Luo N, Johnson JA, Shaw JW, et al. Self-reported health status of the general adult US population as assessed by the EQ-5D and Health Utilities Index

Thomas Jefferson University, Filadelfia, Pennsylvania, United States
Medical Care (Impact Factor: 2.94). 12/2005; 43(11):1078-86. DOI: 10.1097/01.mlr.0000182493.57090.c1
Source: PubMed

ABSTRACT This study aimed to describe the self-reported health status of the general adult U.S. population using 3 multi-attribute preference-based measures: the EQ-5D, Health Utilities Index Mark 2 (HUI2), and Mark 3 (HUI3).
We surveyed the general adult U.S. population using a probability sample with oversampling of Hispanics and non-Hispanic blacks. Respondents to this home-visit survey self-completed the EQ-5D and HUI2/3 questionnaires. Overall health index scores of the target population and selected subgroups were estimated and construct validity of these measures was assessed by testing a priori hypotheses.
Completed questionnaires were collected from 4048 respondents (response rate: 59.4%). The majority of the respondents were women (52.0%); the mean age of the sample was 45 years, with 14.8% being 65 or older. Index scores (standard errors) for the general adult U.S. population as assessed by the EQ-5D, HUI2, and HUI3 were 0.87 (0.01), 0.86 (0.01), and 0.81 (0.01), respectively. Generally, younger, male and Hispanic or non-Hispanic black adults had higher (better) index scores than older, female and other racial/ethnic adults; index scores were higher with higher educational attainment and household income. The 3 overall preference indices were strongly correlated (Pearson's r: 0.67-0.87), but systematically different, with intraclass correlation coefficients between these indices ranging from 0.59 to 0.77.
This study provides U.S. population norms for self-reported health status on the EQ-5D, HUI2, and HUI3. Although these measures appeared to be valid and demonstrated similarities, health status assessed by these measures is not exactly the same.

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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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    • "Secondary outcomes included pain unpleasantness [27], Physical and Mental Component Summary Scales of the short-form 12 [28], Health State Visual Analog Scale from EuroQol [29], perceived pain and disability improvement , and the number of the following in the previous 4 weeks: days with pain and disability and medication use. Additional baseline variables included demographics, Fear-Avoidance Beliefs Questionnaire [30], confidence in treatment success [14], and any from a list of comorbid conditions (arthritis, asthma or allergies, gastrointestinal problems, gynecological problems, hypertension, or other chronic condition) [31]. "
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    • "The EQ-5D utility can also be used to calculate so-called Quality Adjusted Life Years (QALY), where 1 QALY is the equivalent of one year spent in perfect health (i.e., with a utility score of 1). Various studies confirm that BPD indeed is associated with a severely decreased HRQoL with EQ-5D values ranging from 0.48 to 0.52 [35] [24] [29], as HRQoL in the general population as measured with the EQ-5D in various countries has been found to range between 0.83 and 0.87 [5] [19] [30]. There is consensus that newly developed instruments for measuring health status should be tested for validity and reliability before they can be used in clinical studies. "
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