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: 3.31). 07/2009; 20(2):43-50.
Source: PubMed

ABSTRACT 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.

  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the validity of the Patient Activation Measure (PAM13) of patient activation in persons with neurological conditions. "The Everyday Experience of Living with and Managing a Neurological Condition" (The LINC study) surveyed 948 adults with neurological conditions residing in Canada in 2011 and 2012. Using data for 722 respondents who met coding requirements for the PAM-13, we examined the properties of the measure using principle components analysis, inter-item correlations and Cronbach's alpha to assess unidimensionality and internal consistency. Rasch modeling was used to assess item performance and scaling. Construct validity was assessed by calculating associations between the PAM and known correlates. PAM-13 provides a suitably reliable and valid instrument for research in patients with neurological conditions, but scaling problems may yield measurement error and biases for those with low levels of activation. This is of particular importance when used in clinical settings or for individual client care. Our study also suggests that measurement of activation may benefit from tailoring items and scaling to specific diagnostic groups such as people with neurological conditions, thus allowing the PAM-13 to recognize unique attributes and management challenges in those conditions. The PAM-13 is an internally reliable and valid tool for research purposes. The use of categorical activation "level" in clinical settings should be done with caution.
    Quality of Life Research 01/2015; DOI:10.1007/s11136-014-0908-0 · 2.86 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The prevalence of depression in multiple sclerosis (MS) is known to be elevated, but nearly all available studies have estimated period prevalence. The objective of this study was to estimate the point prevalence of depression in a representative community sample using the Patient Health Questionnaire, Brief (PHQ-9). The data source for this study was the Survey of Living with Neurological Conditions in Canada, which was derived from a representative sample of household residents. The sample included 630 respondents with MS. With application of the standard PHQ-9 cut point (10+), the prevalence of depression was 26.0% (95% confidence interval 18.9%-33.0%). Depressed subjects had lower quality of life; an increased frequency of suicidal ideation; and more often reported a negative disease course, high stress, low social support and stigmatization. This study adds to the existing literature by providing point prevalence data: in any 2-week period, about one quarter of community residents with MS experience substantial levels of depressive symptoms.
    General hospital psychiatry 01/2014; DOI:10.1016/j.genhosppsych.2013.12.011 · 2.67 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objectives The objectives of the study were (1) to validate the Chinese version of Health Utilities Index (HUI-Ch); (2) to examine the Health-related Quality of Life (HRQoL) of Chinese subjects with Down syndrome (DS); and (3) to study the impact of chronic health conditions on HRQoL of Chinese with DS.Methods The multiple choice questionnaire for scoring Health Utilities Index Mark 2 (HUI2) and Health Utilities Index Mark 3 (HUI3) was translated and validated. In addition to the HRQoL scores from HUI2 and HUI3, proxy-data on socio-demographics, and 10 common chronic health conditions for people with DS were collected and analyzed. Data analysis involves multiple imputation and multiple regression analysis to predict variations in HRQoL in relation to different factors. Lastly, a gradient interval was constructed on the number of chronic health conditions in relation to HRQoL.ResultsHUI-Ch was validated according to standard guidelines. People with DS were found to have a lower HRQoL as compared to the general population, with the majority categorized as moderate or severe on the scale. Behavioral and hearing problems on HUI2, and hearing problems on HUI3 were found to be statistically significant predictors of a lower HRQoL score. A significant gradient relationship existed showing when the number of health problems increased, the HRQoL scores decreased.ConclusionsHUI-Ch is a valid instrument to assess HRQoL. It can have broad application in Chinese subjects with DS including the study of the impact of different chronic health conditions on their quality of life. The quantifiable nature of HUI-Ch will facilitate longitudinal study on the well-being of subjects with DS and evaluation of effectiveness of intervention programs in the near future.
    Health and Quality of Life Outcomes 10/2014; 12(1):144. DOI:10.1186/s12955-014-0144-x · 2.10 Impact Factor

Full-text (2 Sources)

Available from
May 31, 2014