Health state preference scores for children with permanent childhood hearing loss: a comparative analysis of the QWB and HUI3.
ABSTRACT The aim of this study was to compare two preference-weighted, caregiver-reported measures of health-related quality of life for children with permanent childhood hearing loss to determine whether cost-effectiveness analysis applied to deaf and hard of hearing populations will provide similar answers based on the choice of instrument.
Caregivers of 103 children in Arkansas, USA, with documented hearing loss completed the Quality of Well-Being Scale (QWB) and the Health Utilities Index Mark 3 (HUI3) to describe the health status of their children. Audiology and other clinical measures were abstracted from medical records. Mean scores were compared overall and by degree of hearing loss. Linear regression was used to correlate preference scores with a four-frequency pure-tone average, cochlear implant status, and other factors.
Mean preference scores for the QWB and HUI3 were similar (0.601 and 0.619, respectively) although the HUI3 demonstrated a wider range of values (-0.132 to 1.000) compared to the QWB (0.345-0.854) and was more sensitive to mild hearing loss. Both measures correlated with the pure-tone average, were negatively associated with comorbid conditions and positively associated with cochlear implant status. In the best fitting regression models, similar estimates for cochlear implant status and comorbid conditions were obtained from the two measures.
Despite considerable differences in the HUI3 and the QWB scale, we found agreement between the two instruments at the mean, but clinically important differences across a number of measures. The two instruments are likely to yield different estimates of cost-effectiveness ratios, especially for interventions involving mild to moderate hearing loss.
SourceAvailable from: Karen A Kuhlthau[Show abstract] [Hide abstract]
ABSTRACT: Purpose: To derive utility values associated with the health of children with autism spectrum disorders (ASD) and their parents, and describe how these utility values vary across different severity levels of ASD. Methods: Parents of children with and without ASD were selected from a nationally representative research panel to complete an internet survey. All survey respondents answered a series of time trade-off (TTO) questions to value their own current health state and their child’s current health state. Respondents were also asked socio-demographic and health questions regarding themselves and their child. Parents of children with ASD were asked to report the severity of their child’s ASD symptoms. We calculated utility values from each TTO amount. Regression analyses estimated the change in child health utility associated with ASD diagnosis and increasing symptom severity. Separate regression analyses evaluated the change in parent health utility associated with having a child with ASD. These regression analyses controlled for respondent socio-demographic characteristics, child’s gender, age, insurance status and other non-ASD related illnesses, as well as the presence of other children in the household. Results: We received responses from 69% of parents. Nine percent of respondents were eliminated from the analysis sample due to missing or invalid responses, leaving a final analysis sample size of 255 (135 parents of children with ASD and 120 parents of children without ASD). In adjusted analyses, having any form of ASD was significantly associated with a 0.26 (95% CI: 0.16-0.36) decrease in child health utility, compared to children without ASD. Having a child with ASD was significantly associated with 0.07 (95% CI: 0.02-0.12) decrease in parent health utility, compared to parents of children without ASD. The highest severity level of ASD was significantly associated with a 0.31 (95% CI: 0.12-0. 52) reduction in child health utility and a 0.18 (95% CI: 0.06-0.32) reduction in parent health utility. Conclusions: ASD has a large impact on child health utility values, and this impact is influenced by the severity of the child’s symptoms. In addition, having a child with ASD is associated with a significant decrease in parent health utility.The 34th Annual Meeting of the Society for Medical Decision Making; 10/2012
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ABSTRACT: PURPOSE: This review examines psychometric performance of three widely used generic preference-based measures, that is, EuroQol 5 dimensions (EQ-5D), Health Utility Index 3 (HUI3) and Short-form 6 dimensions (SF-6D) in patients with hearing impairments. METHODS: A systematic search was undertaken to identify studies of patients with hearing impairments where health state utility values were measured and reported. Data were extracted and analysed to assess the reliability, validity (known group differences and convergent validity) and responsiveness of the measures across hearing impairments. RESULTS: Fourteen studies (18 papers) were included in the review. HUI3 was the most commonly used utility measures in hearing impairment. In all six studies, the HUI3 detected difference between groups defined by the severity of impairment, and four out of five studies detected statistically significant changes as a result of intervention. The only study available suggested that EQ-5D only had weak ability to discriminate difference between severity groups, and in four out of five studies, EQ-5D failed to detected changes. Only one study involved the SF-6D; thus, the information is too limited to conclude on its performance. Also evidence for the reliability of these measures was not found. CONCLUSION: Overall, the validity and responsiveness of the HUI3 in hearing impairment was good. The responsiveness of EQ-5D was relatively poor and weak validity was suggested by limited evidence. The evidence on SF-6D was too limited to make any judgment. More head-to-head comparisons of these and other preference measures of health are required.Quality of Life Research 05/2013; DOI:10.1007/s11136-013-0417-6 · 2.86 Impact Factor
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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