Measuring Carer Outcomes in an Economic Evaluation: A Content Comparison of the Adult Social Care Outcomes Toolkit for Carers, Carer Experience Scale, and Care-Related Quality of Life Using Exploratory Factor Analysis

Abstract

Background. To incorporate the spillover effects experienced by carers providing informal care in health policy decisions, new carer-related preference-based measures have been developed for use in economic evaluation, which include the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer), Carer Experience Scale (CES), and Care-Related Quality of Life (CarerQoL). The aim of this study was to investigate the extent to which these 3 instruments measure complementary or overlapping constructs. Methods. Data were derived from an online survey undertaken with carers residing in Australia. An exploratory factor analysis was conducted to ascertain the underlying latent constructs of the 3 measures. Results. Data from 351 informal carers yielded a 5-factor model describing general quality of life outside caring, problems due to caring, fulfilment from caring, social support with caring, and relationship with the care recipient. Most of the ASCOT-Carer and the CarerQol items loaded onto the first and second factors, respectively. The greatest overlap was observed between CarerQol and CES items loading onto the other 3 shared common factors. Limitations. Online data collection resulted in inconsistent responses, which had to be removed to yield logical data. A convenience sampling approach may have compromised the generalizability of study findings. Conclusion. Although some overlap was observed, the 3 carer-related preference-based measures seem to tap into different constructs of carer-related quality of life and caring experiences and cannot be used interchangeably.

Head-to-Head Comparison of the Psychometric Properties of 3 Carer-Related Preference-Based Instruments

“…Content validity was explored using qualitative and quantitative approaches and will be reported separately. 58 The focus of feasibility and internal consistency was the descriptive systems. For all other analyses, preference weights were also taken into account.…”

Addressing fraudulent responses in online surveys: Insights from a web‐based participatory mapping study

“…Typically, discovering suspicious data is the first sign that fraudulent responses have occurred (Conrique et al, 2020;Kok & Barendregt, 2021;Storozuk et al, 2020). Despite progress in addressing fraud, it is still presumed that fraudulent behaviour is relatively rare, that current deterrence will prevent widespread fraud and that fraud is committed chiefly by bots that are easily screened through CAPTCHAS (bot checks), honeypot questions (trick questions to catch bots or lazy responders) and straight-liner checks (wherein respondents are deemed fraudulent for choosing only the first choice, for example on every question; Engel et al, 2020;Underhill & Rimmer, 2019;Wardropper et al, 2021).…”

“…Despite progress in addressing fraud, it is still presumed that fraudulent behaviour is relatively rare, that current deterrence will prevent widespread fraud and that fraud is committed chiefly by bots that are easily screened through CAPTCHAS (bot checks), honeypot questions (trick questions to catch bots or lazy responders) and straight‐liner checks (wherein respondents are deemed fraudulent for choosing only the first choice, for example on every question; Engel et al., 2020; Underhill & Rimmer, 2019; Wardropper et al., 2021). Although bots and bot‐like behaviour tend to receive the most focus from fraud studies (Bybee et al., 2021; Dupuis et al., 2019; Godinho et al., 2020; Griffin et al., 2021; Kuriakose & Robbins, 2015), rigorous methodological approaches and bot‐detection mechanisms have advanced sufficiently to quickly identify bots who find and target surveys for the same reasons as other fraudster types (Buchanan & Scofield, 2018; Prince et al., 2012).…”

How well do the adult social care outcomes toolkit for carers, carer experience scale and care-related quality of life capture aspects of quality of life important to informal carers in Australia?

“…Studies in England have also compared ASCOT-Carer, CES, CarerQol and EuroQol-5 Dimension-5 level (EQ5D-5L) [ 14 , 16 ]. These studies indicate that the instruments tap into different constructs of carer-related QoL and caring experiences, reflecting the original purpose of the instruments and suggests the ASCOT-Carer, CES and CarerQol cannot be used interchangeably [ 16 , 17 ]. The ASCOT-Carer was developed to measure social care-related QoL and support of carers in the setting of policy and formal support interventions [ 5 , 18 ].…”