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.
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ABSTRACT: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%-15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease.Infection and Drug Resistance 01/2015; 8:119-28. DOI:10.2147/IDR.S66739
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ABSTRACT: The reliability and construct validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) were examined in individuals with Huntington disease (HD). We examined factor structure (confirmatory factor analysis), internal consistency reliability (Cronbach's alpha), floor and ceiling effects, convergent validity (Pearson correlations), and known-groups validity (multivariate analysis). Results of a confirmatory factor analysis replicated the six-factor latent model that reflects the six separate scales within the WHODAS 2.0 (understanding and communicating; getting around; self-care; getting along with others; life activities; participation). Cronbach's alpha for the scale was 0.94, suggesting good internal consistency reliability. The WHODAS demonstrated a ceiling effect for 19.5 % of participants; there were no floor effects. There was evidence for convergent validity; the WHODAS demonstrated moderate significant correlations with other general measures of health-related quality of life (HRQOL; i.e., RAND-12, EQ5D). Multivariate analyses indicated that late-stage HD participants indicated poorer HRQOL than both early-stage HD and prodromal HD participants for all HRQOL measures. Findings provide support for both the reliability and validity of the WHODAS 2.0 in individuals with HD.Quality of Life Research 01/2015; DOI:10.1007/s11136-015-0930-x · 2.86 Impact Factor
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ABSTRACT: Objectives The objective of this study was to compare the performance of the 5-level EuroQol 5-dimension (EQ-5D-5L) and the Short Form 6-dimension (SF-6D) instruments in assessing patients with end-stage renal disease (ESRD) in Singapore. Methods In a cross-sectional study, ESRD patients attending a tertiary hospital were interviewed using a battery of questionnaires including the EQ-5D-5L, the kidney disease quality of life instrument (KDQOL-36), and questions assessing dialysis history and socio-demographic characteristics. We reviewed patients’ medical records for their clinical information. We assessed the construct validity of the EQ-5D-5L and SF-6D index scores and compared their ability to distinguish between patients differing in health status and the magnitude of between-group difference they quantified. Results One hundred and fifty ESRD patients on dialysis (mean age, 60.1 years; female, 48.7 %) participated in the study. Both EQ-5D-5L and SF-6D demonstrated satisfactory known-groups validity; the EQ-5D-5L was more sensitive to differences in clinical outcomes and the SF-6D was more sensitive to differences in health outcomes measured by KDQOL scales. The intraclass correlation coefficient between the measures was 0.36. The differences in the EQ-5D-5L index score for patients in better and worse health status were greater than those measured by the SF-6D index score. Conclusions Both EQ-5D-5L and SF-6D are valid instruments for assessing ESRD patients. However, the two preference-based measures cannot be used interchangeably and it appears that EQ-5D-5L would lead to more favorable cost-effectiveness results than SF-6D if they are used in economic evaluations of interventions for ESRD.The European Journal of Health Economics 12/2014; DOI:10.1007/s10198-014-0664-7 · 2.10 Impact Factor