Relative Efficiency of the EQ-5D, HUI2, and HUI3 Index Scores in Measuring Health Burden of Chronic Medical Conditions in a Population Health Survey in the United States

Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Medical care (Impact Factor: 3.23). 02/2009; 47(1):53-60. DOI: 10.1097/MLR.0b013e31817d92f8
Source: PubMed


We sought to compare the ability of the EQ-5D, Health Utilities Index Mark 2 (HUI2), and HUI Mark 3 (HUI3) index scores to discriminate between respondents based on the presence or absence of chronic medical conditions in a population health survey.
Secondary analyses were conducted with data from a probability sample (n = 3480, mean age: 42.5 years, male: 42.4%, Hispanic: 28.6%) of the 2001 noninstitutionalized US general adult population. F-statistic ratios were used to evaluate the relative efficiency of the EQ-5D, HUI2, and HUI3 in differentiating respondents with or without each of 18 chronic medical conditions, and differentiating respondents with low- or high-burden conditions.
In comparing respondents with and without chronic medical conditions, the F-statistic values of these 3 indices were not significantly different, except for EQ-5D versus HUI2 [mean F-statistic ratio: 0.79, 95% confidence interval (CI): 0.59-0.98]. In comparing respondents with a low-burden condition with those with a high-burden condition, the F-statistic values of EQ-5D and HUI2 index scores were similar, while those for EQ-5D versus HUI3 (mean: 0.79; 95% CI: 0.66-0.92) and for HUI2 versus HUI3 (mean: 0.83; 95% CI: 0.71-0.95) were significantly less than 1.0. The overall ceiling effects of the EQ-5D, HUI2, and HUI3 index scores were 48.9%, 15.4%, and 15.3%, respectively.
Although the EQ-5D seems to be marginally less informative, the EQ-5D, HUI2, and HUI3 index scores were generally comparable in determining health burden of chronic medical conditions in this population health survey data.

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    • "The EQ-5D is a widely used health utility index that can be derived from SF-36 scales [26]. It provides a single general measure of health status that can be used in economic analyses and to track the impact of healthcare interventions, and has been shown to be useful in a number of conditions [27] [28] [29] [30] [31] [32]. "
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    ABSTRACT: Objective: Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. Methods: The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. Results: The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. Conclusion: The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. Practice implications: FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy.
    Patient Education and Counseling 05/2014; 96(3). DOI:10.1016/j.pec.2014.05.005 · 2.20 Impact Factor
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    • "The magnitude of score changes reported in the literature were used to assess whether effect sizes reached or exceeded the minimal clinically important differences (MCID) for each measure: EQ-5D utility score—0.03 to 0.07 [20,21]; I-QOL subscales—4 to 11 [13]; OAB-q HRQoL score—5 [22,23]; OAB-q symptom severity score—10 [22,23]. MCIDs for WPAI have been validated only in patients with insomnia and Crohn’s disease [24,25], and thus were deemed insufficiently reliable to be used for comparisons. "
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    • "The EQ-5D questionnaire was selected because it has been used in testing, albeit in a limited way in breast biopsy [22] [23]. The EQ-5D questionnaire has pronounced ceiling effects in prior literature [24] [25] [26]. The version used for many years has three levels in each of five attributes, allowing for 243 health states. "
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