Skip to main content

Advertisement

SpringerLink
Log in

How consistent are health utility values?

  • Published:
Quality of Life Research Aims and scope Submit manuscript

An Erratum to this article was published on 17 September 2008

Abstract

The use of preference-based generic instruments to measure the health-related quality of life of a general population or of individuals suffering from a specific disease has been increasing. However, there are several discrepancies between instruments in terms of utility results. This study compares SF-6D and EQ-5D when administered to patients with cataracts and aims at explaining the differences. Agreement between EQ-5D and SF-6D health state classifications was assessed by correlation coefficients. Simple correspondence analysis was used to assess the agreement among the instrument’s descriptive systems and to investigate similarities between dimensions’ levels. Cluster analysis was used to classify SF-6D and EQ-5D levels into homogeneous groups. There was evidence of floor effects in SF-6D and ceiling effects in EQ-5D. Comparisons of means showed that SF-6D values exceeded EQ-5D values. Agreement between both instruments was high, especially between similar dimensions. However, different valuation methods and scoring algorithms contributed to the main differences found. We suggest that one or both instruments should be revised, in terms of their descriptive systems or their scoring algorithms, in order to overcome the weakness found.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brooks, R. (1996). EuroQol: The current state of play. Health Policy (Amsterdam), 37, 53–72. doi:10.1016/0168-8510(96)00822-6.

    CAS  Google Scholar 

  2. Dolan, P. (1997). Modelling valuations for EuroQol health states. Medical Care, 35, 1095–1108. doi:10.1097/00005650-199711000-00002.

    Article  PubMed  CAS  Google Scholar 

  3. Kind, P., Hardman, G., & Macran, S. (1999). UK Population Norms for EQ-5D. Discussion Paper 172. University of York: Centre for Health Economics.

  4. Torrance, G., Furlong, W., Feeny, D., & Boyle, M. (1995). Multi-attribute preference functions: Health utilities index. PharmacoEconomics, 7, 503–520. doi:10.2165/00019053-199507060-00005.

    Article  PubMed  CAS  Google Scholar 

  5. Torrance, G., Feeny, D., Furlong, W., Barr, R., Zhang, Y., & Wang, Q. (1996). Multi-attribute utility function for a comprehensive health status classification system: Health utilities index mark 2. Medical Care, 34(7), 702–722. doi:10.1097/00005650-199607000-00004.

    Article  PubMed  CAS  Google Scholar 

  6. McCabe, C., Stevens, K., Roberts, J., & Brazier, J. (2005). Health state values for the HUI2 descriptive system: Results from a UK survey. Health Economics, 14, 231–244. doi:10.1002/hec.925.

    Article  PubMed  Google Scholar 

  7. Brazier, J., Usherwood, T., Harper, R., & Thomas, K. (1998). Deriving a preference-based single index from the UK SF-36 health survey. Journal of Clinical Epidemiology, 51(11), 1115–1128. doi:10.1016/S0895-4356(98)00103-6.

    Article  PubMed  CAS  Google Scholar 

  8. Brazier, J., Roberts, J., & Deverill, M. (2002). The estimation of a preference-based measure of health from the SF-36. Journal of Health Economics, 21, 271–292. doi:10.1016/S0167-6296(01)00130-8.

    Article  PubMed  Google Scholar 

  9. Kaplan, R. M., Bush, J. W., & Berry, C. C. (1976). Health status: Types of validity and the index of well-being. Health Services Research, 11(4), 478–507.

    PubMed  CAS  Google Scholar 

  10. Kaplan, R. M., Ganiats, T. G., Sieber, W. J., & Anderson, J. P. (1998). The quality of well-being scale: Critical similarities and differences with SF-36. International Journal for Quality in Health Care, 10, 509–520. doi:10.1093/intqhc/10.6.509.

    Article  PubMed  CAS  Google Scholar 

  11. Anderson, J. P., Kaplan, R. M., Berry, C. C., Bush, J. W., & Rumbaut, R. G. (1989). Interday reliability of function assessment for a health status measure: The quality of well-being scale. Medical Care, 27, 1076–1083. doi:10.1097/00005650-198911000-00008.

    Article  PubMed  CAS  Google Scholar 

  12. Osborne, R., Hawthorne, G., Lew, E., & Gray, L. (2003). Quality of life assessment in the community-dwelling elderly: Validation of the assessment of quality of life (AQoL) instrument and comparison with the SF-36. Journal of Clinical Epidemiology, 56(2), 138–147. doi:10.1016/S0895-4356(02)00601-7.

    Article  PubMed  Google Scholar 

  13. Hawthorne, G., & Osborne, R. (2005). Population norms and meaningful differences for the assessment of quality of life (AQoL) measure. Australian and New Zealand Journal of Public Health, 29(2), 136–142. doi:10.1111/j.1467-842X.2005.tb00063.x.

    Article  PubMed  Google Scholar 

  14. Brazier, J., Roberts, J., Tsuchiya, A., & Busschbach, J. (2004). A comparison of the EQ-5D and SF-6D across seven patient groups. Health Economics, 13, 873–884. doi:10.1002/hec.866.

    Article  PubMed  Google Scholar 

  15. Petrou, S., & Hockley, C. (2005). An investigation into the empirical validity of the EQ-5D and SF-6D based on hypothetical preferences in a general population. Health Economics, 14(11), 1169–1189. doi:10.1002/hec.1006.

    Article  PubMed  Google Scholar 

  16. Stavem, K., Frøland, S. S., & Hellum, K. B. (2005). Comparison of preference-based utilities of the 15D, EQ-5D and SF-6D in patients with HIV/AIDS. Quality of Life Research, 14, 971–980. doi:10.1007/s11136-004-3211-7.

    Article  PubMed  Google Scholar 

  17. Lamers, L., Bouwmans, C., van Straten, A., Donker, M., & Hakkaart, L. (2006). Comparison of EQ-5D and SF-6D utilities in mental health patients. Health Economics, 15(11), 1229–1236. doi:10.1002/hec.1125.

    Article  PubMed  CAS  Google Scholar 

  18. Marra, C., Woolcott, J., Kopec, J., Shojania, K., Offer, R., Brazier, J., et al. (2005). A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and The HAQ) in rheumatoid arthritis. Social Science & Medicine, 60, 1571–1582. doi:10.1016/j.socscimed.2004.08.034.

    Article  Google Scholar 

  19. Feeny, D., Wu, L., & Eng, K. (2004). Comparing short form 6D, standard gamble and health utilities index mark 2 and mark 3 utility scores: Results of total hip arthroplasty patients. Quality of Life Research, 13(10), 1659–1670. doi:10.1007/s11136-004-6189-2.

    Article  PubMed  Google Scholar 

  20. Tsuchiya, A., Brazier, J., & Roberts, J. (2006). Comparison of valuation methods used to generate the EQ-5D and the SF-6D value sets. Journal of Health Economics, 25(2), 334–346. doi:10.1016/j.jhealeco.2005.09.003.

    Article  PubMed  Google Scholar 

  21. Marra, C., Esdaile, J., Guh, D., Kopec, J., Brazier, J., & Koehler, B. (2004). Chalmers, A., Anis, A. A comparison of four indirect methods of assessing utility values in rheumatoid arthritis. Medical Care, 42(11), 1125–1131. doi:10.1097/00005650-200411000-00012.

    Article  PubMed  Google Scholar 

  22. Pickard, A., Simon, J., Jeffrey, A., & Feeny, D. H. (2005). Responsiveness of generic health-related quality of life in stroke. Quality of Life Research, 14, 207–219. doi:10.1007/s11136-004-3928-3.

    Article  PubMed  Google Scholar 

  23. Longworth, L., & Bryan, S. (2003). An empirical comparison of EQ-5D and SF-6D in liver transplant patients. Health Economics, 12(12), 1061–1067. doi:10.1002/hec.787.

    Article  PubMed  Google Scholar 

  24. Hawthorne, G., Richardson, J., & Atherton Day, N. (2001). A comparison of the assessment of quality of life (AQoL) with four other generic utility instruments. Annals of Medicine, 33, 358–370. doi:10.3109/07853890109002090.

    Article  PubMed  CAS  Google Scholar 

  25. Kopec, J., & Willison, K. (2003). A comparative review of four preference-weighted measures of health-related quality of life. Journal of Clinical Epidemiology, 56(4), 317–325. doi:10.1016/S0895-4356(02)00609-1.

    Article  PubMed  Google Scholar 

  26. Everitt, B. S., & Dunn, G. (2001). Applied Multivariate Data Analysis. London: Arnold.

    Google Scholar 

  27. Bryan, S., & Longworth, L. (2005). Measuring health-related utility: Why the disparity between EQ-5D and SF-6D? The European Journal of Health Economics, 50, 253–260. doi:10.1007/s10198-005-0299-9.

    Article  Google Scholar 

  28. Holland, R., Smith, R., Harvey, I., Swift, L., & Lenaghan, E. (2004). Assessing quality of life in the elderly: A direct comparison of the EQ-5D and AQoL. Health Economics, 13(8), 793–805. doi:10.1002/hec.858.

    Article  PubMed  Google Scholar 

  29. O’Brien, B., Spath, M., Blackhouse, G., Severens, J., Dorian, P., & Brazier, J. (2003). A view from the bridge: Agreement between the SF-6d utility algorithm and the health utilities index. Health Economics, 12(11), 975–981. doi:10.1002/hec.789.

    Article  PubMed  Google Scholar 

  30. Gerard, K., Nicholson, T., Mulle, M., Mehta, R., & Roderick, P. (2004). EQ-5D versus SF-6D in an older, chronically Ill patient group. Applied Health Economics and Health Policy, 3(2), 91–102. doi:10.2165/00148365-200403020-00005.

    Article  PubMed  Google Scholar 

  31. Franks, P., Lubetkin, E., Gold, M., Tancredi, D., & Jia, H. (2004). Mapping the SF-12 to the EuroQol EQ-5D index in a national US sample. Medical Decision Making, 24(3), 247–254. doi:10.1177/0272989X04265477.

    Article  PubMed  Google Scholar 

  32. Gray, A., Rivero-Arias, O., & Clarke, P. (2006). Estimating the association between SF-12 responses and EQ-5D utility values by response mapping. Medical Decision Making, 26(18), 18–29. doi:10.1177/0272989X05284108.

    Article  PubMed  Google Scholar 

  33. Tsuchiya, A., Brazier, J., McColl, E., & Parkin, D. (2002). Deriving preference-based single indices from non-preference based condition-specific instruments: Converting AQLQ into EQ5D indices. Discussion Paper 02/1. The University of Sheffield: Sheffield Health Economics Group.

Download references

Acknowledgements

The authors wish to thank Dr. Jorge Correia and his medical and nursing team, who collected the data. The authors are grateful to Professor John Brazier for providing the SF-6D algorithm. We also thank two anonymous referees for their constructive comments and suggestions, which have considerably improved the paper. Earlier versions of this paper have been presented at the 6th European Conference on Health Economics 2006, Budapest, Hungary and at the 13th Annual Conference of the International Society for Quality of Life Research 2006, Lisbon, Portugal. Lara Ferreira and Luís Pereira are the beneficiaries of fellowships (SFRH/BD/25697/2005 and SFRH/BD/36764/2007, respectively) from the Foundation for Science and Technology, Portugal.

Author information

Authors and Affiliations

  1. Faculty of Economics, University of Coimbra, Coimbra, Portugal

    Pedro L. Ferreira

  2. Centre for Health Studies & Research, University of Coimbra, Coimbra, Portugal

    Pedro L. Ferreira, Lara N. Ferreira & Luis N. Pereira

  3. School of Management, Hospitality and Tourism, University of the Algarve, Faro, Portugal

    Lara N. Ferreira

Authors
  1. Pedro L. Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lara N. Ferreira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Luis N. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Pedro L. Ferreira.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s11136-008-9393-7

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ferreira, P.L., Ferreira, L.N. & Pereira, L.N. How consistent are health utility values?. Qual Life Res 17, 1031–1042 (2008). https://doi.org/10.1007/s11136-008-9368-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-008-9368-8

Keywords

Search

Navigation