Article

The Health Utilities Index (HUI): Concepts, measurement properties and applications

Health Utilities Inc, Dundas, ON, Canada.
Health and Quality of Life Outcomes (Impact Factor: 2.1). 02/2003; 1:54. DOI: 10.1186/1477-7525-1-54
Source: PubMed

ABSTRACT This is a review of the Health Utilities Index (HUI) multi-attribute health-status classification systems, and single- and multi-attribute utility scoring systems. HUI refers to both HUI Mark 2 (HUI2) and HUI Mark 3 (HUI3) instruments. The classification systems provide compact but comprehensive frameworks within which to describe health status. The multi-attribute utility functions provide all the information required to calculate single-summary scores of health-related quality of life (HRQL) for each health state defined by the classification systems. The use of HUI in clinical studies for a wide variety of conditions in a large number of countries is illustrated. HUI provides comprehensive, reliable, responsive and valid measures of health status and HRQL for subjects in clinical studies. Utility scores of overall HRQL for patients are also used in cost-utility and cost-effectiveness analyses. Population norm data are available from numerous large general population surveys. The widespread use of HUI facilitates the interpretation of results and permits comparisons of disease and treatment outcomes, and comparisons of long-term sequelae at the local, national and international levels.

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    • "The first, very useful to establish comparability between diseases and overall results of the country, and the latter for specific analysis and as a follow-up support to clinimetry in patients. The most commonly used general measurement systems include EQ-5D (Roset et al. 1999; Krabbe et al. 2004) recently EQ-5D5L (Herdman et al. 2011), the Health Utilities Index (HUI) (Horsman et al. 2003), the Quality of Well Being (QWB) (Pyne et al. 2003) and the SF-6D (Konerding et al. 2009) which was derived from SF-36 (Ware and Sherbourne 1992; McHorney et al. 1993; McHorney et al. 1994). "
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    ABSTRACT: The purpose of this review is to do a discussion about the use of the HRQoL as a health measure of the populations that enable to analyze its potential use as a measure of development and efficiency of health systems. The principal use of the HRQoL is in health technologies economics evaluation; however this measure can be use in public health when need to know the health state of population. The WHO recognizes its potential use but its necessary to do a discussion about your difficulties for its application and restrictions for its use as a performance indicator for the health systems. The review show the different aspects about the use of HRQoL how a measure of efficiency ot the health system, each aspect identified in the literature is analyzed and discussed, developing the pros and cons of their possible use, especially when it comes as a cardinal measure. The analysis allows recognize that measuring HRQoL in countries could serve as a useful indicator, especially when it seeks to measure the level of health and disease, as do most of the indicators of current use. However, the methodological constraints that do not allow comparability between countries especially when you have large socioeconomic differences have yet to be resolved to allow comparison between different regions.
    SpringerPlus 12/2013; 2:664. DOI:10.1186/2193-1801-2-664
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    • "Parent-proxy questionnaires were used at baseline and also at yearly postimplantation intervals to assess the health utility of cochlear implanted children in the CDaCI study. The measurement instrument in this study uses questions from both the Health Utility Index (Horsman et al. 2003) Mark II (HUI2) and the Health Utility Index Mark III (HUI3) surveys. These surveys provide measurements of general health status and health-related quality of life stratified by hearing, speech, vision, emotion, pain, ambulation, dexterity, cognition, and self-care domains of health. "
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    ABSTRACT: OBJECTIVES:: Cochlear implantation (CI) has become the mainstay of treatment for children with severe-to-profound sensorineural hearing loss (SNHL). Yet, despite mounting evidence of the clinical benefits of early implantation, little data are available on the long-term societal benefits and comparative effectiveness of this procedure across various ages of implantation-a choice parameter for parents and clinicians with high prognostic value for clinical outcome. As such, the aim of the present study is to evaluate a model of the consequences of the timing of this intervention from a societal economic perspective. Average cost utility of pediatric CI by age at intervention will be analyzed. DESIGN:: Prospective, longitudinal assessment of health utility and educational placement outcomes in 175 children recruited from six U.S. centers between November 2002 and December 2004, who had severe-to-profound SNHL onset within 1 year of age, underwent CI before 5 years of age, and had up to 6 years of postimplant follow-up that ended in November 2008 to December 2011. Costs of care were collected retrospectively and stratified by preoperative, operative, and postoperative expenditures. Incremental costs and benefits of implantation were compared among the three age groups and relative to a nonimplantation baseline. RESULTS:: Children implanted at <18 months of age gained an average of 10.7 quality-adjusted life years (QALYs) over their projected lifetime as compared with 9.0 and 8.4 QALYs for those implanted between 18 and 36 months and at >36 months of age, respectively. Medical and surgical complication rates were not significantly different among the three age groups. In addition, mean lifetime costs of implantation were similar among the three groups, at approximately $2000/child/year (77.5-year life expectancy), yielding costs of $14,996, $17,849, and $19,173 per QALY for the youngest, middle, and oldest implant age groups, respectively. Full mainstream classroom integration rate was significantly higher in the youngest group at 81% as compared with 57 and 63% for the middle and oldest groups, respectively (p < 0.05) after 6 years of follow-up. After incorporating lifetime educational cost savings, CI led to net societal savings of $31,252, $10,217, and $6,680 for the youngest, middle, and oldest groups at CI, respectively, over the child's projected lifetime. CONCLUSIONS:: Even without considering improvements in lifetime earnings, the overall cost-utility results indicate highly favorable ratios. Early (<18 months) intervention with CI was associated with greater and longer quality-of-life improvements, similar direct costs of implantation, and economically valuable improved classroom placement, without a greater incidence of medical and surgical complications when compared to CI at older ages.
    Ear and hearing 02/2013; 34(4). DOI:10.1097/AUD.0b013e3182772c66 · 2.83 Impact Factor
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    • "We were interested in examining associations between major depression, physical activity, and HRQoL from several different perspectives. A commonly employed interpretation of HUI3 data is a nominal one, with scores <0.70 being considered indicative of low HRQoL (Horsman et al., 2003). However, it is also of interest to examine uncategorized ratings, so we also treated the HUI3 ratings as a continuous variable in some analyses. "
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    ABSTRACT: Background: Major depressive episodes have a negative effect on health-related quality of life (HRQoL). The objective of this study was to determine whether recreational physical activity can ameliorate some of this negative impact. Methods: The data source for the study was the Canadian National Population Health Survey (NPHS). The NPHS is a longitudinal study that has collected data from a representative cohort of 15,254 community residents. Sixteen years of follow-up data are available. The NPHS included: an instrument to assess MDE (the Composite International Diagnostic Interview Short Form for Major Depression), an inventory of recreational activities (each associated with hours of participation and estimated metabolic expenditures), and a HRQoL instrument (the Health Utility Index, Mark 3, or HUI3). Proportional hazard and linear regression models were used in this study to determine whether MDE-related declines in HRQoL were lessened by participation in an active recreational lifestyle. Results: Consistent with expectation, major depression was associated with a significant decline in HRQoL over time. While no statistical interactions were observed, the risk of diminished HRQoL in association with MDE was reduced by physical activity. In a proportional hazards model, the hazard ratio for transition to poor HRQoL was 0.7 (95% CI: 0.6–0.8, p < 0.0001). In linear regression models, physical activity was significantly associated with more positive HRQoL (β = 0.019, 95% CI 0.004 to −0.034, p = 0.02). Conclusion: Recreational physical activity appears to ameliorate some of the decline in HRQoL seen in association with MDE. Physical activity may be an effective tertiary preventive strategy for this condition.
    Frontiers in Psychiatry 04/2013; 4:22. DOI:10.3389/fpsyt.2013.00022