Evaluation of the Health Utilities Index Mark-3 in Heart Failure
The University of Michigan School of Nursing, 400 N. Ingalls, Ann Arbor, MI 48109, USA. Journal of cardiac failure
(Impact Factor: 3.05).
02/2011; 17(2):143-50. DOI: 10.1016/j.cardfail.2010.08.014
The purpose of this study was to evaluate the reliability, validity, and responsiveness to change of the Health Utilities Index Mark-3 (HUI-3) in heart failure (HF) for use in cost-effectiveness studies.
Two hundred eleven patients with HF recruited from outpatient clinics were enrolled; 165 completed the 26-week study. Patients completed 4 health-related quality of life questionnaires (baseline and 4, 8, and 26 weeks), including the HUI-3, the Medical Outcomes Study Short-form 12 (SF-12), the Minnesota Living with Heart Failure Questionnaire (LHFQ), and the Chronic Heart Failure Questionnaire (CHQ). The HUI-3 indicated moderate or fair health-related quality of life overall; the attributes most impaired were pain, ambulation, cognition, and emotion. Internal consistency reliability (Cronbach's alpha = 0.51) was low and test-retest reliability (intraclass correlation coefficient = 0.68) was adequate. The HUI-3 total score was significantly associated with the SF-12, LHFQ, and CHQ total scores. It discriminated among patients with varying New York Heart Association class (P < .001) and varying perceived health (P < .001). The HUI-3 was less responsive to perceived change in health condition than the LHFQ or the CHQ.
The HUI-3 demonstrated satisfactory reliability and validity in this sample supporting its use in cost-effectiveness studies.
Available from: Mari Palta
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ABSTRACT: Preference-based measures of health-related quality of life all use the same dead = 0.00 to perfect health = 1.00 scale, but there are substantial differences among measures.
The objective was to examine agreement in classifying patients as better, stable, or worse.
The EQ-5D, Health Utilities Index Mark 2 and Mark 3, Quality of Well-Being-Self-Administered scale, Short-Form 36 (Short-Form 6D), and disease-targeted measures were administered prospectively in 2 clinical cohorts. The study was conducted at academic medical centers: University of California, Los Angeles; University of California, San Diego; University of Wisconsin-Madison; and University of Southern California. Patients undergoing cataract extraction surgery with lens replacement completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25). Patients newly referred to congestive heart failure specialty clinics completed the Minnesota Living with Heart Failure Questionnaire (MLHF). In both cohorts, subjects completed surveys at baseline and at 1 and 6 months. The NEI-VFQ-25 and MLHF were used as gold standards to assign patients to categories of change. Agreement was assessed using κ.
There were 376 cataract patients recruited. Complete data for baseline and the 1-month follow-up were available on all measures for 210 cases. Using criteria specified by Altman, agreement was poor for 6 of 9 pairs of comparisons and fair for 3 pairs. There were 160 heart failure patients recruited. Complete data for baseline and the 6-month follow-up were available for 86 cases. Agreement was negligible for 5 pairs and fair for 1. The study was conducted on selected patients at a few academic medical centers.
The results underscore the lack of interchangeability among different preference-based measures.
Available from: Lucy Busija
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ABSTRACT: Scores on the SF-36 and SF-12 scales range from 0–100, with higher scores indicating better health. On the physical functioning scale, low scores are typical of someone who experiences many limitations in physical activities, including bathing or dressing, while high scores represent someone who is able to perform these types of activities without limitations. Low scores on the role physical scale represent someone who experiences many limitations in work or other daily activities, and high scores characterize someone who has no difficulties with these activities. Low scores on the social functioning typify a person who experiences a great deal of difficulties in normal social activities due to physical and emotional health problems, and high scores represent someone who is able to perform normal social activities without interference due to physical or emotional health. Low scores on the bodily pain scale are typical of a person who has very severe and extremely limiting pain, and high scores represent individuals who have no pain or pain-related limitations. On the mental health scale, low scores represent high levels of nervousness and depression, while high scores characterize someone who feels peaceful, happy, and calm. Low scores on the role emotional scale represent someone who experiences many problems with work or other daily activities as a result of emotional ill health, and high scores represent those who have no problems with work or other daily activities as a result of emotional health. On the vitality scale, low scores are typical of someone who feels tired and worn out all of the time, while high scores characterize those who feel full of pep and energy. Low scores on the general health scale represent a person who believes their health to be poor and likely to get worse, and high scores represent someone who sees their health as excellent (1).
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ABSTRACT: To investigate the effects of unilateral multi-channel cochlear implant surgery on health-related quality of life and to determine if there is an age-related impact of cochlear implantation on these effects.
Tertiary health-care center.
The Short Form-36 survey (SF-36) was administered to determine the health-related quality of life of 283 age-stratified patients before and after cochlear implant surgery.
Precochlear to postcochlear implantation changes in health-related quality of life as determined by the SF-36 questionnaire.
There were significant increases in precochlear and postcochlear implantation scores for 5 of the 8 SF-36 survey domains: vitality, physical role functioning, mental health, emotional role functioning, and social functioning. Significant differences were found between age groups in the domains of social functioning, emotion role functioning, and mental health.
Cochlear implant surgery significantly improves health-related quality of life as categorically stratified by the SF-36 questionnaire. These improvements were most evident in the mental health, emotional and social functioning, and physical functioning at work questions of the survey. Cochlear implant recipients younger than 65 years perceive a greater improvement in their level of energy, mental health, and social function compared with those older than 65 years.
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