Validation of disability categories derived from Health Utilities Index Mark 3 scores

Income Statistics Division, Statistics Canada, Ottawa, Ontario, K1A 0T6.
Health reports / Statistics Canada, Canadian Centre for Health Information = Rapports sur la santé / Statistique Canada, Centre canadien d'information sur la santé (Impact Factor: 2.67). 07/2009; 20(2):43-50.
Source: PubMed


To establish empirical evidence for the validity of the following disability categories derived from Health Utilities Index Mark III (HUI3) global utility scores: none (1.00), mild (0.89 to 0.99), moderate (0.70 to 0.88), and severe (less than 0.70).
Data from the 2005 Canadian Community Health Survey (cycle 3.1) were analyzed. Frequency distributions, stratum-specific likelihood ratios, and multinomial regression were used to examine the relationship between health indicators and the HUI3 disability categories.
People reporting chronic conditions, activity restrictions, and fair/poor self-rated health (general and mental) were more likely to be in the moderate and severe disability categories. Those having more positive outcomes on the health indicators tended to fall into the mild and no disability groups. The stratum-specific likelihood ratios increased monotonically with the severity of disability level. Compared to those with positive health status characteristics, those with negative health status characteristics had the highest odds of falling in the severe rather than the non-disabled category.
This study makes an initial contribution to the evidence base for the validity of the proposed HUI3 disability categories. The categories were well-supported empirically and are likely to be useful for assessing disability levels.

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    • "It was a common convention in these articles to mention several statistical programs with the most frequent combination being SAS and SUDAAN. Upon further analysis (not presented) we found that the majority references of the SUDAAN statistical application was the result of being used in conjunction with SAS for its callable bootstrapping procedures [15,16]. "
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    ABSTRACT: The Canadian Community Health Survey (CCHS) is a cross-sectional survey that has collected information on health determinants, health status and the utilization of the health system in Canada since 2001. Several hundred articles have been written utilizing the CCHS dataset. Previous analyses of statistical methods utilized in the literature have focused on a particular journal or set of journals to understand the statistical literacy required for understanding the published research. In this study, we describe the statistical methods referenced in the published literature utilizing the CCHS dataset(s). A descriptive study was undertaken of references published in Medline, Embase, Web of Knowledge and Scopus associated with the CCHS. These references were imported into a java application utilizing the searchable Apache Lucene text database and screened based upon pre-defined inclusion and exclusion criteria. Full-text PDF articles that met the inclusion criteria were then used for the identification of descriptive, elementary and regression statistical methods referenced in these articles. The identification of statistical methods occurred through an automated search of key words on the full-text articles utilizing the java application. We identified 4811 references from the 4 bibliographical databases for possible inclusion. After exclusions, 663 references were used for the analysis. Descriptive statistics such as means or proportions were presented in a majority of the articles (97.7%). Elementary-level statistics such as t-tests were less frequently referenced (29.7%) than descriptive statistics. Regression methods were frequently referenced in the articles: 79.8% of articles contained reference to regression in general with logistic regression appearing most frequently in 67.1% of the articles. Our study shows a diverse set of analysis methods being referenced in the CCHS literature, however, the literature heavily relies on only a subset of all possible statistical tools. This information can be used in identifying gaps in statistical methods that could be applied to future analysis of public health surveys, insight into training and educational programs, and also identifies the level of statistical literacy needed to understand the published literature.
    BMC Medical Research Methodology 01/2014; 14(1):15. DOI:10.1186/1471-2288-14-15 · 2.27 Impact Factor
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    • "The mean WHOQoL score on the “Psychological” domain was tested against the mean score on “Social relationships” with a paired t-test. MAU can be categorized into four levels of disability: none, mild, moderate and severe [21]. Categorization of the MAU score and the eight single attributes score (X) was based on X=1 (none), 1>X>0.90 "
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    ABSTRACT: Background It is important to know the impact of Very Preterm (VP) birth or Very Low Birth Weight (VLBW). The purpose of this study is to evaluate changes in Health-Related Quality of Life (HRQoL) of adults born VP or with a VLBW, between age 19 and age 28. Methods The 1983 nationwide Dutch Project On Preterm and Small for gestational age infants (POPS) cohort of 1338 VP (gestational age <32 weeks) or VLBW (<1500 g) infants, was contacted to complete online questionnaires at age 28. In total, 33.8% of eligible participants completed the Health Utilities Index (HUI3), the London Handicap Scale (LHS) and the WHOQoL-BREF. Multiple imputation was applied to correct for missing data and non-response. Results The mean HUI3 and LHS scores did not change significantly from age 19 to age 28. However, after multiple imputation, a significant, though not clinically relevant, increase of 0.02 on the overall HUI3 score was found. The mean HRQoL score measured with the HUI3 increased from 0.83 at age 19 to 0.85 at age 28. The lowest score on the WHOQoL was the psychological domain (74.4). Conclusions Overall, no important changes in HRQoL between age 19 and age 28 were found in the POPS cohort. Psychological and emotional problems stand out, from which recommendation for interventions could be derived.
    Health and Quality of Life Outcomes 03/2013; 11(1):51. DOI:10.1186/1477-7525-11-51 · 2.12 Impact Factor
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    • "Also, a Weighted Single Attribute Score (WSAS) may be calculated for each attribute. MAU and WSAS may be categorized into four levels of disability: none, mild, moderate and severe [26,27]. Respondents are the patients themselves, or proxies such as parents. "
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    ABSTRACT: The purpose was, first, to evaluate changes in health-related quality of life (HRQL) in a cohort of very low birth weight (VLBW; <1500 g.) or very preterm (< 32 weeks of gestation) children between ages 14 and 19, and second, to identify correlates of HRQL at age 19. HRQL was assessed using the Health Utilities Index Mark 3 (HUI3). In order to explore correlates of HRQL, we performed a hierarchical regression analysis. Surviving VLBW children (n = 959) from a 1983 Dutch nation-wide cohort were eligible; 630 participated both at age 14 and 19; 54 at age 19 only. The mean HRQL score decreased from 0.87 to 0.86. The HRQL of 45% was stable, 25% were better and 30% were worse. A regression model showed internalizing problems were related most strongly to HRQL. In the transition from adolescence to young adulthood, HRQL in Dutch VLBW children was stable at the group level but varied at the individual level. HRQL was negatively associated with internalizing problems and also with physical handicaps. Long-term follow-up studies on the impact of VLBW on HRQL are all the more called for, given the growing number of vulnerable infants surviving the neonatal period.
    Health and Quality of Life Outcomes 05/2012; 10(1):49. DOI:10.1186/1477-7525-10-49 · 2.12 Impact Factor
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