Comparison of the Health Utilities Index Mark 3 (HUI3) and the EuroQol EQ-5D in patients treated for intermittent claudication Authors
Cite this article as: Bosch, J.L. & Hunink, M.G.M. Qual Life Res (2000) 9: 591. doi:10.1023/A:1008929129537 Abstract
The Health Utilities Index Mark 3 (HUI3) and the EuroQol EQ-5D (EQ-5D) were compared to each other and to other quality-of-life (QoL) measures in patients treated for intermittent claudication. A total of 88 patients with intermittent claudication completed the HUI3, EQ-5D, RAND 36-Item Health Survey 1.0, time tradeoff, standard gamble, and rating scale before revascularization and at follow-up at 1 month, 3 months, and 1 year. The effect of treatment on the HUI3 and EQ-5D dimensions and the overall scores, calculated using published formulas based on societal preferences, were compared. After 1 month of treatment, the majority of patients showed improvement on the HUI3 dimensions ambulation and pain and on the EQ-5D dimensions mobility, usual activities, and pain/discomfort. The mean HUI3 score was significantly higher than the mean EQ-5D score (0.66 and 0.57, respectively,
p < 0.01) before treatment. After treatment, however, they were not significantly different from each other (e.g., 12 months after treatment: 0.77 and 0.75, respectively ( p > 0.05). After 1 month, the scores did not change significantly over time ( p > 0.05). The intraclass correlation coefficient between changes over time in the HUI3 and EQ-5D scores was 0.30, with other health-related quality-of-life (HRQoL) measures the correlations for HUI3 and EQ-5D were very similar. In conclusion, both the HUI3 and EQ-5D demonstrated an effect of treatment in patients with intermittent claudication; in addition, they showed similar relationships with other (HRQoL) measures. To demonstrate the effect of revascularization in patients with intermittent claudication, however, clinicians and researchers should be aware of the differences in the mean HUI3 and EQ-5D scores. EuroQol EQ-5D (EQ-5D) Health-related quality-of-life Health Utilities Index (HUI) Intermittent claudication Randomized controlled trial Rating scale SF-36 Standard gamble Time tradeoff
This revised version was published online in June 2006 with corrections to the Cover Date.
Gold MR, Siegel JE, Russel LB, Weinstein MC. Cost-Effectiveness in Health and Medicine. New York: Oxford University Press, 1996.
Feeny D, Furlong W, Boyle M, Torrance GW. Multi-attribute health status classication systems: Health Utilities Index. PharmacoEconomics 1995; 7: 490–502.
Torrance GW, Furlong W, Feeny D, Boyle M. Multi-attribute preference functions: Health Utilities Index. PharmacoEconomics 1995; 7: 503–520.
Brooks R, with the EuroQol group. EuroQol: The current state of play. Health Policy 1996; 37: 53–72.
Dolan P. Modeling valuations for EuroQol health states. Med Care 1997; 35: 1095–1108.
Gold M, Franks P, Erickson P. Assessing the health of the nation. The predictive validity of a preference-based measure and self-rated health. Med Care 1996; 34: 163–177.
Whitton AC, Rhydderch H, Furlong W, Feeny D, Barr RD. Self-reported comprehensive health status of adult brain tumor patients using the Health Utilities Index. Cancer 1997; 80: 258–265.
Neumann PJ, Kuntz KM, Leon J, et al. Health utilities in Alzheimer's disease. A cross-sectional study of patients and caregivers. Med Care 1999; 37: 27–32.
Glick HA, Polsky D, Willke RJ, Schulman KA. A comparison of preference assessment instruments used in a clinical trial: Responses to the visual analog scale from the EuroQol EQ-5D and the Health Utilities Index. Med Decis Making 1999; 19: 26–275.
Brazier J, Jones N, Kind P. Testing the validity of the EuroQol and comparing it with the SF36 health survey questionnaire. Qual Life Res 1993; 2: 169–180.
Hurst NP, Jobanputra P, Hunter M, Lambert M, Loch-head A, Brown H. Validity of EuroQol – a generic health status instrument – in patients with rheumatoid arthritis. Br J Rheumatol 1994; 33: 655–662.
Johnson JA, Coons SJ. Comparison of the EQ-5D and SF-12 in an adult US sample. Qual Life Res 1998; 7: 155–166.
Johnson JA, Pickard AS. Comparison of the EQ-5D and SF-12 health surveys in a general population survey in Alberta, Canada. Med Care 2000; 38: 115–121.
Myers C, Wilks D. Comparison of EuroQol EQ-5D and SF-36 in patients with chronic fatigue syndrome. Qual Life Res 1999; 8: 9–16.
Kind P, Dolan P, Williams A. Variations in population health status: Results from a United Kingdom national questionnaire survey. Br Med J 1998; 316: 736–741.
Read JL, Quinn RJ, Berwick DM, Fineberg HV, Weinstein MC. Preferences for health outcomes: Comparisons of assessment methods. Med Decis Making 984; 4: 315–329.
Revicki DA, Kaplan RM. Relationship between psycho-metric and utility-based approaches to the measurement of health-related quality of life. Qual Life Res 1993; 2: 477–487.
Bosch JL, Hunink MGM. The relationship between descriptive and valuational quality-of-life measures in patients with intermittent claudication.Med Decis Making 1996; 16: 217–225.
Jenkinson C, Gray A, Doll H, Lawrence K, Keoghane S, Layte R. Evaluation of index and profile measures of health status in a randomized controlled trial. Comparison of the Medical Outcomes Study 36-Item Short From Health Survey, EuroQol, and disease specific measures. Med Care 1997; 35: 1109–1118.
Tetteroo E, van der Graaf Y, Bosch JL, van Engelen AD, Hunink MGM, Eikelboom BC, Mali WPThM, for the 600 Dutch Iliac Stent Trial Study Group. Randomised comparison of primary stent placement versus primary angi-oplasty followed by selective stent placement in patients with iliac artery occlusive disease. Lancet 1998; 351: 1153–1159.
Bosch JL, Van der Graaf Y, Hunink MGM, for the Dutch Iliac Stent Trial Study Group. Health-related quality of life after angioplasty and stent placement in patients with iliac artery occlusive disease: Results of a randomized controlled clinical trial. Circulation 1999; 99: 3155–3160.
Furlong WJ, Torrance GW, Feeny DH. Algorithm for determining Mark II and Mark III health status classification levels, health states and health state utility scores from 1992-10-20 self-administered health status questionnaire. McMaster University, Center for Health Economics and Policy Analysis, March 1995.
Furlong W, Feeny D, Torrance GW, Goldsmith CH, De Pauw S, Zhu Z, Denton M, Boyle M. Multiplicative multi-attribute utility function for the Health Utilities Index Mark 3 (HUI3) system: A technical report. McMaster University, Center for Health Economics and Policy Analysis, Working Paper 98–11, December 1998.
Tetteroo E, Haaring C, van der Graaf Y, van Schaik JPJ, van Engelen AD, Mali WPThM. Intraarterial pressure gradients after randomized angioplasty or stenting of iliac artery lesions. Cardiovasc Intervent Radiol 1996; 19: 411–417.
Drummond MF, Stoddard GL, Torrance GW. Methods for the Economic Evaluation of Health Care Programmes. Oxford, UK: Oxford University Press, 1987.
Hays RD, Sherbourne CD, Mazel RM. The RAND 36-item health survey 1.0. Health Economics 1993; 2: 217–227.
VanderZee KI, Sanderman R, Heyink JW, De Haes H. Psychometric qualities of the RAND 36-Item Health Survey 1.0: A multidimensional measure of general health status. Int J Behav Med 1996; 3(2): 104–122.
VanderZee KI, Sanderman R. Het meten van de algemene gezondheidstoestand met de RAND-36, een handleiding. Northern Center for Healthcare Research.
Van Wijck EEE, Bosch JL, Hunink MGM. Time trade-o€ values and standard-gamble utilities assessed during telephone interviews versus face-to-face interviews. Med Decis Making 1998; 18: 400–405.
Boyd NF, Sutherland HJ, Haesman KZ, Tritchler DL, Cummings BJ. Whose utilities for decision analysis? Med Decis Making 1990; 10: 58–67.
Rosner B. Fundamentals of Biostatistics. (4th edn) Boston: Duxbury Press, 1995.
Currie IC, Wilson YG, Baird RN, Lamont PM. Treatment of intermittent claudication: The impact on quality of life. Eur J Vasc Endovasc Surg 1995; 10: 356–361.
Cook TA, O'Regan M, Galland RB. Quality of life following percutaneous transluminal angioplasty for claudication. Eur J Vasc Endovasc Surg 1996; 11: 191–194.
Whyman MR, Fowkes FGR, Kerracher EMG, Gillespie IN, Lee AJ, Housley E, Ruckley CV. Randomised controlled trial of percutaneous transluminal angioplasty for intermittent claudication. Eur J Vasc Endovasc Surg 1996; 12: 167–172.
Von Neumann J, Morgenstern O. Theory of Games and Economic Behaviour. (1–3 edns) Princeton, NJ: Princeton University Press
© Kluwer Academic Publishers 2000