Quality of Life Research

, Volume 14, Issue 5, pp 1333–1344 | Cite as

Are indirect utility measures reliable and responsive in rheumatoid arthritis patients?

  • Carlo A. Marra
  • Amir A. Rashidi
  • Daphne Guh
  • Jacek A. Kopec
  • Michal Abrahamowicz
  • John M. Esdaile
  • John E. Brazier
  • Paul R. Fortin
  • Aslam H. Anis
Article

Abstract

Background: Preference-based, generic measures are increasingly being used to measure quality of life and as sources for quality weights in the estimation of Quality Adjusted Life Years (QALYs) in rheumatoid arthritis (RA). However, among the most commonly used instruments (the Health Utilities Index 2 and 3 [HUI2 and HUI3], the EuroQoL-5D [EQ-5D], and the Short Form-6D [SF-6D], there has been little comparative research. Therefore, we examined the reliability and responsiveness of these measures and the Rheumatoid Arthritis Quality of Life (RAQoL) and the Health Assessment Questionnaire (HAQ) in a sample of RA patients. Major findings: Test–retest reliability was acceptable for all of the instruments with the exception of the EQ-5D. Using two external criteria to define change (a patient transition question and categories of the patient global assessment of disease activity VAS), the RAQoL was the most responsive of the instruments. For the indirect utility instruments, the HUI3 and the SF-6D were the most responsive for measuring positive change. On average, for patients whose RA improved, the absolute change was highest for the HUI3. Conclusions: The HUI3 and the SF-6D appear to be the most responsive of the preference-based instruments in RA. However, differences in the magnitude of the absolute change scores have important implications for cost-effectiveness analyses.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines for the Management of Rheumatoid Arthritis: 2002 Update. Arthritis Rheum 2002; 46: 326–348.Google Scholar
  2. 2.
    Lipsky, PE, Heijde, DM, St Clair, EW.,  et al. 2000Infliximab and methotrexate in the treatment of rheumatoid arthritis Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study GroupN Eng J Med34315941602CrossRefGoogle Scholar
  3. 3.
    Blumenauer, B, Cranney, A, Clinch, J, Tugwell, P. 2003Quality of life in patients with rheumatoid arthritis: Which drugs might make a difference?Pharmacoeconomics21927940CrossRefPubMedGoogle Scholar
  4. 4.
    Scott, DL. 1999Leflunomide improves quality of life in rheumatoid arthritisScand J Rheumatol Suppl1122329CrossRefPubMedGoogle Scholar
  5. 5.
    Zhao, SZ, Fiechtner, JI, Tindall, EA.,  et al. 2000Evaluation of health-related quality of life of rheumatoid arthritis patients treated with celecoxibArthritis Care Res13112121CrossRefPubMedGoogle Scholar
  6. 6.
    Hammond, A, Young, A, Kidao, R. 2004A randomised controlled trial of occupational therapy for people with early rheumatoid arthritisAnn Rheum Dis632330CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Eberhardt, K, Duckberg, S, Larsson, BM, Johnson, PM, Nived, K. 2002Measuring health related quality of life in patients with rheumatoid arthritis – reliability, validity, and responsiveness of a Swedish version of RAQoLScand J Rheumatol31612CrossRefPubMedGoogle Scholar
  8. 8.
    Drummond, MFO’Brien, BStoddart, GLTorrance, GW. eds. 1997Methods for the Economic Evaluation of Health Care Programmes2Oxford Medical PublicationsOxfordGoogle Scholar
  9. 9.
    Hurst, NP, Kind, P, Ruta, D, Hunter, M, Stubbings, A. 1997Measuring health-related quality of life in rheumatoid arthritis: Validity, responsiveness and reliability of EuroQol (EQ-5D)Br J Rheumatol36551559CrossRefPubMedGoogle Scholar
  10. 10.
    Walters, SJ, Brazier, JE. 2003What is the relationship between the minimally important difference and health state utility values? The case of the SF-6DHealth Qual Life Outcomes11412CrossRefGoogle Scholar
  11. 11.
    Conner-Spady, B, Surez-Almazor, ME. 2003Variation in the estimation of quality-adjusted life-years by different preference-based instrumentsMed Care41791801CrossRefPubMedGoogle Scholar
  12. 12.
    Blanchard, C, Feeny, D, Mahon, JL.,  et al. 2003Is the Health Utilities Index responsive in total hip arthroplasty patients?J Clin Epidemiol5610461054CrossRefPubMedGoogle Scholar
  13. 13.
    Terwee, CB, Dekker, FW, Wiersinga, , Prummel, MF, Bossuyt, PMM. 2003On assessing the responsiveness of health-related quality of life instruments: Guidelines for instrument evaluationQual Life Res12349362CrossRefPubMedGoogle Scholar
  14. 14.
    Liang, MH, Lew, RA, Stucki, G, Fortin, PR, Daltroy, L. 2002Measuring clinically important changes with patient-oriented questionnairesMed Care40II-45II-51Google Scholar
  15. 15.
    Arnett, FC, Edworthy, SM, Bloch, DA.,  et al. 1988The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritisArthritis Rheum31315324CrossRefPubMedGoogle Scholar
  16. 16.
    Wong, AL, Wong, WK, Harker, J.,  et al. 1999Patient self-report tender and swollen joint counts in early rheumatoid arthritis Western Consortium of Practicing RheumatologistsJ Rheumatol2625512561PubMedGoogle Scholar
  17. 17.
    Fortin, PR, Abrahomowicz, , Clarke, AE.,  et al. 2000Do lupus disease activity measures detect clinically important changes?J Rheumatol2714211428PubMedGoogle Scholar
  18. 18.
    Redelmeier, DA, Lorig, K. 1993Assessing the clinical importance of symptomatic improvements – an illustration in rheumatologyArch Intern Med15313371342CrossRefPubMedGoogle Scholar
  19. 19.
    Wells, GA, Tugwell, P, Kraag, GR, Baker, PR, Groh, J, Redelmeier, DA. 1993Minimum important difference between patients with rheumatoid arthritis: The patient’s perspectiveJ Rheumatol20557560PubMedGoogle Scholar
  20. 20.
    Marra CA, Woolcott JC, Shojania K, et al. (1999). An assessment of the construct validity of four indirect utility measures in rheumatoid arthritis. Social Science and Medicine (in press).Google Scholar
  21. 21.
    Kopec, JA, Willison, KD. 2003A comparative review of four preference-weighted measures of health-related quality of lifeJ Clin Epidemiol56317325CrossRefPubMedGoogle Scholar
  22. 22.
    Grootendorst, P, Feeny, D, Furlong, W. 2000Health Utilities Index Mark 3: Evidence of construct validity for stroke and arthritis in a population health surveyMed Care38290299CrossRefPubMedGoogle Scholar
  23. 23.
    Samsa, G, Edelman, D, Rothman, M, Williams, GR, Lipscomb, J, Matchar, D. 1999Determining clinically important differences in health status measures A general approach with illustrations to the Health Utilities Index Mark IIPharmacoeconomics15141155CrossRefPubMedGoogle Scholar
  24. 24.
    Horsman J, Furlong W, Feeny D, Torrance G. The Health Utilities Index (HUI®): Concepts, measurement properties and applications. Health and Quality of Life Outcomes 2003; 1: 54 (http://hqlo.com/content/1/1/54).Google Scholar
  25. 25.
    Norman, GR, Wridhar, FG, Guyatt, GH, Walter, SD. 2001Relation of distribution- and anchor-based approaches in interpretation of changes in health-related quality of lifeMed Care3910391047CrossRefPubMedGoogle Scholar
  26. 26.
    Norman, GR, Sloan, JA, Wyrwich, KW. 2003Interpretation of changes in health-related quality of life The remarkable universality of half a standard deviationMed Care41582592PubMedGoogle Scholar
  27. 27.
    Cohen, J. 1992A power primerPsychol Bull112155159CrossRefPubMedGoogle Scholar
  28. 28.
    Deyo, RA, Diehr, P, Patrick, DL. 1991Reproducibility and responsiveness of health status measuresStatistics and strategies for evaluation. Control Clin Trials12142S158SCrossRefPubMedGoogle Scholar
  29. 29.
    Cohen, J. 1988Statistical Power Analysis for the Behavioural Sciences2Lawrence Erlbaum AssocHillsdale, (NJ)Google Scholar
  30. 30.
    Wiebe, S, Guyatt, G, Weaver, B, Matijevic, S, Sidwell, C. 2003Comparative responsiveness of generic and specific quality-of-life instrumentsJ Clin Epidemiol565260CrossRefPubMedGoogle Scholar
  31. 31.
    Chang, E, Abrahamowicz, M, Ferland, D, Fortin, PR. 2002CaNIOS Investigators Comparison of the responsiveness of lupus disease activity measures to changes in systemic lupus erythematosus activity relevant to patients and physiciansJ Clin Epidemiol55488497CrossRefPubMedGoogle Scholar
  32. 32.
    Abrahamowicz, M, Ramsay, JO. 1992Multicategorical spline model for item response theoryPsychometrika57527CrossRefGoogle Scholar

Copyright information

© Springer 2005

Authors and Affiliations

  • Carlo A. Marra
    • 1
    • 2
  • Amir A. Rashidi
    • 3
  • Daphne Guh
    • 3
  • Jacek A. Kopec
    • 4
    • 5
  • Michal Abrahamowicz
    • 6
  • John M. Esdaile
    • 5
    • 7
  • John E. Brazier
    • 8
  • Paul R. Fortin
    • 9
  • Aslam H. Anis
    • 4
  1. 1.Faculty of Pharmaceutical SciencesUniversity of British ColumbiaCanada
  2. 2.Centre for Clinical Epidemiology and EvaluationVancouver Coastal Health Research InstituteVancouverCanada
  3. 3.Centre for Health Evaluation and Outcome SciencesSt. Paul’s HospitalVancouverCanada
  4. 4.Department of Health Care and Epidemiology, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  5. 5.Arthritis Research Centre of CanadaVancouverCanada
  6. 6.Department of Epidemiology and BiostatisticsMcGill UniversityMontrealCanada
  7. 7.Division of Rheumatology, Faculty of MedicineUniversity of British ColumbiaUK
  8. 8.Sheffield Health Economics Group, School of Health & Related ResearchUniversity of SheffieldSheffieldUK
  9. 9.Division of Rheumatology, Toronto Western HospitalUniversity of TorontoTorontoCanada

Personalised recommendations