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


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.


Rheumatoid Arthritis Rheumatoid Arthritis Patient Quality Adjust Life Absolute Change Health Assessment Questionnaire 
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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

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