 10 553 patients over the age of 16 years completed the survey. All patients reported scores above 75 for 7 of the 13 patient experience topic areas (0 = lowest score, 100 = highest score). Patients from very remote and outer regional EDs reported the highest scores for the topic Environment and facilities, and remote facility patients reported the highest scores for the topic Leaving the ED - Delays. The same two topic areas were scored most highly by patients from smaller facilities in comparison to principal referral hospital EDs. CONCLUSIONS:Patients attending smaller and more rurally located EDs reported more positive experiences than those attending larger, metropolitan EDs on two of the 13 topic areas. However, these differences were marginal. Future research should aim to determine what constitutes clinically meaningful differences between groups when comparing patient-reported experience scores, and understand the characteristics of small and rural EDs that may be associated with better patient experiences.
Campbell, JA, Jelinek, GA, Weiland, TJ, Nag, N, Neate, SL, Palmer, AJ, Mulhern, B, De Livera, A & Simpson, S 2020, 'SF-6D health state utilities for lifestyle, socio-demographic and clinical characteristics of a large international cohort of people with multiple sclerosis', Quality of Life Research.
Comans, TA, Nguyen, KH, Ratcliffe, J, Rowen, D & Mulhern, B 2020, 'Valuing the AD-5D Dementia Utility Instrument: An Estimation of a General Population Tariff', PharmacoEconomics, vol. 38, no. 8, pp. 871-881.View/Download from: Publisher's site
© 2020, Springer Nature Switzerland AG. Objective: This paper reports on the valuation of quality-of-life states in the Alzheimer's Disease Five Dimensions (AD-5D) instrument in a representative sample of the general population in Australia using the discrete-choice experiment with duration (DCETTO) elicitation technique. Method: A DCE with 200 choice sets of two quality-of-life (QoL) state–duration combinations blocked into 20 survey versions, with ten choice sets in each version, was designed and administered online to a sample representative of the Australian population. Two additional choice sets comprising internal consistency and dominance checks were included in each survey version. A range of model specifications investigating preferences with respect to duration and interactions between AD-5D dimension levels were estimated. Utility weights were developed, with estimated coefficients transformed to the 0 (being dead) to 1 (full health) scale, suitable for the calculation of quality-adjusted life-year (QALY) weights for use in economic evaluation. Results: In total, 1999 respondents completed the choice experiment. Overall, respondents were slightly better educated and had higher annual incomes than the Australian general population. The estimation results from different specifications and models were broadly consistent with the monotonic nature of the AD-5D: utility increased with increased life expectancy and decreased as the severity level for each dimension worsened. A utility value set was generated for the calculation of utilities for all QoL states defined by the AD-5D descriptive system. Conclusion: The DCE-based utility value set is now available to use to generate QALYs for the economic evaluation of treatments and interventions targeting people with dementia and/or their family caregivers.
Engel, L, Bucholc, J, Mihalopoulos, C, Mulhern, B, Ratcliffe, J, Yates, M & Hanna, L 2020, 'A qualitative exploration of the content and face validity of preference-based measures within the context of dementia', Health and Quality of Life Outcomes.
Marten, O, Mulhern, B, Bansback, N & Tsuchiya, A 2020, 'Implausible States: Prevalence of EQ-5D-5L States in the General Population and Its Effect on Health State Valuation', Medical Decision Making.
Tonmukayakul, U, Imms, C, Mihalopoulos, C, Reddihough, D, Carter, R & Mulhern, B 2020, 'Health-related Quality of Life and Upper Limb Impairment in Children with Cerebral Palsy: Comparing and Mapping CPQoL-Child and CHU9D', Developmental Medicine and Child Neurology.View/Download from: Publisher's site
van Hout, B, Mulhern, B, Feng, Y, Shah, K & Devlin, N 2020, 'The EQ-5D-5L Value Set for England: Response to the "Quality Assurance"', Value in Health, vol. 23, no. 5, pp. 649-655.View/Download from: Publisher's site
Pearce, A, Mulhern, B, Watson, V & Viney, R 2020, 'How Are Debriefing Questions Used in Health Discrete Choice Experiments? An Online Survey', Value in Health, vol. 23, no. 3, pp. 287-293.View/Download from: Publisher's site
Devlin, N, Shah, K, Mulhern, BJ & van Hout, B 2019, 'A new method for valuing health: directly eliciting personal utility functions', European Journal of Health Economics, vol. 20, no. 2, pp. 257-270.View/Download from: Publisher's site
Franklin, M, Mukuria, C, Mulhern, B, Tran, I, Brazier, J & Watson, S 2019, 'Measuring the burden of schizophrenia using clinician and patient-reported measures: an exploratory analysis of construct validity', The Patient: Patient Centered Outcomes Research, vol. 12, no. 4, pp. 405-417.View/Download from: Publisher's site
Tonmukayakul, U, Le, LK-D, Mudiyanselage, SB, Engel, L, Bucholc, J, Mulhern, B, Carter, R & Mihalopoulos, C 2019, 'A systematic review of utility values in children with cerebral palsy.', Quality of Life Research, vol. 28, no. 1, pp. 1-12.View/Download from: Publisher's site
Project aims include the following: (i) to identify reported utility values associated with CP in children aged ≤ 18 years; (ii) to explore utility value elicitation techniques in published studies; and (iii) to examine performance of the measures and/or elicitation approaches.Peer-reviewed studies published prior to March 2017 were identified from six electronic databases. Construct validity, convergent validity, responsiveness, and reliability of instruments were assessed.Five studies met the inclusion criteria. Utility values of hypothetical general CP states obtained from a general population of parents ranged from 0.55 to 0.88 using time trade off (TTO) and 0.60-0.87 using standard gamble (SG) techniques. Utility values reported by clinicians of three hypothetical spastic quadriplegic CP states, using the Health Utility Index Mark 2 (HUI-2), ranged from 0.40 to 0.13. Other sources of utilities identified were based on both proxy and child ratings using Health Utility Index Mark 3 (HUI-3) (values ranged from - 0.013 to 0.84 depending on the valuation source) and the Assessment of Quality of Life 4 Dimension instrument, with values ranging from 0.01 to 0.58. Construct validity of the HUI-3 varied from moderate to strong, whereas mixed results were found for convergent validity. Responsiveness and reliability were not reported.There was substantial variation in reported utilities. Indirect techniques (i.e. via multi-attribute utility instruments) were more frequently used than direct techniques (e.g. TTO, SG). Further research is required to improve the robustness of utility valuation of health-related quality of life in children with CP for use in economic evaluation.
Tsuchiya, A, Bansback, N, Hole, AR & Mulhern, B 2019, 'Manipulating the Five Dimensions of the EuroQol Instrument: The Effects on Self-Reporting Actual Health and Valuing Hypothetical Health States', Medical Decision Making, vol. 39, no. 4, pp. 379-392.View/Download from: Publisher's site
Mulhern, B, Norman, R, De Abreu Lourenco, R, Street, D, Malley, J & Viney, R 2019, 'Investigating the relative value of health and social care related quality of life using a discrete choice experiment', Social Science and Medicine, vol. 233, pp. 28-37.View/Download from: Publisher's site
Mulhern, B, Norman, R, Street, D & Viney, R 2019, 'One Method, Many Methodological Choices: A Structured Review of Discrete-Choice Experiments for Health State Valuation', PharmacoEconomics, vol. 37, no. 1, pp. 29-43.View/Download from: Publisher's site
Discrete-choice experiments (DCEs) are used in the development of preference-based measure (PBM) value sets. There is considerable variation in the methodological approaches used to elicit preferences.Our objective was to carry out a structured review of DCE methods used for health state valuation.PubMed was searched until 31 May 2018 for published literature using DCEs for health state valuation. Search terms to describe DCEs, the process of valuation and preference-based instruments were developed. English language papers with any study population were included if they used DCEs to develop or directly inform the production of value sets for generic or condition-specific PBMs. Assessment of paper quality was guided by the recently developed Checklist for Reporting Valuation Studies. Data were extracted under six categories: general study information, choice task and study design, type of designed experiment, modelling and analysis methods, results and discussion.The literature search identified 1132 published papers, and 63 papers were included in the review. Paper quality was generally high. The study design and choice task formats varied considerably, and a wide range of modelling methods were employed to estimate value sets.This review of DCE methods used for developing value sets suggests some recurring limitations, areas of consensus and areas where further research is required. Methodological diversity means that the values should be seen as experimental, and users should understand the features of the value sets produced before applying them in decision making.
Norman, R, Craig, BM, Hansen, P, Jonker, MF, Rose, J, Street, DJ & Mulhern, B 2019, 'Issues in the Design of Discrete Choice Experiments', The Patient: Patient Centered Outcomes Research, vol. 12, no. 3, pp. 281-285.View/Download from: Publisher's site
Bull, C, Byrnes, J & Mulhern, BJ 2018, 'We respect their autonomy and dignity, but how do we value patient-reported experiences?', Medical Decision Making, vol. 3:2, pp. 1-3.View/Download from: Publisher's site
Patients are in a unique position to provide insights regarding their health care management and to assess the quality of health care service delivery. Patient-reported experience measures (PREMs) capture patients' objective health care experiences of what actually happened, as opposed to satisfaction-based measures that aim to vindicate patients' expectations. This is in contrast to patient-reported outcome measures, which measure patients' views of their health status.1 Indeed, it was the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Program that was initiated in the United States in 1995 that highlighted an important transition in assessing health care quality: moving away from measures of patient satisfaction to PREMs for the purposes of obtaining actionable, informed data regarding what actually happens during the provision of health care services.
In recent years, there has been a proliferation of PREMs. While different PREMs across various health care settings and conditions, all with published validation studies, have been identified,2–4 this does not include unpublished PREMs and those developed for specific institutional use.5 The explosion of PREMs is partly due to the increasing focus on patient-centered care, and their adoption as an indicator of health care system quality and performance. For example, the CAHPS program is linked with the US Centers for Medicare and Medicaid to inform hospital benchmarking and pay-for-performance/value-based performance schemes, with the core goal of supporting an objective and meaningful comparison of institutions regarding consumer-based priorities.6 The National Health Service (NHS) of England conducts a similar program called the Overall Patient Experience Scores in partnership with the Care Quality Commission whereby the experiences of NHS consumers can be compared over time.7
Given that PREMs are influential in the assessment of services, it is important to understand what they are measuring...
Cole, A, Shah, K, Mulhern, B, Feng, Y & Devlin, N 2018, 'Valuing EQ-5D-5L health states 'in context' using a discrete choice experiment', European Journal of Health Economics, vol. 19, no. 4, pp. 595-605.View/Download from: Publisher's site
In health state valuation studies, health states are typically presented as a series of sentences, each describing a health dimension and severity 'level'. Differences in the severity levels can be subtle, and confusion about which is 'worse' can lead to logically inconsistent valuation data. A solution could be to mimic the way patients self-report health, where the ordinal structure of levels is clear. We develop and test the feasibility of presenting EQ-5D-5L health states in the 'context' of the entire EQ-5D-5L descriptive system.
An online two-arm discrete choice experiment was conducted in the UK (n = 993). Respondents were randomly allocated to a control (standard presentation) or 'context' arm. Each respondent completed 16 paired comparison tasks and feedback questions about the tasks. Differences across arms were assessed using regression analyses.
Presenting health states 'in context' can significantly reduce the selection of logically dominated health states, particularly for labels 'severe' and 'extreme' (χ2 = 46.02, p < 0.001). Preferences differ significantly between arms (likelihood ratio statistic = 42.00, p < 0.05). Comparing conditional logit modeling results, coefficients are ordered as expected for both arms, but the magnitude of decrements between levels is larger for the context arm.
Health state presentation is a key consideration in the design of valuation studies. Presenting health states 'in context' affects valuation data and reduces logical inconsistencies. Our results could have implications for other valuation tasks such as time trade-off, and for the valuation of other preference-based measures.
Comans, TA, Kim-Huong, N, Mulhern, B, Corlis, M, Li, L, Welch, A, Kurrle, SE, Rowen, D, Moyle, W, Kularatna, S & Ratcliffe, J 2018, 'Developing a dementia-specific preference-based quality of life measure (AD-5D) in Australia: a valuation study protocol', BMJ OPEN, vol. 8, no. 1.View/Download from: Publisher's site
Devlin, N, Feng, Y, Shah, K, Mulhern, B & van Hout, B 2018, 'Valuing Health-Related Quality of Life: An EQ-5D-5L Value Set for England', Health Economics, vol. 27, no. 1, pp. 7-22.View/Download from: Publisher's site
A new version of the EQ‐5D, the EQ‐5D‐5L, is available. The aim of this study is to produce a value set to support use of EQ‐5D‐5L data in decision‐making.
The study design followed an international research protocol. Randomly selected members of the English general public completed 10 time trade‐off and 7 discrete choice experiment tasks in face‐to‐face interviews.
A 20‐parameter hybrid model was used to combine time trade‐off and discrete choice experiment data to generate values for the 3,125 EQ‐5D‐5L health states.
Valuation data are available for 996 respondents. Face validity of the data has been demonstrated, with more severe health states generally given lower values. Problems with pain/discomfort and anxiety/depression received the greatest weight. Compared to the existing EQ‐5D‐3L value set, there are considerably fewer "worse than dead" states (5.1%, compared with over one third), and the minimum value is higher. Values range from −0.285 (extreme problems on all dimensions) to 0.950 (for health states 11211 and 21111).
Results have important implications for users of the EQ‐5D‐5L both in England and internationally. Quality‐adjusted life year gains from interventions seeking to improve very poor health may be smaller using this value set and may previously have been overestimated.
Feng, Y, Devlin, N, Shah, K, Mulhern, B & van Hout, B 2018, 'New Methods for Modelling EQ-5D-5L Value Sets: An Application to English Data', Health Economics, vol. 27, no. 1, pp. 23-38.View/Download from: Publisher's site
Value sets for the EQ‐5D‐5L are required to facilitate its use in estimating quality‐adjusted life years. An international protocol has been developed to guide the collection of stated preference data for this purpose and has been used to generate EQ‐5D‐5L valuation data for England. The aim of this paper is report the innovative methods used for modelling those data to obtain a value set.
Nine hundred and ninety‐six members of the English general public completed time trade‐off (TTO) and discrete choice experiment (DCE) tasks. We estimate models, with and without interactions, using DCE data only, TTO data only, and TTO/DCE data combined. TTO data are interpreted as both left and right censored. Heteroskedasticity and preference heterogeneity between individuals are accounted for. We use Bayesian methods in the econometric analysis. The final model is chosen based on the deviance information criterion (DIC).
Censoring and taking account of heteroskedasticity have important effects on parameter estimation. For DCE data only, TTO data only, and DCE/TTO data combined, models with parameters for all dimensions and levels perform best, as judged by the DIC. Taking account of heterogeneity improves fit, and the multinomial model reports the lowest DIC. This paper presents approaches that suit observed characteristics of EQ‐5D‐5L valuation data and recognise respondents' preference heterogeneity. The methods described are potentially relevant to other value set studies.
Kreimeier, S, Oppe, M, Ramos-Goni, J, Cole, A, Devlin, N, Herdman, M, Mulhern, BJ, Shah, K, Stolk, E, Rivero-Aria, O & Greiner, W 2018, 'Valuation of EuroQol Five-Dimensional Questionnaire, Youth Version (EQ-5D-Y) and EuroQol Five-Dimensional Questionnaire, Three-Level Version (EQ-5D-3L) Health States: The Impact of Wording and Perspective', Value in Health, vol. 21, no. 11, pp. 121-128.View/Download from: Publisher's site
Mulhern, B, Feng, Y, Shah, K, Janssen, B, Herdman, M, van Hout, B & Devlin, N 2018, 'Comparing the UK EQ-5D-3L and English EQ-5D-5L value sets', PharmacoEconomics, vol. 36, no. 6, pp. 669-713.View/Download from: Publisher's site
Mulhern, B, Feng, Y, Shah, K, Janssen, MF, Herdman, M, van Hout, B & Devlin, N 2018, 'Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets (vol 36, pg 699, 2018)', PHARMACOECONOMICS, vol. 36, no. 6, pp. 727-727.View/Download from: Publisher's site
Rowen, D, Labeit, A, Stevens, K, Elliott, J, Mulhern, BJ, Carlton, J, Basarir, H & Brazier, J 2018, 'Estimating a preference-based single index measuring the quality of life impact of self-management for diabetes', Medical Decision Making, vol. 38, no. 6, pp. 699-707.View/Download from: Publisher's site
Rowen, D, Labeit, A, Stevens, K, Mulhern, B, Elliot, J, Basarir, H, Ratcliffe, J & Brazier, J 2018, 'Using a discrete choice experiment involving cost to value a classification system measuring the quality of life impact of self-management for diabetes', Value in Health, vol. 21, no. 1, pp. 69-77.View/Download from: Publisher's site
To describe the use of a novel approach in health valuation of a discrete-choice experiment (DCE) including a cost attribute to value a recently developed classification system for measuring the quality-of-life impact (both health and treatment experience) of self-management for diabetes.
A large online survey was conducted using DCE with cost on UK respondents from the general population (n = 1497) and individuals with diabetes (n = 405). The data were modeled using a conditional logit model with robust standard errors. The marginal rate of substitution was used to generate willingness-to-pay (WTP) estimates for every state defined by the classification system. Robustness of results was assessed by including interaction effects for household income.
There were some logical inconsistencies and insignificant coefficients for the milder levels of some attributes. There were some differences in the rank ordering of different attributes for the general population and diabetic patients. The WTP to avoid the most severe state was £1118.53 per month for the general population and £2356.02 per month for the diabetic patient population. The results were largely robust.
Health and self-management can be valued in a single classification system using DCE with cost. The marginal rate of substitution for key attributes can be used to inform cost-benefit analysis of self-management interventions in diabetes using results from clinical studies in which this new classification system has been applied. The method shows promise, but found large WTP estimates exceeding the cost levels used in the survey.
Rowen, D, Mulhern, BJ, Vermaire, E & Stevens, K 2018, 'Estimating a Dutch value set for the paediatric preference-based CHU-9D using a discrete choice experiment with duration', Value in Health, vol. 21, no. 10, pp. 1234-1242.View/Download from: Publisher's site
Wong, CKH, Mulhern, B, Cheng, GHL & Lam, CLK 2018, 'SF-6D population norms for the Hong Kong Chinese general population.', Quality of Life Research, vol. 27, no. 9, pp. 2349-2359.View/Download from: Publisher's site
To estimate population norms for the SF-6D health preference (utility) scores derived from the MOS SF-36 version 1 (SF-36v1), SF-36 version 2 (SF-36v2), and (SF-12v2) health surveys collected from a representative adult sample in Hong Kong, and to assess differences in SF-6D scores across sociodemographic subgroups.A random telephone survey of 2410 Chinese adults was conducted. All respondents completed questionnaires on sociodemographics and presence of chronic diseases (hypertension, diabetes, chronic rheumatism, chronic lung diseases, stroke, and mental illness), and the short-form 36-item health survey (SF-36) version 1, and selected items of the SF-36v2 that were different from those of SF-36v1. Responses of short-form 12-item health survey (SF-12) were extracted from responses of the SF-36 items. SF-6D health utility scores were derived from SF-36 version 1 (SF-6DSF-36v1), SF-36 version 2 (SF-6DSF-36v2), and SF-12 version 2 (SF-6DSF-12v2) using Hong Kong SF-6D value set.Population norms of SF-6DSF-36v1, SF-6DSF-36v2, and SF-6DSF-12v2 for the Hong Kong Chinese were 0.7947 (± 0.0048), 0.7862 (± 0.0049), and 0.8147 (± 0.0050), respectively. Three SF-6D scores were highly correlated (0.861-0.954), and had a high degree of reliability and absolute agreement. Males had higher health utility scores (SF-6DSF-36v1: 0.0025; SF-6DSF-36v2: 0.025; SF-6DSF-12v2: 0.018) but reported less problems in all the dimensions than women. Respondents with a higher number of chronic diseases had lower SF-6D scores. Among all respondents with one or more chronic diseases, those with hypertension scored the highest whereby those with mental illness scored the least.The SF-6D utility scores derived from different SF-36 or SF-12 health surveys were different. The population norms based on these three health surveys enable the normative comparisons of health utility scores from specific population or patient groups, and provide estimates of age-gender adjusted health utility scores for ...
Mulhern, B, Norman, R, Shah, K, Bansback, N, Longworth, L & Viney, R 2018, 'How should DCE with duration choice sets be presented for the valuation of health states?', Medical Decision Making, vol. 38, no. 3, pp. 306-318.View/Download from: Publisher's site
Background. Discrete Choice Experiments including duration (DCETTO) can be used to generate utility values for health states from measures such as EQ-5D-5L. However, methodological issues concerning the optimum way to present choice sets remain. The aim of the present study was to test a range of task presentation approaches designed to support the DCETTO completion process. Methods. Four separate presentation approaches were developed to examine different task features including dimension level highlighting, and health state severity and duration level presentation. Choice sets included 2 EQ-5D-5L states paired with 1 of 4 duration levels, and a third "immediate death" option. The same design, including 120 choice sets (developed using optimal methods), was employed across all approaches. The online survey was administered to a sample of the Australian population who completed 20 choice sets across 2 approaches. Conditional logit regression was used to assess model consistency, and scale parameter testing investigated poolability. Results. Overall 1,565 respondents completed the survey. Three approaches, using different dimension level highlighting techniques, produced mainly monotonic coefficients that resulted in a larger disutility as the severity level increased (excepting usual activities levels 2/3). The fourth approach, using a level indicator to present the severity levels, has slightly more non-monotonicity and produced larger ordered differences for the more severe dimension levels. Scale parameter testing suggested that the data cannot be pooled. Conclusions. The results provide information regarding how to present DCE tasks for health state valuation. The findings improve our understanding of the impact of different presentation approaches on valuation, and how DCE questions could be presented to be amenable to completion. However, it is unclear if the task presentation impacts online respondent engagement.
Mulhern, B, Labeit, A, Rowen, D, Knowles, E, Meadows, K, Elliott, J & Brazier, J 2017, 'Developing preference-based measures for diabetes: DHP-3D and DHP-5D', Diabetic Medicine, vol. 34, no. 9, pp. 1264-1275-1264-1275.
Mulhern, BJ, Bansback, N, Hole, AR & Tsuchiya, A 2017, 'Using Discrete Choice Experiment with duration to model EQ-5D-5L health state preferences: Testing experimental design strategies', Medical Decision Making, vol. 37, no. 3, pp. 285-297.View/Download from: Publisher's site
Mulhern, BJ, Pink, J, Rowen, D, Borghs, S, Butt, T, Hughes, D, Marson, A & Brazier, J 2017, 'Comparing generic and condition specific preference based measures in epilepsy: EQ-5D-3L and NEWQOL-6D', Value in Health, vol. 20, no. 4, pp. 687-693.View/Download from: Publisher's site
Nguyen, K-H, Mulhern, B, Kularatna, S, Byrnes, J, Moyle, W & Comans, T 2017, 'Developing a dementia-specific health state classification system for a new preference-based instrument AD-5D', Health and Quality of Life Outcomes, vol. 15.View/Download from: Publisher's site
Shah, K, Mulhern, B, Longworth, L & Janssen, MF 2017, 'Views of the UK general public on important aspects of health not captured by EQ-5D', The Patient: Patient Centered Outcomes Research, vol. 10, no. 6, pp. 701-709.View/Download from: Publisher's site
Mulhern, B, Norman, R, Lorgelly, P, Lancsar, E, Ratcliffe, J, Brazier, J & Viney, R 2017, 'Is Dimension Order Important when Valuing Health States Using Discrete Choice Experiments Including Duration?', PharmacoEconomics, vol. 35, no. 4, pp. 439-451.View/Download from: Publisher's site
Herdman, M, Cole, A, Hoyle, CK, Coles, V, Carroll, S & Devlin, N 2016, 'Sources and Characteristics of Utility Weights for Economic Evaluation of Pediatric Vaccines: A Systematic Review', VALUE IN HEALTH, vol. 19, no. 2, pp. 255-266.View/Download from: Publisher's site
Mulhern, BJ, Shah, K, Janssen, MF, Ibbotson, R & Longworth, L 2016, 'Valuing health using Time Trade Off and Discrete Choice methods: Does dimension order impact on health state values?', Value in Health, vol. 19, no. 2, pp. 210-217.View/Download from: Publisher's site
Pantiri, K, Shah, K, Devlin, N, Mulhern, B & van Hout, B 2016, 'DIRECTLY ELICITING PERSONAL UTILITY FUNCTIONS FROM A CONVENIENCE SAMPLE OF 30 HEALTH OUTCOMES PROFESSIONALS: A PILOT STUDY', VALUE IN HEALTH, vol. 19, no. 7, pp. A473-A473.View/Download from: Publisher's site
Shah, K, Mulhern, BJ, Longworth, L & Janssen, MF 2016, 'An empirical study of two alternative comparators for use in time-trade off studies', Value in Health, vol. 19, no. 1, pp. 53-59.View/Download from: Publisher's site
Mulhern, B, Norman, R, Viney, R & Stolk, E 2016, 'USING DISCRETE CHOICE EXPERIMENTS TO VALUE GENERIC PREFERENCE-BASED MEASURES: A SYSTEMATIC REVIEW', VALUE IN HEALTH, vol. 19, no. 3, pp. A95-A96.View/Download from: Publisher's site
Mulhern, B, Norman, R, Viney, R, Lorgelly, P, Lancsar, E, Ratcliffe, J & Brazier, J 2016, 'Valuing EQ-5D-5L using discrete choice experiments with duration: Investigating dimension order', Value in Health, vol. 19, no. 3, pp. A94-A94.
Norman, R, Mulhern, B, Viney, R, Bansback, N & Pearce, A 2016, 'The Impact of Duration on EQ‐5D‐5L Value Sets Derived from a Discrete Choice Experiment', Value in Health, vol. 19, no. 7, pp. A828-A828.
Norman, R, Mulhern, BJ & Viney, R 2016, 'The impact of different DCE-based approaches when anchoring utility scores', PharmacoEconomics, vol. 34, no. 8, pp. 805-814.View/Download from: Publisher's site
Bansback, N, Mulhern, B, Sawatsky, R, Brazier, J & Whitehurst, D 2015, 'Valuing the SF-6Dv2 in Canada', Quality of Life Research, vol. 24, no. 1, pp. 181-191.
Purpose: Dysmenorrhea refers to the experience of pelvic pain/cramps experienced by women around or during menstruation. A literature review indicated that no existing patient-reported outcome measure was adequate to support labeling claims in dysmenorrhea. Therefore, this study aimed to develop a new measure that could be used as a primary end point in dysmenorrhea clinical trials.
Methods: Open-ended interviews were conducted with 52 dysmenorrhea patients, including a subset of 12 women with a comorbid pelvic pain condition (PPC). Verbatim transcripts were analyzed thematically. The findings were used to generate draft items for an electronic diary (eDiary). A further 24 dysmenorrhea patients pilot-tested the eDiary for 1-5 weeks and completed cognitive interviews to assess content validity. Revisions to the eDiary were implemented based on the findings.
Results: In the first set of interviews, 51 women (98 %) spontaneously reported pain/cramps in or around the pelvic region (abdomen, lower back, legs/upper thighs, and vaginal area). Pain experiences reported were similar across dysmenorrhea and dysmenorrhea plus PPC subgroups, except that the pelvic pain among PPC patients occurred throughout the month, not only during menstruation. All participants described the detrimental impact of dysmenorrhea on health-related quality of life.
Conclusions: The eDiary was conceptually comprehensive and easy to complete/understand during cognitive debriefing. The resulting nine-item diary included assessment of: menstrual bleeding severity; pain severity; use of analgesics; impact on work/school, physical activities, social and leisure activities, and sleep. Psychometric validation is ongoing and will assess the reliability, validity, and responsiveness of the eDiary as a comprehensive dysmenorrhea assessment.
Devlin, N, Shah, K, Mulhern, B & van Hout, B 2015, 'A new valuation method: direct elicitation of personal utility functions for EQ-5D', Quality of Life Research, vol. 24, pp. 176-176.
Mulhern, BJ, O'Gorman, H, Rotherham, N & Brazier, J 2015, 'Comparing the measurement equivalence of EQ-5D-5L across different modes of administration', Health and Quality of Life Outcomes, vol. 13.View/Download from: Publisher's site
Palfreyman, S & Mulhern, B 2015, 'The psychometric performance of generic preference-based measures for patients with pressure ulcers', Health and Quality of Life Outcomes, vol. 13.View/Download from: Publisher's site
Rowen, D, Mulhern, B, Banerjee, S, Tait, R, Watchurst, C, Smith, SC, Young, TA, Knapp, M & Brazier, JE 2015, 'Comparison of General Population, Patient, and Carer Utility Values for Dementia Health States', MEDICAL DECISION MAKING, vol. 35, no. 1, pp. 68-80.View/Download from: Publisher's site
Shah, K, Devlin, N, Mulhern, B & van Hout, B 2015, 'DIRECTLY ELICITING PERSONAL UTILITY FUNCTIONS: A NEW WAY TO VALUE HEALTH-RELATED QUALITY OF LIFE', VALUE IN HEALTH, vol. 18, no. 3, pp. A37-A37.View/Download from: Publisher's site
Bansback, N, Hole, AR, Mulhern, B & Tsuchiya, A 2014, 'Testing a discrete choice experiment including duration to value health states for large descriptive systems: addressing design and sampling issues.', Social Science and Medicine, vol. 114, pp. 38-48.View/Download from: Publisher's site
There is interest in the use of discrete choice experiments that include a duration attribute (DCETTO) to generate health utility values, but questions remain on its feasibility in large health state descriptive systems. This study examines the stability of DCETTO to estimate health utility values from the five-level EQ-5D, an instrument with depicts 3125 different health states. Between January and March 2011, we administered 120 DCETTO tasks based on the five-level EQ-5D to a total of 1799 respondents in the UK (each completed 15 DCETTO tasks on-line). We compared models across different sample sizes and different total numbers of observations. We found the DCETTO coefficients were generally consistent, with high agreement between individual ordinal preferences and aggregate cardinal values. Keeping the DCE design and the total number of observations fixed, subsamples consisting of 10 tasks per respondent with an intermediate sized sample, and 15 tasks with a smaller sample provide similar results in comparison to the whole sample model. In conclusion, we find that the DCETTO is a feasible method for developing values for larger descriptive systems such as EQ-5D-5L, and find evidence supporting important design features for future valuation studies that use the DCETTO.
Brazier, J, Connell, J, Papaioannou, D, Mukuria, C, Mulhern, B, Peasgood, T, Jones, ML, Paisley, S, O'Cathain, A, Barkham, M, Knapp, M, Byford, S, Gilbody, S & Parry, G 2014, '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.', Health Technology Assessment, vol. 18, no. 34, pp. vii-188.View/Download from: Publisher's site
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.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.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.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.The interviews were undertaken with 19 people with a broad range of mental health problems at varying levels of severity.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).(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 ...
Longworth, L, Yang, Y, Young, T, Mulhern, B, Hernández Alava, M, Mukuria, C, Rowen, D, Tosh, J, Tsuchiya, A, Evans, P, Devianee Keetharuth, A & Brazier, J 2014, 'Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: a systematic review, statistical modelling and survey.', Health Technology Assessment, vol. 18, no. 9, pp. v-224.View/Download from: Publisher's site
The National Institute for Health and Care Excellence recommends the use of generic preference-based measures (GPBMs) of health for its Health Technology Assessments (HTAs). However, these data may not be available or appropriate for all health conditions.To determine whether GPBMs are appropriate for some key conditions and to explore alternative methods of utility estimation when data from GPBMs are unavailable or inappropriate.The project was conducted in three stages: (1) A systematic review of the psychometric properties of three commonly used GPBMs [EQ-5D, SF-6D and Health Utilities Index Mark 3 (HUI3)] in four broadly defined conditions: visual impairment, hearing impairment, cancer and skin conditions. (2) Potential modelling approaches to 'map' EQ-5D values from condition-specific and clinical measures of health [European Organisation for Research and Treatment of Cancer Quality-of-life Questionnaire Core 30 (EORTC QLQ-C30) and Functional Assessment of Cancer Therapy - General Scale (FACT-G)] are compared for predictive ability and goodness of fit using two separate data sets. (3) Three potential extensions to the EQ-5D are developed as 'bolt-on' items relating to hearing, tiredness and vision. They are valued using the time trade-off method. A second valuation study is conducted to fully value the EQ-5D with and without the vision bolt-on item in an additional sample of 300 people.The valuation surveys were conducted using face-to-face interviews in the respondents' homes.Two representative samples of the UK general population from Yorkshire (n=600).None.Comparisons of EQ-5D, SF-6D and HUI3 in four conditions with various generic and condition-specific measures. Mapping functions were estimated between EORTC QLQ-C30 and FACT-G with EQ-5D. Three bolt-ons to the EQ-5D were developed: EQ + hearing/vision/tiredness. A full valuation study was conducted for the EQ + vision.(1) EQ-5D was valid and responsive for skin conditions and most cancers; in vision, it...
Mulhern, B & Brazier, J 2014, 'Developing SF-6D-V2: The classification system', Quality of Life Research, vol. 23, pp. 49-49.
Mulhern, B & Meadows, K 2014, 'The construct validity and responsiveness of the EQ-5D, SF-6D and Diabetes Health Profile-18 in type 2 diabetes.', Health and Quality of Life Outcomes, vol. 12, pp. 1-10.View/Download from: Publisher's site
BACKGROUND: Interest in the measurement of health related quality of life and psychosocial functioning from the patient's perspective in diabetes mellitus has grown in recent years. The aim of this study is to investigate the psychometric performance of and agreement between the generic EQ-5D and SF-6D and diabetes specific DHP-18 in Type 2 diabetes. This will support the future use of the measures by providing further evidence regarding their psychometric properties and the conceptual overlap between the instruments. The results will inform whether the measures can be used with confidence alongside each other to provide a more holistic profile of people with Type 2 diabetes. METHODS: A large longitudinal dataset (n = 1,184) of people with Type 2 diabetes was used for the analysis. Convergent validity was tested by examining correlations between the measures. Known group validity was tested across a range of clinical and diabetes severity indicators using ANOVA and effect size statistics. Agreement was examined using Bland-Altman plots. Responsiveness was tested by examining floor and ceiling effects and standardised response means. RESULTS: Correlations between the measures indicates that there is overlap in the constructs assessed (with correlations between 0.1 and 0.7 reported), but there is some level of divergence between the generic and condition specific instruments. Known group validity was generally good but was not consistent across all indicators included (with effect sizes from 0 to 0.74 reported). The EQ-5D and SF-6D displayed a high level of agreement, but there was some disagreement between the generic measures and the DHP-18 dimensions across the severity range. Responsiveness was higher in those who self-reported change in health (SRMs between 0.06 and 0.25). CONCLUSIONS: The psychometric assessment of the relationship between the EQ-5D, SF-6D and DHP-18 shows that all have a level of validity for use in Type 2 diabetes. This suggests that the me...
Mulhern, B & Shah, K 2014, 'VALUING EQ-5D-5L: DOES THE ORDERING OF THE HEALTH DIMENSIONS IMPACT ON HEALTH STATE VALUATIONS?', VALUE IN HEALTH, vol. 17, no. 7, pp. A331-A331.View/Download from: Publisher's site
Mulhern, B, Bansback, N, Brazier, J, Buckingham, K, Cairns, J, Devlin, N, Dolan, P, Hole, AR, Kavetsos, G, Longworth, L, Rowen, D & Tsuchiya, A 2014, 'Preparatory study for the revaluation of the EQ-5D tariff: methodology report.', Health Technology Assessment, vol. 18, no. 12, pp. vii-191.View/Download from: Publisher's site
EQ-5D is a widely used generic measure of health with a 'tariff', or preference weights, obtained from the general population, using time trade-off (TTO). PRET (Preparatory study for the Re-valuation of the EQ-5D Tariff project) contributes towards the methodology for its revaluation.Stage 1 examined key assumptions typically involved in health-state valuations through a series of binary choice exercises, namely that health-state preferences are independent of (1) duration of the state; (2) whose health it is (i.e. perspective); (3) length of 'lead time' (a mechanism to value all states on the same scale, including those who are worse than being dead); (4) when health events take place (time preference); and (5) satisfaction associated with the state. Further topics addressed were (6) exhaustion of lead time in the worst state; (7) health-state valuation using discrete choice experiments (DCEs) with a duration attribute; and (8) binary choice administration of lead time - time trade-off (LT-TTO). Stage 1 consisted of an online survey with 6000 respondents. Stage 2 compared the results above to those of an identical survey conducted in 200 face-to-face computer-assisted personal interviews (CAPIs), covering topics (1) to (7). Stages 3 and 4 examined - in more detail and depth - issues taken from stage 1. Stage 3 consisted of CAPI surveys of a representative UK sample of 300, using examples of TTO, LT-TTO, and DCE with duration, each followed by extensive feedback questions. Stage 4 was a more intensive exercise involving a qualitative analysis of people's thought processes during both binary choice and iterative health-state valuation exercises. Data were collected through 'think-aloud' methods in 30 interviews of a convenience sample.Stage 1 found that health-state values are not independent of (1) duration of the state but there is no clear pattern; (2) whose health it is; (3) the duration of 'lead time' but there was no clear pattern; (4) when health events tak...
Mulhern, B, Mukuria, C, Barkham, M, Knapp, M, Byford, S, Soeteman, D & Brazier, J 2014, 'Using generic preference-based measures in mental health: psychometric validity of the EQ-5D and SF-6D.', The British journal of psychiatry : the journal of mental science, vol. 205, no. 3, pp. 236-243.View/Download from: Publisher's site
BACKGROUND: Generic preference-based measures (EuroQoL-5D (EQ-5D) and SF-6D) are used in the economic evaluation of mental health interventions. However, there are inconsistent findings regarding their psychometric properties. AIMS: To investigate the psychometric properties of the EQ-5D and SF-6D in different mental health conditions, using seven existing data-sets. METHOD: The construct validity and responsiveness of the measures were assessed in comparison with condition-specific indicators. RESULTS: Evidence for construct validity and responsiveness in common mental health and personality disorders was found (correlations 0.22-0.64; effect sizes 0.37-1.24; standardised response means 0.45-1.31). There was some evidence for validity in schizophrenia (correlations 0.05-0.43), but responsiveness was unclear. CONCLUSIONS: EQ-5D and SF-6D can be used in the economic evaluation of interventions for common mental health problems with some confidence. In schizophrenia, a preference-based measure focused on the impact of mental health should be considered.
Mulhern, B, Rowen, D, Snape, D, Jacoby, A, Marson, T, Hughes, D, Baker, G & Brazier, J 2014, 'Valuations of epilepsy-specific health states: a comparison of patients with epilepsy and the general population.', Epilepsy and Behavior, vol. 36, pp. 12-17.View/Download from: Publisher's site
AIMS: Utility values that can be used in the economic evaluation of treatments for epilepsy can be elicited from the general population and the patient population, but it is unclear how the health state values differ. The aim of this study is to compare the preferences of the general population and a sample of people with epilepsy for health states described by the NEWQOL-6D QALY measure. METHODS: The Time Trade Off preference elicitation technique was used to value eight NEWQOL-6D health states. The general population sample was recruited and interviewed in their homes, and the sample with epilepsy was recruited and interviewed in an epilepsy service in North West England. Descriptive analysis and regression modeling were used to compare health state values across the populations. RESULTS: A sample of 70 people with epilepsy and a sample of 60 members of the general population were included. The populations differed across a range of background characteristics, but there were limited differences between the health state values. Patients provided significantly higher (better) values for the most severe health state described by the NEWQOL-6D (p<0.01) and nonsignificant higher values for states with intermediate severity. The general population health state value was only higher for the best health state described by the NEWQOL-6D. CONCLUSIONS: The similarities in the patient and general population values for NEWQOL-6D health states suggest that the use of the general population utility weights for the estimation of QALYs in the economic evaluation of epilepsy interventions is appropriate and largely representative of patient preferences.
O'Gorman, H, Mulhern, B, Brazier, J & Rotherham, N 2014, 'COMPARING THE EQUIVALENCE OF EQ-5D-5L ACROSS DIFFERENT MODES OF ADMINISTRATION', VALUE IN HEALTH, vol. 17, no. 7, pp. A517-A517.
Wong, CKH, Mulhern, B, Wan, Y-F & Lam, CLK 2014, 'Responsiveness was similar between direct and mapped SF-6D in colorectal cancer patients who declined.', Journal of Clinical Epidemiology, vol. 67, no. 2, pp. 219-227.View/Download from: Publisher's site
OBJECTIVES: To evaluate the responsiveness of generic and mapped preference-based measures based on the anchor of global change in health condition of colorectal cancer (CRC) patients. STUDY DESIGN AND SETTING: A baseline sample of 333 Chinese CRC patients was recruited between September 2009 and July 2010 and was surveyed prospectively at 6-month follow-up. Preference-based indices were derived from the generic SF-6D measure (SF-6DDirect), from the Short Form-12 (SF-6DSF-12), and mapped from the condition-specific Functional Assessment of Cancer Therapy-Colorectal (SF-6DFACT-C). Responsiveness of three measures was assessed using standardized effect size, standardized response mean, responsiveness statistic, and receiver operating characteristic (ROC) curve analysis. RESULTS: The SF-6DSF-12 and SF-6DFACT-C indices were significantly more responsive to detect positive changes than the SF-6DDirect index in improved groups. In worsened group, the SF-6DDirect and SF-6DFACT-C indices showed significant decline from baseline to 6-month follow-up. The areas under the ROC curve for SF-6DDirect and SF-6DFACT-C indices were not statistically different from 0.7. The SF-6DFACT-C index was more responsive to changes in health status compared with other indices. CONCLUSION: Direct SF-6D measure was more responsive than mapped preference-based measures in improved group but the direction was reversed in worsened group. The use of a preference-based index mapped from a condition-specific measure captures both negative and positive important changes among CRC.
Bewick, BM, West, RM, Barkham, M, Mulhern, B, Marlow, R, Traviss, G & Hill, AJ 2013, 'The Effectiveness of a Web-Based Personalized Feedback and Social Norms Alcohol Intervention on United Kingdom University Students: Randomized Controlled Trial', JOURNAL OF MEDICAL INTERNET RESEARCH, vol. 15, no. 7, pp. 106-116.View/Download from: Publisher's site
Mulhern, B & Meadows, K 2013, 'Investigating the minimally important difference of the Diabetes Health Profile and the EQ-5D and SF-6D in a diabetes mellitus population', Health, vol. 5, no. 6, pp. 1045-1054.View/Download from: Publisher's site
Objectives: It is important to know what patient
reported outcome measure (PROM) scores relate
to a meaningful change in health status
across time. The aim of this study was to investigate
the minimally important difference (MID)
of the Diabetes Health Profile (DHP-18), EQ-5D
and SF-6D in a Type 1 and Type 2 diabetes patient
sample. Methods: A longitudinal dataset
including a UK community sample of people
with Type 1 and Type 2 diabetes was used for the
analysis. A combination of anchor and distribution
methods was used to investigate the MID.
For the anchor based method, a global health
change indicator was used if it correlated with
the PROM scores at baseline and follow up. To
calculate the anchor based MID, the change in
PROM score for those reporting no change on
the anchor was subtracted from those reporting
small change. For the distribution based estimation,
the 1 Standard Error of Measurement,
0.5 and 0.33 standard deviation methods were
used. Results: The anchor was not correlated
with the DHP-18 dimensions so was only used to
estimate MID values for the EQ-5D and SF-6D.
For the DHP-18, MID estimates for the Psychological
Distress domain range from 6.99 to 10.59,
the Barriers to Activity domain range from 6.48
to 9.89, and the Disinhibited Eating domain
range from 7.52 to 11.39. The EQ-5D estimations
range from 0.058 to 0.158, and the SF-6D estimations
range from 0.038 to 0.081. The 0.5 SD
and 1SEM estimations are of a similar magnitude
across the three measures. Conclusions:
This study has derived a range of values for
each measure that may correspond to an important
change in health status. The MID values
may guide researchers who are using the
measures as part of their assessment of both
Type 1 and Type 2 patients with diabetes mellitus.
Mulhern, B, Longworth, L, Brazier, J, Rowen, D, Bansback, N, Devlin, N & Tsuchiya, A 2013, 'Binary Choice Health State Valuation and Mode of Administration: Head-to-Head Comparison of Online and CAPI', VALUE IN HEALTH, vol. 16, no. 1, pp. 104-113.View/Download from: Publisher's site
Mulhern, B, Rowen, D, Brazier, J, Smith, S, Romeo, R, Tait, R, Watchurst, C, Chua, K-C, Loftus, V, Young, T, Lamping, D, Knapp, M, Howard, R & Banerjee, S 2013, 'Development of DEMQOL-U and DEMQOL-PROXY-U: generation of preference-based indices from DEMQOL and DEMQOL-PROXY for use in economic evaluation', HEALTH TECHNOLOGY ASSESSMENT, vol. 17, no. 5, pp. 1-+.View/Download from: Publisher's site
Wong, CKH, Lam, CLK, Mulhern, B, Law, W-L, Poon, JTC, Kwong, DLW & Tsang, J 2013, 'Measurement invariance of the Functional Assessment of Cancer Therapy-Colorectal quality-of-life instrument among modes of administration', QUALITY OF LIFE RESEARCH, vol. 22, no. 6, pp. 1415-1426.View/Download from: Publisher's site
Mulhern, B, Brazier, J, Alonso, J, Connell, J, Papaioannou, D & Vilagut, G 2012, 'Are generic preference-based measures valid in mental health? A mixed methods enquiry', Quality of Life Research, vol. 21, pp. 1-1.
Mulhern, B, Brazier, JE, Rowen, D, Young, TA, Smith, SC & Banerjee, S 2012, 'Response to Comments on Mulhern et al., "Improving the Measurement of QALYs in Dementia: Developing Patient- and Carer-Reported Health State Classification Systems Using Rasch Analysis"', VALUE IN HEALTH, vol. 15, no. 5, pp. 787-788.View/Download from: Publisher's site
Mulhern, B, Rowen, D, Jacoby, A, Marson, T, Snape, D, Hughes, D, Latimer, N, Baker, GA & Brazier, JE 2012, 'The development of a QALY measure for epilepsy: NEWQOL-6D', EPILEPSY & BEHAVIOR, vol. 24, no. 1, pp. 36-43.View/Download from: Publisher's site
Mulhern, B, Smith, SC, Rowen, D, Brazier, JE, Knapp, M, Lamping, DL, Loftus, V, Young, TA, Howard, RJ & Banerjee, S 2012, 'Improving the Measurement of QALYs in Dementia: Developing Patient- and Carer-Reported Health State Classification Systems Using Rasch Analysis', VALUE IN HEALTH, vol. 15, no. 2, pp. 323-333.View/Download from: Publisher's site
Rowen, D, Mulhern, B, Banerjee, S, van Hout, B, Young, TA, Knapp, M, Smith, SC, Lamping, DL & Brazier, JE 2012, 'Estimating Preference-Based Single Index Measures for Dementia Using DEMQOL and DEMQOL-Proxy', VALUE IN HEALTH, vol. 15, no. 2, pp. 346-356.View/Download from: Publisher's site
Mulhern, B, Meadows, K, Rowen, D & Brazier, J 2011, 'Mapping between the DHP-18 and the EQ-5D', Value in Health, vol. 14, pp. A242-A242.
Bewick, BM, West, R, Gill, J, O'May, F, Mulhern, B, Barkham, M & Hill, AJ 2010, 'Providing Web-Based Feedback and Social Norms Information to Reduce Student Alcohol Intake: A Multisite Investigation', JOURNAL OF MEDICAL INTERNET RESEARCH, vol. 12, no. 5.View/Download from: Publisher's site
Rowen, D, Carlton, J, Brazier, JE, Mulhern, B, Palfreyman, S, Stevens, K & Tsuchiya, A 2010, 'FDA on PROMs Two important points', BRITISH MEDICAL JOURNAL, vol. 341.View/Download from: Publisher's site
Twigg, E, Barkham, M, Bewick, BM, Mulhern, B, Connell, J & Cooper, M 2009, 'The young person's CORE: Development of a brief outcome measure for young people', Counselling and Psychotherapy Research, vol. 9, no. 3, pp. 160-168.View/Download from: Publisher's site
Background: There is a need for a user-friendly measure of change for use in school and youth counselling services which is easy for practitioners to administer and score, and which is appropriate for brief interventions. Aims: To develop such a measure and to present psychometric data on reliability, validity and sensitivity to change for the measure. Method: We employed a three-stage approach: first, creating a pool of potential items; second, developing an 18-item version; and third, refining to a final version comprising 10 items. We called the measure the Young Person's CORE (YP-CORE). Results: The measure comprised eight negative and two positive items and included a single (negatively-framed) risk-to-self item. Psychometric properties were all acceptable. Sensitivity to change was good and yielded an average improvement of 10 points on the YP-CORE in a clinical group, broadly equivalent to changes in adult versions (e.g. Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM)). Conclusion: Initial validation work showed the measure to be well designed and sensitive to change. Analysis showed considerable variability as a function of age and gender suggesting the need for the collection of a large and diverse data set in order to produce gender and age-specific norms. © 2009 British Association for Counselling and Psychotherapy.
Bewick, BM, Gill, J, Mulhern, B, Barkham, M & Hill, AJ 2008, 'Using electronic surveying to assess psychological distress within the UK university student population: a multi-site pilot investigation', E-Journal of Applied Psychology, vol. 4, no. 2, pp. 1-5.
Bewick, BM, Mulhern, B, Barkham, M, Trusler, K, Hill, AJ & Stiles, WB 2008, 'Changes in undergraduate student alcohol consumption as they progress through university', BMC PUBLIC HEALTH, vol. 8.View/Download from: Publisher's site
Bewick, BM, Trusler, K, Barkham, M, Hill, AJ, Cahill, J & Mulhern, B 2008, 'The effectiveness of web-based interventions designed to decrease alcohol consumption - A systematic review', PREVENTIVE MEDICINE, vol. 47, no. 1, pp. 17-26.View/Download from: Publisher's site
Bewick, BM, Trusler, K, Mulhern, B, Barkham, M & Hill, AJ 2008, 'The feasibility and effectiveness of a web-based personalised feedback and social norms alcohol intervention in UK university students: A randomised control trial', ADDICTIVE BEHAVIORS, vol. 33, no. 9, pp. 1192-1198.View/Download from: Publisher's site
Turner, RN, Forrester, R, Mulhern, B & Crisp, RJ 2005, 'Impairment of executive abilities following a social category prime', Current Research in Social Psychology, vol. 11, no. 3, pp. 29-29.
Addo, R, Haywood, P, Mulhern, B, Reardon, O, Page, K & Sampson, C 2020, 'Comparing the EQ-5D descriptive system with quality of life measures used for people with cognitive impairment: Is ther overlap in what is measured?', 1st EuroQol Early Career Researcher Meeting, Prague, Czech Republic.
Haywood, P, Addo, R, Reardon, O, Page, K, Sampson, C, Mott, D, Shah, K, Janssen, B, Herdman, M & Mulhern, B 2020, 'Generating criteria for the development and selection of candidate bolt-on dimensions', 1st EuroQol Early Career Researcher Meeting, Prague, Czech Republic.
Comans, T, Nguyen, K-H, Mulhern, B & Ratcliffe, J 2019, 'Valuation of a New Dementia Specific Utility Instrument, the AD-5D', iHEA 2019 Congress: New Heights in Health Economics, Basel, Switzerland.
Hartman, J, Mulhern, B & Norman, R 2019, 'Non-Linear Time Preferences in Health Valuation', 35th EuroQol Plenary Meeting, Brussels, Belgium.
Janssen, B, Shah, K, Mulhern, B, Molla, PC & Mott, D 2019, 'Understanding what aspects of health and quality of life are important to people', ISOQOL 26th Annual Conference, San Diego, USA.
Mulhern, B & Brazier, J 2019, 'Utility Measures', International Society for Pharmacoeconomics and Outcomes Research, New Orleans, USA.
Peasgood, T, Mukuria, C, Brazier, J, Marten, O, Kreimeier, S, Luo, N, Mulhern, B, Greiner, W, Pickard, S, Augustovski, F, Engel, L, Belizan, M, Yang, Z & Monteiro, A 2019, 'Developing a new generic classifier of quality of life: initial results from the Extending the QALY (EQALY) psychometric surveys', ISOQOL 26th Annual Conference, San Diego, USA.
Peasgood, T, Mukuria, C, Brazier, J, Marten, O, Kreimeier, S, Luo, N, Mulhern, B, Greiner, W, Pickard, S, Augustovski, F, Engel, L, Belizan, M, Yang, Z & Monteiro, A 2019, 'Developing a new generic classifier of quality of life: initial results from the Extending the QALY (EQALY) psychometric surveys', 35th EuroQol Plenary Meeting, Brussels, Belgium.
Shah, K, Mulhern, B, Molla, PC, Janssen, B & Mott, D 2019, 'Understanding what aspects of health and quality of life are important to people', 35th EuroQol Plenary Meeting, Brussels, Belgium.
Haywood, P, Sampson, C, Addo, R, Herdman, M, Janssen, B, Mulhern, B, Page, K, Reardon, O, Rodes Sanchez, M, Schneider, J, Shah, K & Thetford, C 2019, 'Development Of EQ-5D-5L bolt-ons for cognition and vision', Value in Health, ISPOR Europe 2019, Elsevier, Copenhagen, Denmark, pp. S733-S733.View/Download from: Publisher's site
Mulhern, B, Norman, R, Street, D, Lancsar, E, Ratcliffe, J, Shah, K, Devlin, N, Meshcheriakova, O, Saing, S, Manipis, K, Addo, R, Nolasco, V, Brazier, J & Viney, R 2019, 'Valuing EQ-5D-5L: comparing the time trade off and discrete choice experiment valuation methods', 11th Meeting of the International Academy of Health Presference Research, Auckland, New Zealand.
Viney, R, Mulhern, B, Norman, R, Shah, K & Devlin, N 2019, 'Quality control vs. 'data curation': where should we draw the line in researcher judgements about the stated preference data used to value EQ-5D?', 35th EuroQol Plenary Meeting, Brussels, Belgium.
Viney, R, Mulhern, B, Norman, R, Street, D, Feng, Y, Shah, K, Lorgelly, P & Ratcliffe, J 2019, 'Are Results from Discrete Choice Experiments Similar to Time Trade-Off? Comparison of Health State Valuation Methods Using the EQ-5D-5L in an Australian General Population Sample', iHEA 2019 Congress, Basel, Switzerland.
Yu, WS, Mulhern, B, Norman, R, Viney, R, Stolk, E, Gudex, C, Augustovski, F, Tejada, RA, Jensen, CE, Jonker, M & Street, D 2019, 'A developmental perspective on DCE with duration for the valuation of health', 35th EuroQol Plenary Meeting, Brusells, Belgium.
Comans, T, Nguyen, H, Wu, Y-T & Mulhern, BJ 2018, 'Modelling disease progression and economic outcomes of dementia interventions: Exploring options for a complex health problem', ISPOR Asia Pacific 2018, Tokyo, Japan.
Engel, L, Whitehurst, D, Mihalopoulos, C & Mulhern, BJ 2018, 'Content analysis of condition-specific preference-based measures: Identifying overlapping dimensions with generic preference-based measures', EuroQol Plenary Meeting, Lisbon, Portugal.
Mulhern, BJ 2018, 'Measuring and valuing dementia related quality of life. Workshop Presentation', ISPOR Asia Pacific, Tokyo, Japan.
Nguyen, KH, Mulhern, BJ, Li, L, Comans, T, Welch, A & Ratcliffe, J 2018, 'Empirical comparison of BWS and DCE with duration in developing a health utility index for dementia', International Academy of Health Preference Research, Hobart.
Manipis, K, Mulhern, B, Pearce, A, Haywood, P, Viney, R & Goodall, S 2018, 'Estimating the willingness to pay to avoid the impacts of foodborne illnesses: A Discrete Choice Experiment', ISPOR Asia Pacific 2018, Tokyo, Japan.
Mulhern, BJ, Norman, R, Street, D, Lancsar, E, Ratcliffe, J, Shah, K, Lorgelly, P & Viney, R 2018, 'A comparison of the EQ-VT protocol and DCE with duration', EuroQol Plenary Meeting, Lisbon, Portugal.
Trevena, L, Mulhern, B, Viney, R & De Abreu Lourenco, R 2018, 'That's what I want to avoid: Do clinical recommendations on risk reduction mirror what the community wants to avoid?', PC4 Scientific Symposium, Sydney.
Brazier, J & Mulhern, B 2017, 'Utility measures - Short Course', International Society for Pharmacoeconomics and Outcomes Research 22nd Annual International Meeting, Boston, USA.
Marten, O, Bansback, N, Mulhern, B & Tsuchiya, A 2017, 'Modelling implausible EQ-5D-5L states: Prevalence in the general public and its effect on health state valuation – preliminary results [Conference Presentation]', 34th EuroQol Plenary Meeting, Barcelona.
Oppe, M, Janssen, MF, Luo, N, Mulhern, B & Craig, B 2017, 'DS-WG research: Where we are, how we got there, and where we are going', EuroQol Academy, Noordwijk, Netherlands.
Flattery, M, Mulhern, B, Norman, R, Viney, R, Street, D, Feng, Y, Addo, R, Manipis, K, Meshcheriakova, O & Saing, S 2017, 'Valuing EQ-5D-5L in Australia using an adapted EQ-VT: Informing the further development of a revised valuation protocol', 34th EuroQol Plenary Meeting, Barcelona.
Manipis, K, Mulhern, B, Haywood, P, Viney, R & Goodall, S 2017, 'Estimating the impact of paid and unpaid sick leave on preferences for avoiding the negative impacts of foodborne illnesses [conference presentation]', 39th Annual Australian Health Economics Society Conference, Sydney.
Mulhern, B, Norman, R, De Abreu Lourenco, R & Viney, R 2017, 'Investigating the relative value of health and social care related quality of life using discrete choice', International Society for Pharmacoeconomics and Outcomes Research 22nd Annual International Meeting, Boston, USA.
Mulhern, B, Norman, R, Viney, R, Street, D & Flattery, M 2017, 'Assessing the relationship between the EQ-5D-5L descriptive system and a range of outcome measures using psychometric and Rasch analysis [Conference Presentation]', 34th EuroQol Plenary Meeting, Barcelona.
Norman, R, Viney, R, Mulhern, B, Brazier, J, Ratcliffe, J, Lancsar, E, Lorgelly, P, Street, D & Flattery, M 2017, 'A large Australian DCE with duration and dead to value EQ-5D-5L health states [Conference Presentation]', 34th EuroQol Plenary Meeting, Barcleona.
Viney, RC, Mulhern, B, Norman, R & De Abreu Lourenco, R 2017, 'Investigating the relative value of health and social care related quality of life using discrete choice experiments [Conference Presentation]', iHEA Boston World Congress, Boston, USA.
Cole, A, Shah, K, Mulhern, B, Feng, Y & Devlin, N 2016, 'A New Approach to Presenting Health States in Stated Preference Valuation Studies', Value in Health, Elsevier, pp. A384-A385.
Mulhern, BJ & Brazier, J 2016, 'Utility measures (Workshop)', ISPOR 21st Annual International Meeting, Washington DC.
Rowen, D, Labeit, A, Brazier, J, Stevens, K, Elliott, J, Mulhern, B, Carlton, J & Basarir, H 2016, 'Valuing the impact of self-management on quality of life in diabetes using discrete choice experiments', Quality of Life Research, Springer Verlag (Germany).
Mulhern, BJ, De Abreu Lourenco, R & Viney, R 2016, 'Investigating the relative value of health and social care related quality of life using discrete choice', 38th Annual Australian Health Economics Society Conference, Perth.
Bansback, N, Mulhern, B, Sawatzky, R, Brazier, J & Whitehurst, DG 2015, 'Valuing the SF-6D Version 2 in Canada', QUALITY OF LIFE RESEARCH, SPRINGER, pp. 180-181.
Brazier, J & Mulhern, BJ 2015, 'Preference methods', ISPOR 20th Annual International Meeting, Philadelphia, USA.
Devlin, N, Shah, K, Mulhern, BJ & van Hout, B 2015, 'A new valuation method: direct eliciting personal utility functions for EQ-5D', EuroQol Group Plenary 2015, Krakow, Poland.
Kreimeier, S, Cole, A, Devlin, N, Herdman, A, Mulhern, BJ, Oppe, M, Shah, K, Stolk, E, Ramos-Goñi, JM, Rivero-Arias, O & Greiner, W 2015, 'Comparing valuation of the EQ-5D-Y and the EQ-5D-3L: The impact of wording and perspective', EuroQol Group Plenary 2015, Krakow, Poland.
Mulhern, BJ & Brazier, J 2015, 'Developing SF-6Dv2: The UK value set', ISPOR European Congress, Milan, Italy.
Mulhern, BJ, Bansback, N, Norman, R & Brazier, J 2015, 'Developing SF-6Dv2 utility weights for the UK using a Discrete Choice Experiment with duration', International Academy of Health Preference Research, Brisbane.
Mulhern, BJ, Bansback, N, Norman, R & Brazier, J 2015, 'Developing SF-6Dv2 utility weights for the UK using a Discrete Choice Experiment with duration', 37th Annual Australian Health Economics Society Conference, Brisbane.
Mulhern, BJ, Bjorner, J & Brazier, J 2015, 'Developing SF-6D-V2: examining the dimensionality of the SF-36 using large multinational datasets', ISPOR 20th Annual International Meeting, Philadelphia, USA.
Shah, K, Mulhern, BJ, Longworth, L & Janssen, MF 2015, 'Important aspects of (full) health not captured by EQ-5D', EuroQol Group Plenary 2015, Krakow, Poland.
Viney, R, Mulhern, BJ, Norman, R, Ratcliffe, J, Lorgelly, P, Lancsar, E & Brazier, J 2015, 'What is the impact of the order of EQ-5D-5L dimensions on health state values elicited using DCE with duration?', EuroQol Group Plenary 2015, Krakow, Poland.
Mulhern, B & Brazier, JE 2014, 'Developing version 2 of the SF-6D: The health state classification system', QUALITY OF LIFE RESEARCH, SPRINGER, pp. 49-49.
Mulhern, B, Feng, Y, Shah, K, van Hout, B, Janssen, MF, Herdman, M & Devlin, N 2017, 'Comparing the UK EQ-5D-3L and the English EQ-5D-5L Value Sets', Office of Health Economics Research Paper 17/02.
Devlin, N, Shah, K, Feng, Y, Mulhern, BJ & van Hout, B 2016, 'Valuing Health-Related Quality of Life: An EQ-5D-5L Value Set for England. Office of Health Economics Research Paper 16/01', Office of Health Economics Research Paper.
Feng, Y, Devlin, N, Shah, K, Mulhern, BJ & van Hout, B 2016, 'New Methods for Modelling EQ-5D-5L Value Sets: An Application to English Data. Office of Health Economics Research Paper 16/02', Office of Health Economics Research Paper.
Mulhern, B, Shah, KK, Janssen, MF & Longworth, L 2016, 'Important aspects of health not captured by EQ-5D: Views of the UK general public', EuroQol Working Paper 16001.
Mulhern, B, Shah, KK, Longworth, L & Janssen, MF 2015, 'Valuing EQ-5D-5L using TTO and DCE - Does dimension order impact on health state values?', EuroQol Working Paper 15002.
Shah, KL, Mulhern, BJ, Longworth, L & Janssen, B 2015, 'An empirical study of two alternative comparators for use in time trade-off studies. EuroQol Working Paper, 15001'.