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
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.
- SourceAvailable from: Drenna Waldrop-Valverde
[Show abstract] [Hide abstract]
- "The EQ-5D is a widely used health utility index that can be derived from SF-36 scales . 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      . "
ABSTRACT: Objective: Researchers have identified significant limitations in some currently used measures of health literacy. The purpose of this paper is to present data on the relation of health-related quality of life, health status, and health service utilization to performance on a new measure of health literacy in a nonpatient population. Methods: The new measure was administered to 475 English- and Spanish-speaking community-dwelling volunteers along with existing measures of health literacy and assessments of health-related quality of life, health status, and healthcare service utilization. Relations among measures were assessed via correlations and health status and utilization was tested across levels of health literacy using ANCOVA models. Results: The new health literacy measure is significantly related to existing measures of health literacy as well as to participants' health-related quality of life. Persons with lower levels of health literacy reported more health conditions, more frequent physical symptoms, and greater healthcare service utilization. Conclusion: The new measure of health literacy is valid and shows relations to measures of conceptually related constructs such as quality of life and health behaviors. Practice implications: FLIGHT/VIDAS may be useful to researchers and clinicians interested in a computer administered and scored measure of health literacy.Patient Education and Counseling 05/2014; 96(3). DOI:10.1016/j.pec.2014.05.005 · 2.60 Impact Factor
[Show abstract] [Hide abstract]
- "Secondary outcomes included pain unpleasantness , Physical and Mental Component Summary Scales of the short-form 12 , Health State Visual Analog Scale from EuroQol , 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 , confidence in treatment success , and any from a list of comorbid conditions (arthritis, asthma or allergies, gastrointestinal problems, gynecological problems, hypertension, or other chronic condition) . "
ABSTRACT: There have been no full-scale trials of the optimal number of visits for the care of any condition with spinal manipulation. To identify the dose-response relationship between visits to a chiropractor for spinal manipulation and chronic low back pain (cLBP) outcomes and to determine the efficacy of manipulation by comparison with a light massage control. Practice-based randomized controlled trial. Four hundred participants with cLBP. The primary cLBP outcomes were the 100-point modified Von Korff pain intensity and functional disability scales evaluated at the 12- and 24-week primary end points. Secondary outcomes included days with pain and functional disability, pain unpleasantness, global perceived improvement, medication use, and general health status. One hundred participants with cLBP were randomized to each of four dose levels of care: 0, 6, 12, or 18 sessions of spinal manipulation from a chiropractor. Participants were treated three times per week for 6 weeks. At sessions when manipulation was not assigned, they received a focused light massage control. Covariate-adjusted linear dose effects and comparisons with the no-manipulation control group were evaluated at 6, 12, 18, 24, 39, and 52 weeks. For the primary outcomes, mean pain and disability improvement in the manipulation groups were 20 points by 12 weeks and sustainable to 52 weeks. Linear dose-response effects were small, reaching about two points per six manipulation sessions at 12 and 52 weeks for both variables (p<.025). At 12 weeks, the greatest differences from the no-manipulation control were found for 12 sessions (8.6 pain and 7.6 disability points, p<.025); at 24 weeks, differences were negligible; and at 52 weeks, the greatest group differences were seen for 18 visits (5.9 pain and 8.8 disability points, p<.025). The number of spinal manipulation visits had modest effects on cLBP outcomes above those of 18 hands-on visits to a chiropractor. Overall, 12 visits yielded the most favorable results but was not well distinguished from other dose levels.The spine journal: official journal of the North American Spine Society 10/2013; 14(7). DOI:10.1016/j.spinee.2013.07.468 · 2.80 Impact Factor
[Show abstract] [Hide abstract]
- "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   , 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   . 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. "
ABSTRACT: Borderline Personality Disorder (BPD) is a severe psychiatric disorder and is associated with significant impairment in quality of life. The aim of the present study is to assess the internal and external responsiveness of the EuroQoL-5D (EQ-5D) in BPD patients. Data from 49 patients included in a multi-center Dutch randomized trial were used. We used both the EQ-5D utility score and the Visual Analogue Scale of the EuroQoL, and the Borderline Personality Disorder Severity Index-IV (BPDSI-IV). To determine internal responsiveness, we calculated the standardized response mean (SRM). To determine external responsiveness, we calculated Spearman correlations for the change scores, and compared EQ-5D scores for clinically improved vs. non-clinically improved patients as measured with the BPDSI-IV. Patient scores improved on all instruments during the three years. SRMs for BPDSI-IV were significantly higher than EQ-5D utility. Three-year Spearman correlation between change scores of BPDSI-IV and EQ-5D utility was 0.487, between BPDSI-IV and EQ-VAS it was 0.404, both statistically significant. EQ-5D utility scores for patients who clinically improved were significantly higher than for patients who did not. We conclude that the EQ-5D is fairly responsive in BPD, and, therefore, especially because of its brevity and user-friendliness, can serve as a useful tool in economic evaluations in patients with BPD.European Psychiatry 03/2009; 24(2):79-85. DOI:10.1016/j.eurpsy.2008.11.001 · 3.44 Impact Factor