Background: To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes' Adoption (DACHA) study, we assessed the construct validity of QoL measures and analysed factors associated with QoL. This was to demonstrate the value of the pilot MDS data and to provide evidence for the inclusion of QoL measures in a future MDS. Methods: Care home records for 679 residents aged over 65 from 34 care homes were available that had been linked to health records and official care home provider data. In addition to data on demographics, level of needs and impairment, several questions about the social care- and health-related QoL of participants were completed through proxy report (ASCOT proxy-resident, ICECAP-O, EQ5D-5D-5L Proxy 2). Construct validity was assessed through testing hypotheses developed from previous research and QoL measure constructs using discriminant analysis. Multilevel regression models were developed to understand how QoL was influenced by personal characteristics (e.g. sex, levels of functional and cognitive ability), care home level factors (type of home, level of quality) and resident use of health services (potentially avoidable emergency hospital admissions). Multiple imputation was used for missing data. Results: All three measures were negatively associated with levels of cognitive impairment, whilst ICECAP-O and EQ-5D-5L Proxy 2 were negatively associated with low levels of functional ability. ASCOT Proxy-Resident was positively associated with aspects of quality and care effectiveness at both resident- and care home-level. All three QoL measures had acceptable construct validity and captured different aspects of QoL. Conclusion: The study found acceptable construct validity for ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L Proxy 2 in care homes as complementary measures based on different constructs. The study has demonstrated both the value of the DACHA study pilot MDS data and a rationale for the inclusion of these QoL measures in any future MDS.

Authors SA, SR, AMT and NS are part of the developer team for the ASCOT. AG has received honoraria from Gilead Sciences and Pfizer for consultancy work undertaken in relation to COVID-19 in care homes.

https://bmjopen.bmj.com/content/13/2/e071686

This project is funded by the National Institute for Health Research (NIHR) Health Service Research and Delivery programme (HS&DR NIHR127234) and supported by the NIHR Applied Research Collaboration (ARC) East of England. AMT, AG, KS, AK and CG are supported by the NIHR Applied Research Collaborations in Kent, Surrey and Sussex; East Midlands; Yorkshire and Humber and East of England, respectively. AG, KS and CG are NIHR Senior Investigators. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The London Queens Square Research Ethics Committee gave ethical approval for this work (22/LO/0250).

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I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

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Anonymised data extracted from digital care records will be available on request from the corresponding author, SA, following a 24 month embargo from the date of publication.