Evaluation of the Health Utilities Index Mark-3 in heart failure.
ABSTRACT The purpose of this study was to evaluate the reliability, validity, and responsiveness to change of the Health Utilities Index Mark-3 (HUI-3) in heart failure (HF) for use in cost-effectiveness studies.
Two hundred eleven patients with HF recruited from outpatient clinics were enrolled; 165 completed the 26-week study. Patients completed 4 health-related quality of life questionnaires (baseline and 4, 8, and 26 weeks), including the HUI-3, the Medical Outcomes Study Short-form 12 (SF-12), the Minnesota Living with Heart Failure Questionnaire (LHFQ), and the Chronic Heart Failure Questionnaire (CHQ). The HUI-3 indicated moderate or fair health-related quality of life overall; the attributes most impaired were pain, ambulation, cognition, and emotion. Internal consistency reliability (Cronbach's alpha = 0.51) was low and test-retest reliability (intraclass correlation coefficient = 0.68) was adequate. The HUI-3 total score was significantly associated with the SF-12, LHFQ, and CHQ total scores. It discriminated among patients with varying New York Heart Association class (P < .001) and varying perceived health (P < .001). The HUI-3 was less responsive to perceived change in health condition than the LHFQ or the CHQ.
The HUI-3 demonstrated satisfactory reliability and validity in this sample supporting its use in cost-effectiveness studies.
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ABSTRACT: The HEALTH UTILITIES INDEX(®) (HUI(®)) is a family of systems designed to measure utility scores of health-related quality of life for comprehensive health states. There are two current HUI systems: HUI2 and HUI3. Since no Thai version of self-administered HUI was available, the study objective was to translate and test the psychometric properties of the HUI self-complete Thai-language questionnaire in terms of practicality, reliability, validity and responsiveness. A convenience sample of 216 outpatients with ischemic heart disease (IHD) was selected. Mean age was 60.3 ± 7.2 (range 37-77) and 37.2 % were males. The floor and ceiling effects of the total scores for both HUI were <15 %. The intraclass correlation coefficients were from moderate to high for all attributes and total scores. The correlations of HUI2 and HUI3 when compared with the EQ-5D and MacNew global scores were high (Spearman's rho > 0.5, P < 0.001). Discriminant validity was proved among three groups of different specific activity scale classes (P < 0.001). The effect size was the highest (0.92) in the patients reporting worsened health status assessed by the HUI2. In conclusion, both of the HUIs demonstrated conditionally satisfactory psychometric properties in the patients with IHD.Quality of Life Research 10/2012; · 2.86 Impact Factor
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ABSTRACT: BACKGROUND:: The goal of comparative effectiveness research (CER) is to explain the differential benefits and harms of alternate methods to prevent, diagnose, treat, and monitor a clinical condition or to improve the delivery of care. To inform decision making, information from the patient's perspective that reflects outcomes that patients care about are needed and can be collected rigorously using appropriate patient-reported outcomes (PRO). It can be challenging to select the most appropriate PRO measure given the proliferation of such questionnaires over the past 20 years. OBJECTIVE:: In this paper, we discuss the value of PROs within CER, types of measures that are likely to be useful in the CER context, PRO instrument selection, and key challenges associated with using PROs in CER. METHODS:: We delineate important considerations for defining the CER context, selecting the appropriate measures, and for the analysis and interpretation of PRO data. Emerging changes that may facilitate CER using PROs as an outcome are also reviewed including implementation of electronic and personal health records, hospital and population-based registries, and the use of PROs in national monitoring initiatives. The potential benefits of linking the information derived from PRO endpoints in CER to decision making is also reviewed. CONCLUSIONS:: The recommendations presented for incorporating PROs in CER are intended to provide a guide to researchers, clinicians, and policy makers to ensure that information derived from PROs is applicable and interpretable for a given CER context. In turn, CER will provide information that is necessary for clinicians, patients, and families to make informed care decisions.Medical care 08/2012; · 3.24 Impact Factor
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ABSTRACT: Context/objectives: To describe the relationships between secondary health conditions and health preference in a cohort of adults with chronic spinal cord injury (SCI). Cross-sectional telephone survey. Community. Community-dwelling adult men and women (N = 357) with chronic traumatic and non-traumatic SCI (C1-L3 AIS A-D) who were at least 1 year post-injury/onset. Not applicable. Health Utilities Index-Mark III (HUI-Mark III) and SCI Secondary Conditions Scale-Modified (SCS-M). SCS-M responses for different secondary health conditions were used to create "low impact = absent/mild" and "high impact = moderate/significant" secondary health condition groups. Analysis of covariance was used to examine differences in HUI-Mark III scores for different secondary health conditions while controlling for impairment. The mean HUI-Mark III was 0.24 (0.27, range, -0.28 to 1.00). HUI-Mark III scores were lower (P < 0.001) in high impact groups for spasms, bladder and bowel dysfunction, urinary tract infections, autonomic dysreflexia, circulatory problems, respiratory problems, chronic pain, joint pain, psychological distress, and depression compared with the low impact groups. As well, HUI-Mark III scores were lower (P < 0.05) in high impact groups for pressure sores, unintentional injuries, contractures, heterotopic bone ossification, sexual dysfunction, postural hypotension, cardiac problems, and neurological deterioration than low-impact groups. High-impact secondary health conditions are negatively associated with health preference in persons with SCI. Although further work is required, the HUI-Mark III data may be a useful tool for calculating quality-adjusted life years, and advocating for additional resources where secondary health conditions have substantial adverse impact on health.The journal of spinal cord medicine 09/2012; 35(5):361-70. · 1.54 Impact Factor